Information Collection

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

IC 39687 under ICR 201904-1545-016 · OMB 1545-0193.

⚠️ Notice: This information collection may be referencing outdated material.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 and Instruction
FORM 4972 Tax on Lump-Sum Distributions f4972--2018-00-00.pdf www.irs.gov/pub/irs-pdf/f4972.pdf Form and Instruction
2019-4972-Burden-2019-03-28 13-53-20.pdf 2019 Burden IC Document

Information Collection (IC) Details

View Information Collection (IC)

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 and Instruction	FORM 4972	Tax on Lump-Sum Distributions	f4972--2018-00-00.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: IRS 24.030--Customer Account Data Engine Individual Master File	FR Citation: 83 FR 42980

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	Previously Approved
Annual Number of Responses for this IC	17,720	17,720
Annual IC Time Burden (Hours)	77,968	77,968
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
2019 Burden	2019-4972-Burden-2019-03-28 13-53-20.pdf	04/26/2019

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