This form is used by an employer to
permit employees to make salary reduction contributions to a
savings incentive match plan (SIMPLE IRA) described in Code section
408(p). This form is not to be filed with IRS but to be retained in
the employers' records as proof of establishing such a plan,
thereby justifying a deduction for contributions made to the SIMPLE
IRA. The data is used to verify the deduction.
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.