SCHEDULE A (FORM 990-BL) IS USED
SOLELY TO REPORT INITIAL EXCISE TAXES ON TAX EXEMPT BLACK LUNG
BENEFIT TRUSTS AND CERTAIN RELATED PERSONS FOR ENGAGING IN
ACTIVITIES PRESCRIBED BY IRC SECTIONS 4951, 4952 AND 4953. THE
SCHEDULE A (FORM 990-BL) IS ALWAYS FILED AS AN ATTACHMENT OT FORM
990-BL. THE INFORMATION OBTAINED IS NECESSARY TO ASCERTAIN THAT THE
CORRECT EXCISE TAX HAS BEEN REPORTED.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.