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Cat. No. 11870M Rev. 4-2009 Form 5330 Rev. 4-2009 Page Name of Filer 14 Section 4980 tax on reversion of qualified plan assets to an employer from Schedule I line 3. Form Return of Excise Taxes Related to Employee Benefit Plans Rev. April 2009 Department of the Treasury Internal Revenue Service Filer tax year beginning A OMB No. 1545-0575 Under sections 4965 4971 4972 4973 a 3 4975 4976 4977 4978 4979 4979A 4980 and 4980F of the Internal Revenue .

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