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
05/31/1995
05/31/1995
10/31/1992
50,000
0
50,000
715,500
0
691,000
0
0
0
FORM LISTED IN ITEM 4 IS AN ANNUAL
RETURN FILED BY A ONE PARTICIPANT OR ONE PARTICIPANT AND SPOUSE
PENSION PLAN. THE IRS USES THIS DATA TO DETERMINE IF THE PLAN
APPEARS TO BE OPERATING PROPERLY AS REQUIRED UNDER THE LAW OR
WHETHER THE PLAN SHOULD BE AUDITED.
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.