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otherwise). When completing the

should be updated based on the

Where To File

application, use the following

Required Amendments List that was

guidelines.

issued during the second calendar year

File Form 5300 at the address indicated

N/A (not applicable) is accepted as a

preceding the submission of the DL

below.

response only if an N/A block is

application (and prior Required

Internal Revenue Service

provided.

Amendments List). However, plans

P.O. Box 12192

If a number is requested, a number

submitted for initial qualification during

Covington, KY 41012-0192

must be entered.

the 2017 calendar year will be reviewed

If an item provides a choice of boxes

based on the 2015 Cumulative List. See

to mark, mark only one box unless

Rev. Proc. 2016-37.

Private delivery services. The

instructed otherwise.

organization can use only the

6. A copy of any Voluntary

If an item provides a box to mark,

Correction Program compliance

IRS-designated private delivery

written responses aren’t permitted.

statement or Audit Closing Agreement

services below to meet the “timely

The application has formatted fields

Program closing agreement regarding

mailing as timely filing/paying” rule for

that will limit the number of characters

the plan.

tax returns and payments. These private

entered per field.

delivery services include only the

7. For a DB plan, include one of the

All responses should be entered in

following.

following paragraphs in the cover letter

Courier 10 point font.

DHL Express 9:00, DHL Express

to your application indicating whether

Alpha characters should be entered

10:30, DHL Express 12:00, DHL

the plan provides for lump-sum risk

in capital letters.

Express Worldwide, DHL Express

transfers, as described in Notice

Enter a space between each word.

Envelope, DHL Import Express 10:30,

2015-49, 2015-30 I.R.B. 79.

Spaces count as characters.

DHL Import Express 12:00, and DHL

a. If not provided in the plan, add

All date fields are entered as an

Import Express Worldwide.

the following paragraph: “The plan

eight-digit field (MM/DD/YYYY).

Federal Express (FedEx): FedEx First

doesn’t provide for lump-sum risk

Any required attachment should refer

Overnight, FedEx Priority Overnight,

transfers, as described in Notice

to the form and the line item.

FedEx Standard Overnight, FedEx

2015-49.”

The IRS may require additional

2Day, FedEx International Next Flight

information.

b. If provided in the plan, add the

Out, FedEx International Priority, FedEx

following paragraph: “The plan provides

International First, and FedEx

for lump-sum risk transfers, as

International Economy.

What To File

described in section II of Notice

United Parcel Service (UPS): UPS

See the instructions under line 4a for

2015-49. This provision (satisfies)

Next Day Air Early AM, UPS Next Day

Partial Termination Request.

(doesn’t satisfy) one of the four

Air, UPS Next Day Air Saver, UPS 2nd

conditions for Pre-Notice Acceleration

Day Air, UPS 2nd Day Air AM, UPS

All applications (including

described in section IV of Notice

Worldwide Express Plus, and UPS

applications for M&P or VS plans,

2015-49.” (If you state that the plan

Worldwide Express.

unless otherwise noted) must contain an

"satisfies" one of the four conditions for

original signature and be accompanied

For private delivery services, deliver

Pre-Notice Acceleration, describe in

by the following.

the return to:

detail how the plan complies with the

1. A completed Form 5300,

conditions.)

Internal Revenue Service

including the procedural requirements

201 West Rivercenter Blvd.

8. For an adopting employer of a

checklist.

Attn: Extracting Stop 312

M&P or VS plan, attach a statement

2. A Form 8717, User Fee for

Covington, KY 41011

explaining why the 5300 is being filed,

Employee Plan Determination Letter

and include a copy of the opinion or

Request, and a check for the

advisory letter for the plan. Do not

The private delivery service can tell

appropriate user fee (unless payment

include any interim amendments

you how to get written proof of the

was made through ).

adopted by the employer, except in the

mailing date.

Submit a separate check for each

case of a VS plan that doesn’t authorize

Private delivery services can’t

application. Make checks payable to

the practitioner with respect to a M&P or

deliver items to P.O. boxes. You

“United States Treasury.”

VS plan to amend the plan on behalf of

must use the U.S. Postal

Note. If the user fee is paid using

adopting employers. The plan will be

CAUTION

Service to mail any item to an IRS P.O.

, a copy of the payment

reviewed on the basis of the Cumulative

box.

confirmation must be submitted along

List that was considered in issuing the

with the paper Form 8717.

opinion or advisory letter for the M&P or

VS plan. See section 20 of Rev. Proc.

3. Form 8905, Certification of Intent

How To Complete the

2016-37.

To Adopt a Pre-Approved Plan, if

Application

applicable.

9. For an employee stock ownership

The application must be completed and

plan (ESOP), attach:

4. A copy of the current plan

signed by the employer, plan

document and prior plan document(s), if

a. Form 5309, Application for

administrator, or authorized

the plan has been restated.

Determination of Employee Stock

representative.

Ownership Plan;

5. Copies of all signed and dated

plan amendments. If the plan was

b. A statement indicating whether

Note. Stamped signatures aren’t

amended, include a copy of the last

the employer is a C corporation or an S

acceptable. It is important that an

favorable DL and any amendments

corporation; and

appropriate response be entered for

since the last favorable DL. The plan

each line item (unless instructed

-2-

Instructions for Form 5300

Instructions For Form 5300 - Application For Determination For Employee Benefit Plan Page 2

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