Employee Benefits Security Administration Forms and Office Locations – Government Agency in U.S.

The Employee Benefits Security Administration (EBSA) offers information and assistance on employer-sponsored retirement benefit and health benefit plans.

Forms & Documents Contact Info & Office Locations Questions & Answers

Forms & Documents

Browse all Employee Benefits Security Administration government forms

1 - 20 of 158 forms

Form Title	Topics
Administrative Subpoena to Appear & Testify at a Deposition
Administrative Subpoena to Appear & Testify at a Hearing
Administrative Subpoena to Produce Documents, Information or Objects, or to Permit Inspection of Premises
Agreement and Undertaking (Insurance Carrier)
Agreement and Undertaking (Self-Insured Employer)
Agreement to Mediate
Agricultural and Food Processing Clearance Order
Annual Return of a One-Participant Retirement Plan or a Foreign Plan
Annual Return/Report of Employee Benefit Plan
Annual Return/Report of Employee Benefit Plan-2016
Annual Return/Report of Employee Benefit Plan-2017
Annual Return/Report of Employee Benefit Plan-2018
Annual Return/Report of Employee Benefit Plan-2019
Annual Return/Report of Employee Benefit Plan-2020
Annual Return/Report of Small Employee Benefit Plan
Annual Return/Report of Small Employee Benefit Plan-2016
Annual Return/Report of Small Employee Benefit Plan-2018
Annual Return/Report of Small Employee Benefit Plan-2018
Annual Return/Report of Small Employee Benefit Plan-2020
Appeal Form

Contact Information & Office Locations

1 - 20 of 64 contact points

Alabama

Address:
Atlanta Regional Office
61 Forsyth St, SW
Ste 7B54
Atlanta, GA 30303

Phone numbers:

(404) 302-3900

Fax numbers:

(404) 302-3975

Alaska

Address:
Seattle District Office
300 Fifth Avenue
Ste 1110
Seattle, WA 98104

Phone numbers:

(206) 757-6781

Fax numbers:

(206) 757-6662

American Samoa

Address:
Los Angeles Regional Office
35 N. Lake Ave.
Ste 300
Pasadena, CA 91101

Phone numbers:

(626) 229-1000

Fax numbers:

(626) 229-1098

Arizona

Address:
Los Angeles Regional Office
35 N. Lake Ave.,
Ste 300
Pasadena, CA 91101

Phone numbers:

(626) 229-1000

Fax numbers:

(626) 229-1098

Arkansas

Address:
Dallas Regional Office
525 South Griffin St,
Rm 900
Dallas, TX 75202-5025

Phone numbers:

(972) 850-4500

Fax numbers:

(214) 767-1055

California (northern)

Address:
San Francisco Regional Office
90 7th St
Ste 11-300
San Francisco, CA 94103

Phone numbers:

(415) 625-2481

Fax numbers:

(415) 625-2450

California (southern)

Address:
Los Angeles Regional Office
35 N. Lake Ave.
Ste 300
Pasadena, CA 91101

Phone numbers:

(626) 229-1000

Fax numbers:

(626) 229-1098

Colorado

Address:
Kansas City Regional Office
2300 Main St.
Ste 1100
Kansas City, MO 64108

Phone numbers:

(816) 285-1800

Fax numbers:

(816) 285-1888

Connecticut

Address:
Boston Regional Office
JFK Federal Bldg
15 New Sudbury St.
Rm 575
Boston, MA 02203

Phone numbers:

(617) 565-9600

Fax numbers:

(617) 565-9666

Delaware

Address:
Philadelphia Regional Office
1835 Market Street
21st Floor
Mailstop EBSA/21
Philadelphia, PA 19103-2968

Phone numbers:

(215) 861-5300

Fax numbers:

(215) 861-5347

Florida (northern)

Address:
Atlanta Regional Office
61 Forsyth St, SW
Ste 7B54
Atlanta, GA 30303

Phone numbers:

(404) 302-3900

Fax numbers:

(404) 302-3975

Florida (southern)

Address:
Miami District Office
1000 S Pine Island Road
Ste 100
Plantation, FL 33324

Phone numbers:

(954) 424-4022

Fax numbers:

(954) 424-0548

Georgia

Address:
Atlanta Regional Office
61 Forsyth St, SW
Ste 7B54
Atlanta, GA 30303

Phone numbers:

(404) 302-3900

Fax numbers:

(404) 302-3975

Guam

Address:
Los Angeles Regional Office
35 N. Lake Ave.
Ste 300
Pasadena, CA 91101

Phone numbers:

(626) 229-1000

Fax numbers:

(626) 229-1098

Hawaii

Address:
Los Angeles Regional Office
35 N. Lake Ave.
Ste 300
Pasadena, CA 91101

Phone numbers:

(626) 229-1000

Fax numbers:

(626) 229-1098

Idaho

Address:
Seattle District Office
300 Fifth Avenue
Ste 1110
Seattle, WA 98104

Phone numbers:

(206) 757-6781

Fax numbers:

(206) 757-6662

Illinois (northern)

Address:
Chicago Regional Office
John C. Kluczynski Federal Bldg
230 S. Dearborn Street
Ste 2160
Chicago, IL 60604

Phone numbers:

(312) 353-0900

Fax numbers:

(312) 353-1023

Illinois (southern)

Address:
Kansas City Regional Office
2300 Main St
Ste 1100
Kansas City, MO 64108

Phone numbers:

(816) 285-1800

Fax numbers:

(816) 285-1888

Indiana (northern)

Address:
Chicago Regional Office
John C. Kluczynski Federal Bldg
230 S. Dearborn Street
Ste 2160
Chicago, IL 60604

Phone numbers:

(312) 353-0900

Fax numbers:

(312) 353-1023

Indiana (southern)

Address:
Cincinnati Regional Office
1885 Dixie Hwy
Ste 210
Ft. Wright, KY 41011-2664

Phone numbers:

(859) 578-4680

Fax numbers:

(859) 578-4688

Forms & Documents

Browse all Employee Benefits Security Administration government forms

Contact Information & Office Locations

Alabama

Alaska

American Samoa

Arizona

Arkansas

California (northern)

California (southern)

Colorado

Connecticut

Delaware

Florida (northern)

Florida (southern)

Georgia

Guam

Hawaii

Idaho

Illinois (northern)

Illinois (southern)

Indiana (northern)

Indiana (southern)

Have Questions About This Agency? Ask An Expert For Help:

Have Questions About This Agency?
Ask An Expert For Help: