Tax on Lump-Sum Distributions (From Qualified Retirement Plans of Plan Participants Born Before 1936)

Form 4972---Tax on Lump-Sum Distributions (From Qualified Retirement Plans of Plan Participants Born Before 1936)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0193 can be found here:

Documents and Forms

Document Name Document Type
Form FORM 4972 Tax on Lump-Sum Distributions (From Qualified Retirement Plans of Plan Participants Born Before 1936) Form
FORM 4972 Tax on Lump-Sum Distributions f4972--2015-00-00.pdf www.irs.gov/pub/irs-pdf/f4972.pdf Form
2016 Burden.pdf 2016 Burden IC Document

Information Collection (IC) Details

IC Title:	Tax on Lump-Sum Distributions (From Qualified Retirement Plans of Plan Participants Born Before 1936)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 11.402(e)(4)(A) 26 CFR 11.402(e)(4)(B) 26 CFR 1.402(e)-2, 3, 14

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FORM 4972	Tax on Lump-Sum Distributions	f4972--2015-00-00.pdf	https://www.irs.gov/pub/irs-pdf/f4972.pdf	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 17,720	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 16 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	17,720	3,798	13,922
Annual IC Time Burden (Hours)	77,968	16,711	61,257
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
2016 Burden	2016 Burden.pdf	02/26/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.