Form 14234 - Pre-Cap And Cap Application Form - 2011 Page 2
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2Paperwork Reduction Act Notice.
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 burden for
taxpayers who file this form is 1 hour and 52 minutes.
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. NW, IR-6526, Washington, DC 20224. Do not send the form to this
address.
Form 14234 (4-2011)
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