This form is
used by individual and other taxpayers. The portion of the burden
imposed on individual taxpayers is approved under OMB Control
Number 1545-0074. In its next submission under this OMB Control
Number, the agency is instructed to ensure that the estimate of
burden associated with this Control Number includes only the burden
imposed on non-individual taxpayers. If the agency finds that the
current burden estimate includes burden imposed on individual
taxpayers, it must immediately submit an adjustment request that
eliminates this double-counting. In its next submission of this
information collection, the agency is instructed to provide the
Line of Business and Subfunction under the Federal Enterprise
Architecture Business Reference Module.
Inventory as of this Action
Requested
Previously Approved
09/30/2009
36 Months From Approved
09/30/2006
21,709
0
21,709
95,520
0
95,520
0
0
0
IRC Section 402(e) allows taxpayers to
compute a separate tax on a lump sum distribution from a qualified
retirement plan. Form 4972 is used to correctly figure that tax.
The data is used to verify the correctness of the separate tax.
Form 4972 is also to make the special 20% capital gain election
attributable to pre-1974 participation from the lump-sum
distribution.
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.