Approved with the understanding that the box labeled "2nd TIN NOT," will not appear on Copy B. 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
08/31/1993
08/31/1993
10/31/1992
96,282,800
0
89,449,766
22,145,044
0
19,678,949
0
0
0
THE FORM IS USED BY THE SERVICE TO INSURE THAT DIVIDENDS ARE PROPERLY REPORTED AS REQUIRED BY CODE SECTION 6042 AND THAT LIQUIDATION DISTRIBUTIONS ARE CORRECTLY REPORTED AS REQUIRED BY CODE SECTION 6043 AND TO DETERMINE WHETHER PAYEES ARE CORRECTLY REPORTING THEIR INCOME.
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.