THIS FORM IS USED BY INDIVIDUALS TO
REPORT THEIR INCOME TAXES (IRC SECTIONS 408(F) AND 409(C)) AND
EXCISE TAXES (IRC SECTIONS 4973 AND 4974) ON INDIVIDUAL RETIREMENT
ARRANGEMENTS. THE DATA IS USED TO HELP VERIFY THAT THE CORRECT
AMOUNT OF TAX HAS BEEN PAID.
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.