For extension or
revision of this approval, the Department is to provide a detailed
description of purpose and use of each data element. Also identify
all items that are not entered into the computer and explain the
consequence of not collecting these items.
Inventory as of this Action
Requested
Previously Approved
12/31/1982
12/31/1982
2,500
0
0
17,500
0
0
0
0
0
IRS USES THE FORM TO DETERMINE FROM
THE INFORMATION GIVEN WHETHER THE APPLICANT IS A QUALIFIED PLAN
UNDER SECTION 401(A) OF THE INTERNAL REVENUE CODE AND MEETS THE
ERISA REQUIREMENTS FOR AN EMPLOYEE PENSION PLAN. IRS ALSO
DETERMINES WHETHER THE RELATED TRUST QUALIFIES FOR TAX EXEMPTION
UNDER SECTION 501(A), IF SO, THE EMPLOYER MAY DEDUCT CONTRIBUTIONS
TO THE PLAN.
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.