Approved. You may omit printing the expiration date on this form. Also, you may continue to use previous versions of this form.
Inventory as of this Action
Requested
Previously Approved
10/31/1993
10/31/1993
10/31/1992
1,000,000
0
1,291,321
5,260,000
0
7,450,922
0
0
0
THIS FORM IS USED TO COMPUTE AND COLLECT TAXES RELATED TO DISTRIBUTIONS FROM INDIVIDUAL RETIREMENT ARRANGEMENT (IRAS) AND OTHER QUALIFIED PLANS. THESE TAXES ARE EXCESS CONTRIBUTIONS TO AN IRA, PREMATURE DISTRIBUTIONS FROM AN IRA, AND OTHER QUALIFIED RETIREMENT PLANS EXCESS ACCUMULATIONS IN AN IRA AND EXCESS DISTRIBUTIONS FROM QUALIFIED RETIREMENT PLANS. THE DATA IS USED TO HELP VERIFY THAT THE CORRECT AMOUNT OF TAX HAS
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.
RETURN FOR ADDITIONAL TAXES ATTRIBUTABLE TO QUALIFIED RETIREMENT PLANS (INCLUDING IRA'S), ANNUITIES, AND MODIFIED ENDOWMENT CONTRACTS