Form 14035 - Pilot Questionnaire For Governmental Plans Initiative Page 24
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24Pilot Questionnaire for Governmental Plans Initiative
62. Are there questions in this questionnaire that you were unable to answer because you are part of a
retirement system?
Yes
No
If “Yes,” identify the specific questions and describe how the questions should be modified to address
these difficulties?
PART 9 - FEEDBACK
63. On a scale from 1 to 5, with 5 being the most burdensome, how burdensome was this questionnaire to
complete?
1
2
3
4
5
Not at all burdensome . . . . . . . . . . . . . . . . . . . Very burdensome
64. Estimate how long it took you complete this questionnaire (include the time of all individuals who
participated)?
hours
65. Explain any additional information you would like to share related to the questionnaire in general or any
specific question.
Contact information for person responsible for completing this questionnaire
Name
Phone
Email
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 ensure that you are complying with these laws.
The IRS may not conduct or sponsor data gathering efforts, and 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 collection of information must be retained as long as the contents may become material in the
administration of any Internal Revenue law. Generally, tax returns and tax return information are confidential, as required
by 26 USC 6103.
14035
Form
(Rev. 02-2009)
Catalog Number 52098A
Page 24
Department of the Treasury - Internal Revenue Service
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