ANY REQUEST TO
EXTEND THE USE OF THIS FORM OR TO REVISE IT, MUST BE RECEIVED BY
OMB NO LATER THAN 10/31/82. ALL PREVIOUS CONDITIONS OF APPROVAL
APPLY TO THIS ACTION.
Inventory as of this Action
Requested
Previously Approved
12/31/1982
12/31/1982
12/31/1982
1,028
0
1,028
8,441
0
8,022
0
0
0
IRS USES THE FORM TO DETERMINE FROM
THE INFORMATION GIVEN WHETHER THE APPLICANT'S PLAN QUALIFIES UNDER
SECTION 401(A) OF THE INTERNAL REVENU CODE AND WHETHER THE RELATED
TRUST QUALIFIES FOR TAX EXEMPT STATUS UNDER SECTION 501(A) OF THE
CODE.
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.