APPLICATION FOR APPROVAL OF MASTER OR PROTOTYPE DEFINED CONTRIBUTION PLAN/BENEFIT PLAN FOR SELF-EMPLOYED INIVIDUALS

ICR 198211-1545-025

OMB: 1545-0060

Federal Form Document

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ICR Details
1545-0060 198211-1545-025
Historical Active 198109-1545-126
TREAS/IRS
APPLICATION FOR APPROVAL OF MASTER OR PROTOTYPE DEFINED CONTRIBUTION PLAN/BENEFIT PLAN FOR SELF-EMPLOYED INIVIDUALS
Revision of a currently approved collection   No
Regular
Approved without change 01/27/1983
Retrieve Notice of Action (NOA) 11/29/1982
APPROVED THROUGH 3/31/84 TO ALLOW TIME TO CONSOLIDATE THE TWO FORMS INTO ONE. INSTRUCTIONS FOR THE NEW SINGLE FORM SHOULD INDICATE THAT APPLICANTS OF PREVIOUSLY APPROVED PLANS (AS DISTINCT FROM APPLICANTS FOR NEW PLANS) NEED ONLY COMPLETE CERTAIN PARTS OF THE FORM.
  Inventory as of this Action Requested Previously Approved
03/31/1984 03/31/1984 01/31/1983
1,500 0 1,500
21,365 0 12,853
0 0 0

IRS USES THESE FORMS TO DETERMINE FROM THE INFORMATION GIVEN WHETHER THE APPLICANT PLAN QUALIFIES UNDER SECTION 401(A) OF THE INTERNAL REVENUE CODE AND UNDER THE APPLICABLE PARTS OF ERISA AS AN APPROVED EMPLOYEE BENEFIT PLAN. A DETERMINATION IS ALSO MADE ON WHETHER THE RELATED TRUST QUALIFIES FOR TAX EXEMPT STATUS UNDER SECTION 501(A) OF THE CODE.

None
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1
IC Title Form No. Form Name
APPLICATION FOR APPROVAL OF MASTER OR PROTOTYPE DEFINED CONTRIBUTION PLAN/BENEFIT PLAN FOR SELF-EMPLOYED INIVIDUALS 3672, 3672-A

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,500 1,500 0 0 0 0
Annual Time Burden (Hours) 21,365 12,853 0 8,512 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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.
11/29/1982


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