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.
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.