THIS FORM IS USED IN CONJUNCTION WITH
FORMS 5300, 5301 AND 5307 WHEN APPLYING TO IRS FOR A DETERMINATION
LETTER STATING THE PENSION OR PROFIT-SHARING PLAN OF THE EMPLOYER
MEETS THE REQUIREMENTS OF SECTION 401(A) OF THE IRC. THE DATA
SUBMITTED ALLOWS THE IRS TO DETERMINE THAT THE PLAN DOES NOT
DISCRIMINATE IN FAVOR OF THE PROHIBITED GROUP.
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.