IRC SECTION 402(E) ALLOWS A RECIPIENT
OF A SHARE OF LUMP-SUM DISTRIBUTION TO COMPUTE A SEPARATE TAX ON
THE ORDINARY INCOME PORTION. FORM IS USED TO CORRECTLY COMPUTE THE
SEPARATE TAX. THE INFORMATION IS USED TO DETERMINE WHETHER THE
DISTRIBUTION HAS BEEN REPORTED PROPERLY AND THE SEPARATE TAX
COMPUTED CORRECTLY.
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.