Privacy Act and Paperwork Reduction Act Notice.
We ask for the information on this form to carry out the Internal Revenue laws of the United States. We need it to determine
whether your defined
benefit or defined contribution plan, as amended, qualifies for approval under section 401(a) of the Internal Revenue Code
and is exempt from taxation
under section 501(a) of the Code. Section 6109 of the Code requires you to provide your taxpayer identification number. Routine
uses of the
information provided on this form include giving it to the Department of Justice for civil and criminal litigation and to
other Federal agencies, as
provided by law. We may disclose the information to cities, states, the District of Columbia, and U.S. Commonwealths or possessions
to administer
their tax laws. We may also disclose this information to other countries under a tax treaty, or to Federal and state agencies
to enforce Federal
nontax criminal laws and to combat terrorism. The authority to disclose information to combat terrorism expired on December
31, 2003. Legislation is
pending that would reinstate this authority. If you do not provide all of the information requested on this form, we may be
unable to make a
determination with respect to your amendment. If you provide false or fraudulent information, you may be subject to penalties.
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless
the form displays a valid
OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may
become material in the
administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by
section 6103.
The time needed to complete and file this form will vary depending on individual circumstances. The estimated average time
is:
| Recordkeeping |
14 hr., 21 min. |
| Learning about the law or the form |
2 hr., 13 min. |
| Preparing the form |
4 hr., 25 min. |
| Copying, assembling, and sending the form to the IRS |
32 min. |
If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we would
be happy to hear from
you. You can write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution
Ave. N.W., Washington,
D.C. 20224. Do not send the form to this office. Instead, see Where To File on page 2.
