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
07/31/1995
07/31/1995
11/30/1992
1,000
0
1,000
1,030
0
1,030
0
0
0
THIS FORM WAS DEVELOPED TO ALLOW A
TRUSTEE OF A TRUST OR AN EXECUTOR O AN ESTATE TO MAKE AN ELECTION
UNDER IRC SECTION 643(G) TO ALLOCATE ANY PAYMENT OF ESTIMATED TAX
TO A BENEFICIARY(IES). THIS FORM SERVES AS A TRANSMITTAL SO THAT
SERVICE CENTER PERSONNEL CAN DETERMINE THE CORRE AMOUNTS THAT ARE
TO BE TRANSFERRED FROM THE FIDUCIARY'S ACCOUNT TO THE INDIVIDUAL'S
ACCOUNT.
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.