Form 8950 - Instructions January 2013 (Page 2 of 5) in pdf

retirement plan subject to Title I of the

This must be a signed and dated

If a line provides a choice of boxes to

Employee Retirement Income Security Act

statement that includes the

check, check only one box unless

of 1974 (ERISA) is not an orphan plan if it

representative’s title and printed name.

instructed otherwise; and

is terminated pursuant to Department of

If a line provides a box to check, written

Group Submissions

Labor (DOL) Regulations section 2578.1

responses and attachments are not

governing the termination of abandoned

acceptable unless instructed otherwise.

For failures affecting a large number of

individual account plans.

individual plans, an eligible organization

What to File

may make a group submission. The

An eligible party for an orphan plan is

failures in the submission must result from

Form 8950 must be accompanied by the

defined as one of the following:

a systemic error involving the eligible

following items:

A court-appointed representative with

organization that affects at least 20 plans

The applicable compliance fee and

specific authority to terminate the plan and

and that results in at least 20 plans

Form 8951. Submit a separate check and

dispose of the plan’s assets;

implementing correction.

Form 8951 for each Form 8950. Make

In the case of an orphan plan under

checks payable to “United States

investigation by the DOL, a person or

An eligible organization is defined as

Treasury.” In addition, include a

entity determined by the DOL to have

follows:

photocopy of your check with your VCP

accepted responsibility for terminating the

A sponsor (as defined in Rev. Proc.

submission;

plan and distributing the plan's assets; or

2005-16, section 4.07, or Rev. Proc.

All descriptions, information,

In the case of a qualified plan to which

2011-49, section 4.07) of a master and

documents, sample computations (if

Title I of ERISA has never applied, a

prototype plan;

applicable), attachments, and

surviving spouse who is the sole

A volume submitter practitioner (as

representations required by Rev. Proc.

beneficiary of a plan that provided benefits

defined in Rev. Proc. 2005-16, section

2013-12, section 11. In order to assist

to a participant who was (i) the sole owner

13.04, or Rev. Proc. 2011-49, section

VCP applicants, the IRS encourages the

of the business that sponsored the plan

13.05);

use of the Model VCP Submission

and (ii) the only participant in the plan.

An insurance company or other entity

Compliance Statement included in Rev.

that has issued annuity contracts or

Proc. 2013-12, Appendix C, including its

The applicant must include a written

provides services relating to assets for

supporting schedules. Appendix C and

letter indicating that the submission

403(b) plans; or

Appendix D (Acknowledgement Letter)

concerns an orphan plan, and must

An entity that provides its clients with

are available in electronic format at

provide documentation that establishes

administrative services relating to qualified

that they are an eligible party. See Rev.

plans, 403(b) plans, SEPs, SARSEPs, or

Plan-Errors. Attachments and written

Proc. 2013-12, sections 5.03 and 11.10.

SIMPLE IRAs.

explanations that are included with the

submission should include the full name of

Anonymous Submissions

For special rules and procedures that

the plan, employer identification number

Taxpayers have the option of submitting a

are applicable to group submissions, see

(EIN), and plan number. For assistance in

VCP submission on an anonymous basis.

Rev. Proc. 2013-12, section 10.11.

determining what documents and

Form 8950 and all applicable VCP

attachments are needed in order to have a

Where to File

submission documents may be submitted

complete VCP submission, refer to the

on a redacted basis. However, once the

Procedural Requirements Checklist at the

Send Form 8950, Form 8951 and the

IRS and the applicant agree on the

end of Form 8950.

related VCP submission to:

correction methodology that would resolve

the qualification failure that is the subject

Who Must Sign

Internal Revenue Service

of the VCP submission, the identity of the

P.O. Box 12192

Form 8950 must be signed by:

plan sponsor and the plan must be

Covington, KY 41012-0192

The employer (including a sole

disclosed to the IRS, along with a signed

proprietor or partnership) maintaining a

Form 2848 and applicable penalty of

VCP submissions shipped by express

single-employer plan;

perjury statements. See Rev. Proc.

mail or a delivery service should be sent

The plan administrator of a multiple

2013-12, section 10.10.

to:

employer plan or a multiemployer plan;

The eligible organization filing a group

An anonymous submission and Form

Internal Revenue Service

8950 will not be processed unless the

submission; or

201 West Rivercenter Blvd

representative includes a signed

The eligible person who is filing a VCP

Attn: Extracting Stop 312

statement indicating that the

submission on behalf of an orphan plan.

Covington, KY 41011

representative has been authorized by the

An original signature is required.

plan sponsor, is able to legally represent

How to Complete the

An anonymous submission should not

the plan sponsor, and is willing to submit a

Application

be signed. Instead, the authorized

signed Form 2848 if identifying information

representative should attach a signed

is ultimately submitted to the IRS. See

Form 8950, and any related determination

perjury statement. See Anonymous

Rev. Proc. 2013-12, sections 10.10,

letter application are screened to ensure

Submissions, above.

11.07, and 11.08. Attach the following

completeness. An incomplete application

signed statement to Form 8950:

Note: Form 8950 may not be signed by

may be returned to the applicant. It is

an authorized representative designated

important that an appropriate response be

“Under penalties of perjury, I declare that I

on Form 2848, Power of Attorney and

entered for each line (unless instructed

am an authorized representative of the

Declaration of Representative.

otherwise). In completing Form 8950, pay

plan sponsor who complies with the power

careful attention to the following:

of attorney requirements described in Rev.

Specific Instructions

N/A (not applicable) is accepted as a

Proc. 2013-12, section 11.07. I will submit

response only if an N/A block is provided;

an executed Form 2848 upon the

If a number is requested, enter the

disclosure of the identity of the plan

Lines 1a-h. Enter the name, address and

appropriate number;

sponsor to the IRS.”

telephone number of the plan sponsor.

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Form 8950 - Instructions January 2013 Page 2

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