Information Collection

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

IC 39687 under ICR 202203-1545-023 · OMB 1545-0193.

Documents and Forms

Documents and forms in this information collection
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--2021-00-00.pdf www.irs.gov/pub/irs-pdf/f4972.pdf	Form and Instruction
FORM 4972 Tax on Lump-Sum Distributions f4972--2021-00-00.pdf www.irs.gov/pub/irs-pdf/f4972.pdf	Form and Instruction
2022-4972-Burden-2022-04-28 08-25-40.pdf 2022 Burden	IC Document
2022-4972-Burden-2022-04-28 08-25-40.pdf 2022 Burden	IC Document

IC Title:

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:

table that charts list of 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--2021-00-00.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: 5,601

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 16 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,601	-12,119	17,720
Annual IC Time Burden (Hours)	24,644	-53,324	77,968
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
2022 Burden	2022-4972-Burden-2022-04-28 08-25-40.pdf	04/28/2022

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