The agency is
not required to display the expiration date.
Inventory as of this Action
Requested
Previously Approved
02/28/2005
02/28/2005
02/28/2002
100,000
0
100,000
4,566,000
0
4,546,000
0
0
0
This form is filed by employers or
plan administrators who have adopted a master or prototype plan
approved by the IRS National Office or a regional prototype plan
approved by the IRS District Director to obtain a ruling that the
plan adopted is qualified under IRC sections 401(a) and 501(a). It
may not be used to request a letter for a multiple employer
plan.
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.