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special rule for section 401(k) plans and

are not employed on the last day of the

for line 13d, the information provided in

section 401(m) plans in Regulations

plan year.

lines 13e through 13k relates to the

section 1.401(a)(4)-1(b)(2)(ii)(B) (such

portion of the plan that is not subject to

Line 13e(4). If this plan benefits the

as nonelective contributions), complete

the rule in Regulations section

employees of one QSLOB, enter on

lines 13e through 13k with respect to

1.401(a)(4)-1(b)(2)(ii)(B).

this line the number of employees of

the portion of the plan that includes

Line 13k. See the instructions for line

the employer’s other QSLOBs. This is

these contributions and enter the ratio

13i for the meaning of ‘‘benefiting under

not applicable if the plan is tested under

percentage for this portion of the plan

the plan.’’

the special rule for employer-wide plans

on line 13l.

in Regulations section

Line 13l. To obtain the ratio

1.414(r)-1(c)(2)(ii).

Otherwise, complete lines 13e

percentage:

through 13k with respect to the section

Line 13e(5). Enter the number of

Step 1. Divide the number on line

401(k) part of the plan (or the section

employees who are nonresident aliens

13k (nonexcludable NHCEs benefiting

401(m) plan if there is no section 401(k)

who receive no earned income (as

under the plan) by the number on line

arrangement) and leave line 13l blank.

defined in section 911(d)(2)) from the

13j (nonexcludable NHCEs).

In all cases, enter the ratio percentages

employer that constitutes income from

Step 2. Divide the number on line

for the section 401(k) and the section

sources within the United States (as

13i (nonexcludable HCEs benefiting

401(m) parts of the plan, as applicable,

defined in section 861(a)(3)).

under the plan) by the number on line

on line 13m. These percentages should

Line 13g. Subtract the total of lines

13h (nonexcludable HCEs).

be based on the actual nonexcludables

13(e)(1) through 13(e)(5) as reported

in the sections 401(k) and 401(m)

Step 3. Divide the result from Step 1

on line 13(f) from the total employees

portions, respectively. It is suggested

by the result from Step 2.

reported on line 13(d). The result is the

that these calculations be submitted

Note. If the ratio percentage entered

number of ‘‘nonexcludable employees.’’

with the application, but this is optional.

on line 13l and/or line 13m is less than

These are the employees who cannot

Do not base the calculations on

70%, the plan does not satisfy the ratio

be excluded from the plan for statutory

lines 13(m)(1) and (2) on the

percentage test. In this case, the plan

or regulatory reasons and must be

nonexcludable employees

must satisfy the average benefit test. A

CAUTION

considered in the calculation of the ratio

reported on line 13(g) unless all of the

determination regarding the average

percentage even though they might not

disaggregated plans (profit sharing,

benefit test can be requested on line

‘‘benefit’’ under the plan. If they meet

section 401(k), and section 401(m))

13o by submitting a Demo 5.

the age and service requirements of

have the same nonexcludable

section 410 and are not otherwise

Line 13m. See the Note following the

employees with the same age and

excludable employees, they must be

instructions for line 13d. To determine

service requirements.

included in this number.

the ratio percentages for the section

401(k) and all section 401(m) (matching

Line 13e(1). Enter the number of

Line 13h. Enter the number of

and employee contribution) portions of

employees who are excluded because

employees on line 13g who are highly

the plan, follow the steps described in

they have not attained the lowest

compensated employees (HCEs) as

the instructions for lines 13d through

minimum age and service requirements

defined in section 414(q).

13l, but treat an employee as benefiting

for any employee under this plan. If the

Line 13i. In general, an employee is

under the rules for section 401(k) plans

employer is separately testing the

treated as benefiting under the plan for

and section 401(m) plans described in

portion of a plan that benefits otherwise

coverage tests purposes only if the

the instruction for line 13i.

excludable employees, attach a

employee receives an allocation of

separate schedule describing which

Line 13o. Plans that use the average

contributions or forfeitures or accrues a

employees are treated as excludable

benefit test to satisfy section 410(b) for

benefit under the plan for the plan year.

employees on account of the minimum

the year of termination must attach a

Certain other employees are treated as

age and service requirements under

Demo 5 (see Guidelines for

benefiting if they fail to receive an

each separate portion of the plan.

Demonstrations) unless the plan has

allocation of contributions and/or

received a favorable determination

Line 13e(2). Enter the number of

forfeitures, or to accrue a benefit, solely

regarding the average benefit test in

employees who are excluded because

because they are subject to plan

the 3 years preceding the date of

they are collectively bargained

provisions that uniformly limit plan

termination and the plan has not

employees as defined in Regulations

benefits, such as a provision for

experienced a material change in the

section 1.410(b)-6(d)(2), regardless of

maximum years of service, maximum

facts (including benefits provided and

whether those employees benefit under

retirement benefits, application of

employee demographics) on which the

the plan. For this purpose, an employee

offsets or fresh start wear-away

determination was based.

covered under a Collective Bargaining

formulas, or limits designed to satisfy

Agreement (CBA) is not considered a

section 415.

Line 14. Do not complete line 14 if line

collectively bargained employee if more

13p is completed. Complete line 14 to

An employee is treated as benefiting

than 2% of the employees who are

indicate how the plan satisfied the

under a plan to which elective

covered under the agreement are

requirements of section 401(a)(4).

contributions under section 401(k) or

professional employees as defined in

Complete this line as of the date

employee contributions and matching

Regulations section 1.410(b)-9.

entered in line 13c. If this plan has

contributions under section 401(m) may

been disaggregated into separate plans

Line 13e(3). Enter the number of

be made if the employee is currently

or restructured into component plans,

employees who do not receive an

eligible to make such elective or

attach a Demo 4 indicating how each

allocation or accrue a benefit under the

employee contributions, or to receive a

separate disaggregated plan or

plan only because they do not satisfy a

matching contribution, whether or not

restructured component plan satisfies

minimum hours of service requirement

the employee actually makes or

the nondiscrimination in amount

or a last-day-of-the-plan year

receives such contributions,

requirement of Regulations section

requirement, provided they do not have

(Regulations sections 1.401(k)-1(g)(4)

1.401(a)(4)-1(b)(2).

more than 500 hours of service, and

and 1.401(m)-1(f)(4)). However, do not

they are not employed on the last day

apply this rule to determine if an

If any restructured component plan

of the plan year. Do not enter on this

employee is to be counted as benefiting

or disaggregated plan relies on a

line any employees who have more

for lines 13i and 13k if, in accordance

nondesign-based safe harbor or a

than 500 hours of service, even if they

with the note following the instruction

general test, leave line 14c blank.

-4-

Instructions For Form 5310 - Application For Determination For Terminating Plan - Department Of Treasury Page 4

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