Instructions For Form 5310-A (May 1991) Notice Of Merger, Consolidation, Or Transfer Of Plan Assets Or Liabilities (Page 3 of 3) in pdf

414(b), (c), or (m) whose sponsor is more

as employed by a single employer for

functions are performed on a regular

than one of the entities required to be

purposes of certain qualification

and continuous basis) and whether or

aggregated, should enter only the EIN of

requirements such as coverage. If the

not it is unusual for such management

one of the sponsoring members. This

plan sponsor is a member of such a

functions to be performed by employees

EIN must be used in all subsequent

group, attach a statement showing in

of organizations in the employer’s

filings of determination letter requests

detail all members of the group, their

business field in the United States.

for this plan. This is also the EIN used

relationship to the plan sponsor, the type

(8) If management functions are

for filing annual returns/reports unless

of plans each member has, and the

performed by the employer for the

there is a change of sponsor.

plans common to all members.

member(s)(or possible member(s)) of the

1c. Enter the month the tax year ends

5a. If the employer is a member of an

affiliated service group, a description as

for the employer whose EIN you entered

affiliated service group, enter 1. If not,

to what part of the employer’s business

on line 1b.

enter 2. If you are uncertain as to

constitutes the performance of

whether or not you are a member of an

management functions for the

3a. Enter the name you designated for

affiliated service group, attach the

member(s) (or possible member(s)) of the

your plan.

following information:

group (including the percentage of gross

3b. Enter the 3-digit number that the

receipts derived from management

(1) A description of the nature of the

employer or plan administrator has

activities as compared to the gross

business of the employer, specifically

assigned to the plan. This number

receipts from other activities).

discussing whether it is a service

should be the same as the 3-digit

organization whose principal business is

(9) A brief description of any other

number entered on the latest Form

the performance of management

plan maintained by the member(s) (or

5500, or Form 5500-C/R filed for this

functions for another organization,

possible member(s)) of the affiliated

plan.

including the reasons therefor.

service group, and such other plan(s) is

3c. Plan year means the calendar,

designated as a unit for qualification

(2) The identification of other members

policy, or fiscal year on which the

purposes with the plan for which a

(or possible members) of the affiliated

records of the plan are kept. Enter four

determination letter has been requested,

service group.

digits in month-day order. For example,

and

March 31 would be 0331.

(3) A description of the nature of the

(10) A description of how the plan(s)

business of each member (or possible

3d. Enter the date the plan originally

satisfies the coverage requirements of

member) of the affiliated service group

became effective. Enter six digits in

section 410(b) if the member(s) (or

describing the type of organization

month-day-year order.

possible member(s)) of the affiliated

(corporation, partnership, etc.) and

3e. Enter the total number of

service group is considered part of an

indicating whether such member is a

participants. The term “participants”

affiliated service group with the

service organization or an organization

includes retirees and other former

employer.

whose principal business is the

employees and the beneficiaries of both

performance of management functions

5b. If the employer is a member of a

who are receiving benefits under the

for the other group member(s).

controlled group, enter 1. If not, enter 2.

plan or will at some future time receive

(4) the ownership interests between

6. Enter 1 if this is a governmental

benefits under the plan. Enter the total

the employer and the members (or

plan or church plan not subject to

of: (1) the number of employees who are

possible members) of the affiliated

ERISA.

participating in the plan including

service group (including ownership

employees under a section 401(k)

Enter 2 if this is a multiple employer

interests as described in section

qualified cash or deferred arrangement

plan described in section 413(c). A

414(m)(2)(B)).

who are eligible, but do not make

multiple employer plan is a plan

elective deferrals, (2) former employees

(5) A description of services

maintained by more than one employer,

who are receiving benefits under the

performed for employers by the

that is NOT maintained pursuant to a

plan or will at some future date receive

members (or possible members) of the

collective bargaining agreement. Under

benefits under the plan, and (3)

affiliated service group, or vice versa

this plan type, contributions from each

beneficiaries of former employees who

(including the percentage of each

group employer must be available to pay

are receiving benefits under the plan.

member’s (or possible member’s) gross

benefits of any participant, even if

(This means one beneficiary for each

receipts and service receipts provided

employed by another employer. Also

former employee regardless of the

by such services, if available, and data

enter the number of employers adopting

number of individuals receiving benefits.

as to whether their services are a

the plan.

For example, payment of a former

significant portion of the member’s

Enter 3 if this plan is not described

employee’s benefit to three children is

business) and whether or not, as of

above. Most plans will enter 3.

considered a payment to one

December 13, 1980, it was unusual for

Complete 7a through f for the plan

beneficiary.)

the services to be performed by

being merged or consolidated or the

employees of organizations in that

4a. Complete line 4a if this is a

plan to which the assets or liabilities of

service field in the United States.

defined benefit plan. Enter the number

the plan are being transferred with the

for the type of benefit in the box at the

(6) A description of how the employer

plan named in 3a. If there is more than

left margin.

and the members (or possible members)

one plan, other than the plan named in

of the affiliated service group associate

4b. Complete line 4b if this is a

3a, attach a separate Form 5310-A with

in performing services for other parties.

defined contribution plan. Enter the

lines 1a, 1b, 3b, and 7a through 7f

number for the type of plan in the box at

(7) A description of management

completed for each of the additional

the left margin.

functions, if any, performed by the

plans.

employer for the member(s) (or possible

5. If the plan sponsor is a member of

7a. List the name of the plan, other

member(s)) of the affiliated service

a controlled group of corporations,

than the plan named in 3a, involved in

group, or received by the employer from

trades or businesses under common

this transaction.

any other member(s) (or possible

control, or an affiliated service group, all

7b through 7f Complete 7b through 7f

member(s)) of the group (including data

employees of the group will be treated

for the plan listed in 7a.

as to whether such management

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Instructions For Form 5310-A (May 1991) Notice Of Merger, Consolidation, Or Transfer Of Plan Assets Or Liabilities Page 3

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