Appendix F, Schedule 9 Correction By Plan Amendment (In Accordance With Appendix B) Page 6

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Plan Name:_____________________________
EIN:
Plan #:
PART II. CHANGE IN ADMINISTRATIVE PROCEDURES
Please include an explanation of how and why the failures arose and a description of the measures that will be
implemented to ensure that the same failures will not occur.
PART III. ENCLOSURES
In addition to the applicable enclosures listed on Appendix F, the Plan Sponsor encloses the following with this
submission:
Copies of all amendments used to correct the failure(s), either as adopted or in proposed form. ( required)
A copy of the plan document in effect prior to any of the amendments used to correct the failure(s).
( required)
For a § 401(a)(17) failure in a defined contribution plan, specific calculations for each affected employee or
a representative sample of affected employees. (The sample calculations must be sufficient to demonstrate
each aspect of the correction method proposed. For example, the determination of the fraction used to
determine the additional amount to be allocated to each employee (other than those for whom there was a
§ 401(a)(17) failure) must be demonstrated.)
6

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