SHORT FORM APPLICATION FOR DETERMINATION FOR AMENDMENT OF EMPLOYER BENEFIT PLAN

ICR 198407-1545-031

OMB: 1545-0229

Federal Form Document

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Document
Name
Status
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ICR Details
1545-0229 198407-1545-031
Historical Active 198109-1545-196
TREAS/IRS
SHORT FORM APPLICATION FOR DETERMINATION FOR AMENDMENT OF EMPLOYER BENEFIT PLAN
Extension without change of a currently approved collection   No
Regular
Approved without change 08/02/1984
Retrieve Notice of Action (NOA) 07/19/1984
THIS SUBMISSION IS APPROVED THROUGH 7/31/87 PROVIDED THE INSTRUCTION ON THE FORM MAKES CLEAR THAT A N/A REFERS TO ITEMS FOR WHICH THERE IS NO AMENDING CHANGE.
  Inventory as of this Action Requested Previously Approved
07/31/1987 07/31/1987 09/30/1984
70,000 0 70,000
87,965 0 87,965
0 0 0

THIS FORM IS USED BY CERTAIN EMPLOYEE PLANS WHO WANT A DETERMINATION LETTER ON AN AMENDMENT TO THE PLAN. THE INFORMATION GATHERED WILL BE USED TO DECIDE WHETHER THE PLAN IS QUALIFIED UNDER CODE SECTION 401(A).

None
None


No

1
IC Title Form No. Form Name
SHORT FORM APPLICATION FOR DETERMINATION FOR AMENDMENT OF EMPLOYER BENEFIT PLAN 6406

  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 70,000 70,000 0 0 0 0
Annual Time Burden (Hours) 87,965 87,965 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
07/19/1984


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