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Prior Year Instructions and Forms

Prior year instructions include mailing addresses that were in effect at the time the instructions were prepared. Since PBGC filing addresses may change from time to time, be sure to use the most current addresses (shown on our Web site or within the most current year's premium instructions).

The forms from 2001 to the present can be downloaded and filed with PBGC. Forms prior to 2001 are samples only. For the plan year beginning in 2002, you may file a photocopy of the premium form (with your original signature). The PBGC will continue to accept the original forms found within the premium filing instruction booklets that are mailed to you, and forms provided by a vendor that has received PBGC approval for an automated (computer-generated) version of the forms. The premium forms are on Optical Character Recognition (OCR) format, which enables PBGC to process plan information quickly and accurately.

If you need additional forms or booklets:

  • Call: (800) 736-2444 or (202) 326-4242; TTY/TDD users should call the federal relay service at at 1-800-877-8339 and ask to be connected to 1-800-736-2444. OR
  • Fax: (202) 326-4250 OR
  • E-mail PBGC at premiums@pbgc.gov OR
  • Write to:

  • Pension Benefit Guaranty Corporation

    Dept. 77840

    P.O. Box 77000

    Detroit, MI 48277-0840

2007 |2006 |2005 |2004 | 2003 | 2002 | 2001 | 2000 | 1999 | 1998 | 1997 |

 

2007 Estimated Premium Package 2007 Premium Payment Package

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2006 Estimated Premium Package 2006 Premium Payment Package

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2005 Estimated Premium Package 2005 Premium Payment Package

 

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2004 Estimated Premium Package 2004 Premium Payment Package

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2003 Estimated Premium Package 2003 Premium Payment Package

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2002 Estimated Premium Package 2002 Premium Payment Package

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2001 Estimated Premium Package 2001 Premium Payment Package

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2000 Estimated Premium Package 2000 Premium Payment Package

* Note for PBGC Form 1 Filers:

In March 2000, the Department of Labor (DoL) granted an automatic extension of the time to file Form 5500 to Oct. 16, 2000. Subsequently, DoL announced that where a filer could establish reasonable cause for a late filing, the Department would not take any action as a result of the late filing. An extension of the due date for filing the Form 5500 does not extend the filing due date for PBGC Form 1.

Although certain information required for the Form 1 is based on data reported on Schedule B to Form 5500, Schedule B need not have been filed before the premium forms are filed. The premium filing may be based on the data the enrolled actuary expects to include on the Schedule B that is later filed. Should that Schedule B contain different data, an amended premium filing would be required.

+ Note about Sample Forms:

The forms are marked "Sample - Do Not Use" and are provided for your convenience. They are not to be used for the actual filing of your premium payment. Only original forms that are in Optical Character Recognition (OCR) format will enable the PBGC to process your plan information quickly and accurately. We have found that even slight variations in the printing of this form can result in errors.

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1999 Estimated Premium Package 1999 Premium Payment Package

+ Note about Sample Forms:

The forms are marked "Sample - Do Not Use" and are provided for your convenience. They are not to be used for the actual filing of your premium payment. Only original forms that are in Optical Character Recognition (OCR) format will enable the PBGC to process your plan information quickly and accurately. We have found that even slight variations in the printing of this form can result in errors.

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1998 Estimated Premium Package 1998 Premium Payment Package

+ Note about Sample Forms:

The forms are marked "Sample - Do Not Use" and are provided for your convenience. They are not to be used for the actual filing of your premium payment. Only original forms that are in Optical Character Recognition (OCR) format will enable the PBGC to process your plan information quickly and accurately. We have found that even slight variations in the printing of this form can result in errors.

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1997 Estimated Premium Package 1997 Premium Payment Package

n/a

+ Note about Sample Forms:

The forms are marked "Sample - Do Not Use" and are provided for your convenience. They are not to be used for the actual filing of your premium payment. Only original forms that are in Optical Character Recognition (OCR) format will enable the PBGC to process your plan information quickly and accurately. We have found that even slight variations in the printing of this form can result in errors.

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