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Get IRS 4972 2011

Rm 4972 and its instructions is available at www.irs.gov/form4972. Attach to Form 1040, Form 1040NR, or Form 1041. Name of recipient of distribution Part I OMB No. 1545-0193 Attachment Sequence No. 28 Identifying number Complete this part to see if you can use Form 4972 Yes No 1 Was this a distribution of a plan participant s entire balance (excluding deductible voluntary employee contributions and certain forfeited amounts) from all of an employer s qualified plans of one kind (p.

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