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2009

Department of the Treasury

Internal Revenue Service

Instructions for Form

8955-SSA

Annual Registration Statement Identifying Separated Participants With Deferred

Vested Benefits

Code or Code section references are to the Internal Revenue

annual return/report. Plan administrators should continue to

Code, unless otherwise noted. ERISA refers to the Employee

report those changes on the Form 5500 return/report for the

Retirement Income Security Act of 1974.

plan year in which the change occurs as indicated in the

Form 5500 instructions.

Purpose of Form

Telephone Assistance

Form 8955-SSA, the designated successor to Schedule

If you have questions and need assistance completing this

SSA (Form 5500), is the form to be used to satisfy the

form, call the IRS Help Line at 1-877-829-5500 and follow

reporting requirements of section 6057(a) of the Code for

the directions as prompted. This toll-free telephone service

plan years beginning after December 31, 2008. New Form

is available Monday through Friday.

8955-SSA is established as a stand-alone reporting form

that is to be filed with the Internal Revenue Service (IRS).

How To Get Forms and Publications

See Where To File. Do not file Form 8955-SSA with the

Form 5500, Annual Return/Report of Employee Benefit

Internet. You can access the IRS website 24 hours a day,

Plan, or Form 5500-SF, Short Form Annual Return/Report

7 days a week at IRS.gov to:

of Small Employee Benefit Plan.

•

Download forms, instructions, and publications;

•

Use Form 8955-SSA to report information about

Order IRS products online;

•

separated participants with deferred vested benefits under

Research your tax questions online;

•

the plan. Report participants who have a deferred vested

Search publications online by topic or keyword; and

•

benefit under the plan and who:

•

separated from service covered by the plan;

By phone and in person. You can order forms and IRS

•

were reported as deferred vested participants on another

publications by calling 1-800-TAX-FORM (1-800-829-3676).

plan’s filing if their benefits were transferred (other than in a

You can also get most forms and publications at your local

rollover) to the plan during the covered period;

IRS office.

•

previously were reported under the plan but have been

paid out or are no longer entitled to those deferred vested

Photographs of Missing Children

benefits; or

•

The Internal Revenue Service is a proud partner with the

previously were reported under the plan but whose

National Center for Missing and Exploited Children.

information is being corrected.

Photographs of missing children selected by the Center may

The information reported on Forms 8955-SSA is

appear in instructions on pages that would otherwise be

generally given to the Social Security Administration (SSA).

blank. You can help bring these children home by looking at

The SSA provides the reported information to separated

the photographs and calling 1-800-THE-LOST

participants when they file for social security benefits.

(1-800-843-5678) if you recognize a child.

Note. Report required information regarding separated

participants only on page 2 of Form 8955-SSA. If additional

space is needed for separated participants, use additional

General Instructions

pages 2 only; do not add another page 1 of Form 8955-SSA.

A Form 8955-SSA need not be filed for a year if no

Who Must File

information is required to be provided for that year by these

Plan administrators of plans subject to the vesting standards

instructions.

of section 203 of ERISA must file Form 8955-SSA. For

The IRS is providing an electronic filing system in 2011

example, the plan administrator of a Code section 403(b)

as an optional filing alternative to filing the Form 8955-SSA

plan that is subject to the vesting standards of section 203 of

on paper.

ERISA must file a Form 8955-SSA with respect to the plan’s

2009 and 2010 plan years. Plan administrators may use a

deferred vested participants. Sponsors and administrators of

separate 2009 Form 8955-SSA to report information for the

government, church, and other plans which are not subject

2010 plan year or combine the information for the 2009 and

to the vesting standards of section 203 of ERISA (including

2010 plan years on a single 2009 Form 8955-SSA. See the

plans that cover only owners and their spouses) may elect

to voluntarily file the Form 8955-SSA. See the instructions

Specific Instructions for Part I regarding the plan year

beginning and ending dates to be entered.

for Part I, line A.

Reporting requirement. Neither the elimination of the

Note. If the 2009 plan year Form 5500 annual return/report

Schedule SSA nor the creation of the Form 8955-SSA

was the final return/report of the plan, the 2009 Form

affects the requirement under Code section 6057(b) that

8955-SSA must report information on deferred vested

plan administrators notify the Secretary of Treasury of

participants, including reporting that previously reported

certain changes to the plan and the plan administrator.

deferred vested participants are no longer deferred vested

These changes are reported on the plan’s Form 5500

participants.

Jun 10, 2011

Cat. No. 52730V

Instructions For Form 8955-Ssa - Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits - Internal Revenue Service - 2009

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