Form 5434-A - Application For Renewal Of Enrollment - Joint Board For The Enrollment Of Actuaries - 2017 Page 3
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Instructions for Form 5434-A, Joint Board for the Enrollment of Actuaries
Application for Renewal of Enrollment
General Instructions
Before completing Form 5434-A, Application for Renewal of Enrollment, review the regulations (Parts 901 and 902 of Title 20 of the
Code of Federal Regulations). Unless otherwise indicated, section numbers (e.g., 901.12(b)) cited on the form and in the instructions
refer to the regulations. You may download a copy of the regulations from
Do not submit Form 5434-A until you have completed the continuing professional education hours required for renewal of enrollment
under section 901.11(e).
Instructions for Certain Line Items
Item 4
The term “authoritative body” includes a court of law, a duly constituted licensing or accreditation authority, a federal or state agency,
board, commission, hearing examiner, administrative law judge, or other official administrative authority. When responding about the
action of an authoritative body, attach a statement specifying (as applicable) the name and address of the authoritative body, the date
of the body's action, the nature of the finding, and the type and duration of discipline imposed.
Item 4A
See section 901.31(c)(2)-(4) for a more detailed description of the circumstances that require you to answer “Yes” to item 4A. In
addition, under section 901.12(f)(3), an actuary may also be suspended or terminated from enrollment if the Joint Board finds that the
actuary submitted false or misleading information on an application for enrollment to perform actuarial services or in any oral or written
information submitted in connection therewith or in any report presenting actuarial information to any person, knowing the same to be
false or misleading.
Item 4B
Under section 901.12(f)(2), the enrollment of an actuary may be suspended or terminated if the actuary has been convicted of any of
the offenses (for example, robbery, bribery, extortion, embezzlement, fraud, murder, rape, perjury) referred to in section 411 of ERISA.
See
ERISA section 411 (i.e., Section 1111 of Title 29, U.S. Code)
for a more detailed list of applicable offenses.
Item 4C
Under section 901.31(c), the enrollment of an actuary may be suspended or terminated if the Joint Board finds that the actuary, during
the period after applying for enrollment, has engaged in disreputable conduct. Answer “Yes” to item 4C if you failed to timely file a
federal tax return or the Internal Revenue Service has issued a finding that you evaded, or attempted to evade, any federal tax or
payment for yourself or a client or a prospective client. Also answer “Yes” to item 4C if you have been disbarred or suspended from
practice as an actuary or other professional or if an authoritative body issued a finding that you have engaged in any of the following
types of conduct listed in section 901.12(f)(1):
i. Conduct evidencing fraud, dishonesty, or breach of trust
ii. Knowingly giving false or misleading information to the Department of the Treasury, Department of Labor, or the Pension Benefit
Guaranty Corporation.
iii. Attempting to influence the action of the Department of the Treasury, Department of Labor, or the Pension Benefit Guaranty
Corporation by coercion or inducement; and
iv. Using abusive language, making false accusations and statements knowing them to be false, or circulating or publishing
malicious or libelous matter in connection with matters before the Department of the Treasury, Department of Labor, or the
Pension Benefit Guaranty Corporation.
See section 901.12(f)(1) for a more detailed description of the circumstances that require you to answer “Yes” to item 4C.
If you failed to timely file all required federal tax returns that became due, specify the type of return, the taxable period covered by the
return, and the type and amount of any penalties imposed in your attachment to item 4C. Note, as part of the application process, we
may check your federal tax history to verify that you have timely filed and paid your federal taxes.
The term “disreputable conduct” is not limited to the items described above. An example of a circumstance when the Joint Board would
investigate to determine whether an enrolled actuary’s conduct was disreputable beyond the conduct specifically listed in section
901.12(f)(1) is when an individual has been disciplined for cheating on an examination. Another example is when an individual has
been disciplined for violating professional standards of an actuarial organization or other profession.
Item 4D
See sections 901.31(b) and 901.31(c)(5) for a more detailed description of the circumstances that require you to answer “Yes” to item
4D.
5434-A
Catalog Number 63767O
Form
(Rev. 2-2017)
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