Appendix F, Schedule 9 Correction By Plan Amendment (In Accordance With Appendix B) Page 3

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Plan Name:_____________________________
EIN:
Plan #:
B.
Hardship Distribution Failure
Hardship distributions were made to participants under the plan. All plan participants were entitled to
request hardship distributions, and all requests were evaluated in accordance with uniform eligibility
standards, as described below:
Enter the plan years in which the failure occurred, the number of hardship distributions made for each plan
year, and the number and amount of distributions made to highly compensated employees (HCEs) and
nonhighly compensated employees (NHCEs) respectively, affected by the failure for each plan year.
Number of
Number of Hardship
Number of
Hardship
Distributions Made
Amount of
Hardship
Amount of
Plan
Distributions
to NHCEs
Distributions
Distributions
Distribution
Year
Made
Made to HCEs
During the
Plan Year
Description of the Proposed Method of Correction:
The failure was (or will be) corrected by retroactively amending the plan to provide for the hardship
distributions that were made available. The effective date of the corrective amendment is:
_____________________________________________________________________________________.

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