Instructions For Form 5310 (Revised January 1996) Application For Determination For Terminating Plan (Page 2 of 4) in pdf

a standardized master or prototype or

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

Line 4e.—Enter on this line the total of:

(1) the number of employees who are

regional prototype plan).

than one of the entities required to be

combined should only enter the EIN of

participating in the plan. Include

Schedule Q (Form 5300),

one of the sponsoring members. This

employees under a section 401(k)

Nondiscrimination Requirements, and

qualified cash or deferred arrangement

EIN must also be used in the annual

any additional schedules required by

returns/reports filed for the plan unless

who are eligible, but do not make

these instructions or the instructions for

there is a change of sponsor.

elective deferrals, (2) retirees and other

Schedule Q.

former employees who have a

Line 1c.—Enter the two digits

Form 6088, if required.

nonforfeitable right to benefits under the

representing the month the employer’s

Note: A multiple-employer plan must

plan, and (3) beneficiaries of deceased

tax year ends. This is the employer

submit a Form 6088 for each employer

employees who are receiving or will in

whose EIN was entered on line 1b. Enter

who adopts the plan.

the future receive benefits under the

“N/A” for plans of more than one

plan. This means one beneficiary for

employer.

Where To File

each deceased employee regardless of

Line 2.—The contact person will receive

the number of individuals receiving

For information on where to file, see the

copies of all correspondence as

benefits. For example, payment of a

instructions for Form 8717, User Fee for

authorized in a power of attorney or

deceased employee’s benefit to three

Employee Plan Determination Letter

other written designation. This line must

children is considered a payment to one

Request. Form 8717 may be obtained by

be completed as described; a reference

beneficiary.

contacting your local IRS District Office

such as “see attached” is not

Line 5a.—If the plan is not described in

or by calling 1-800-TAX-FORM

acceptable.

1, 2, or 3, enter 4 for “other” plan. For

(1-800-829-3676).

Line 3a.—Section 3001 of ERISA

example, if this is a cash balance, enter

requires the applicant to provide

4 and write “Cash Balance” where

Specific Instructions

evidence that each employee who

noted. A cash balance plan is a defined

qualifies as an interested party has been

benefit plan that defines an employee’s

Line 1a.—Enter the name, address, and

notified of the filing of the application. If

benefit by reference to hypothetical

telephone number of the plan sponsor.

you check “Yes,” it means that you have

allocations and interest adjustments.

A plan sponsor for:

notified each employee as required by

Line 5b.—If this is a defined contribution

regulations under section 7476 or you

A plan that covers the employees of

plan, enter the number for the type of

have a one person plan. Rules defining

one employer is the employer.

plan in the box at the left margin.

“interested parties” and the form of

A plan maintained by two or more

Line 6.—If the employer is a member of

notification are in Regulations section

employers (other than a plan sponsored

1.7476-1. An example of an acceptable

a controlled group of corporations

by a group of entities required to be

(section 414(b)), trades or businesses

format is found in Rev. Proc. 96-6,

combined under section 414(b), (c), or

1996-1 IRB 151. If “No” is checked or

under common control (section 414(c)),

(m)), is the association, committee, joint

this line is blank, your application will be

or an affiliated service group (section

board of trustees or other similar group

414(m)), all employees of the group will

returned.

of representatives of those who

be treated as employed by a single

Line 3c.—If a determination letter, or, if

established or maintain the plan.

employer for purposes of certain

this plan is a standardized Master and

A plan sponsored by two or more

qualification requirements such as

Prototype or Regional Prototype plan,

entities required to be aggregated under

coverage. If the employer is a member

and an opinion or notification letter has

section 414(b), (c), or (m) is one of the

of such a group, attach a statement

been received, check “Yes” and attach a

members participating in the plan.

showing in detail all members of the

copy of the latest letter to this

A plan that covers the employees

group, their relationship to the employer,

application. If you do not have a copy of

and/or partner(s) of a partnership is the

the type of plans each member has, and

the latest letter, explain this in the cover

partnership.

the plans common to all members.

letter.

The name of the plan

Line 6a.—If you are not sure if you are a

Line 3d.—If you check “Yes” also attach

sponsor/employer should be the same

member of an affiliated service group,

a statement explaining how the

name that was or will be used when the

attach the following information:

amendments affect or change this or

Form 5500 series annual return/reports

any other plan of the employer.

1. A description of the nature of the

are filed for the plan.

business of the employer. Specifically

Line 3e.—If your plan contains

Address.—Include the suite, room, or

state whether it is a service organization

provisions for a cash or deferred

other unit number after the street

or an organization whose principal

arrangement (CODA) under section

address. If the Post Office does not

business is the performance of

401(k), or for employee or matching

deliver mail to the street address and

management functions for another

contributions described in section

the plan has a P.O. box, show the box

organization, including the reason for

401(m), check “Yes.” Otherwise, check

number instead of the street address.

performing the management function or

“No.”

service.

Line 1b.—Employer identification

Line 4a.—Enter a name for your plan.

number.—Enter the 9-digit EIN assigned

2. The identification of other members

Line 4b.—Assign and enter a three-digit

to the plan sponsor/employer. This

(or possible members) of the affiliated

number, beginning with “001” and

should be the same EIN that was or will

service group.

continuing in numerical order for each

be used when the Form 5500 series

3. A description of the nature of the

plan adopted. This numbering will

annual returns/reports are filed for the

business of each member (or possible

differentiate your plans. The number

plan. Do not use a social security

member) of the affiliated service group

assigned to a plan must not be changed

number or the EIN of the trust. Use

including the type of organization

or used for any other plan.

Form SS-4, Application for Employer

(corporation, partnership, etc.) and

Line 4c.—Plan year means the calendar,

Identification Number, to apply for an

indicate whether such member is a

policy, or fiscal year on which the

EIN. Form SS-4 can be obtained at most

service organization or an organization

records of the plan are kept. Enter four

IRS or Social Security Administration

whose principal business is the

digits in month-day order. For example,

(SSA) offices or by calling

performance of management functions

March 31 would be 0331.

1-800-TAX-FORM (1-800-829-3676).

for the other group member(s).

Line 4d.—Enter the year the plan

The plan of a group of entities

originally became effective.

required to be combined under section

Page 2

Instructions For Form 5310 (Revised January 1996) Application For Determination For Terminating Plan Page 2

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