Appendix F, Schedule 6 Employer Eligibility Failure (401(K) And 403(B) Plans Only)

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APPENDIX F, SCHEDULE 6
Employer Eligibility Failure (401(k) and 403(b) Plans only)
Plan Name: __________________________________ EIN: ________________ Plan #: _____
(Please include the plan name, EIN, and plan number information on each page of the submission.)
PART I. IDENTIFICATION OF FAILURE
The following failure occurred with respect to the plan identified above (check failure that applies)
403(b) Plans
The plan was intended to satisfy the requirements of § 403(b) but was adopted by a Plan Sponsor that was
not a tax-exempt organization described in § 501(c)(3) or a public educational organization described in §
170(b)(1)(A)(ii).
The type of organization sponsoring the Plan during the period of the failure was:
_____________________________________________________________________________________
The failure occurred during the following plan year(s): _________________________________________
Section 401(k) Plans
The plan was intended to include a qualified cash or deferred arrangement and satisfy the requirements of
§§ 401(a) and 401(k) but was adopted by an employer that failed to meet the eligibility requirements to
establish a § 401(k) Plan.
Describe why the employer was ineligible to maintain the § 401(k) plan:
PART II. DESCRIPTION OF PROPOSED METHOD OF CORRECTION
Section 403(b) Plans
1.
All contributions under the plan ceased as of_________________. (Insert date beginning no later
than the date the application under VCP was filed.)
2.
No new employee or employer contributions will be permitted in the future.
3.
The assets in the plan will remain in the trust, annuity contract, or custodial account and will be
distributed no earlier than the occurrence of one of the permitted events under § 403(b)(7) or §
403(b)(11).
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