UNDER IRC SECTION 6058 ALL EMPLOYEE
BENEFIT PLANS ARE REQUIRED TO FILE AN ANNUAL INFORMATION RETURN.
THIS FORM IS TO BE FILED FOR THE YEARS THAT FORM 5500-C OR 5500-K
IS NOT REQUIRED TO FILED. THE INFORMATION FURNISHED IS USED TO HELP
DETERMINE THAT THE PLAN IS OPERATING AS REQUIRED UNDER IRC SECTIONS
401(A) THRU 415, AND ERISA.
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.