Instructions For Form 5310 - Application For Determination For Terminating Plan - Department Of Treasury Page 5

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Line 14a. Check ‘‘Yes’’ if the plan is
the conditions necessary to receive
substantially equal payments (either
intended to satisfy the permitted
such benefits. See section 411(d)(6)
alone or in conjunction with other
disparity requirements of section 401(I).
and Regulations section 1.411(d)-3 and
benefit payments) over the life of the
Rev. Rul. 85-6, 1985-1 C.B. 133.
participant.
Line 14b. To satisfy section 401(l), a
plan must provide that the overall
Line 17d. Answer ‘‘Yes’’ if any funds
Line 17l. Section 416 provides that
permitted disparity limits are not
were contributed in the form of, or
plan participants in a top-heavy plan
invested in, obligations or property of
exceeded and specify how
who are non-key employees must
employer-provided contributions or
the employer (including any entity
accrue a minimum benefit or receive a
related to the employer under section
benefits under the plan are adjusted, if
minimum contribution.
necessary, to satisfy the overall
414(b) or 414(c)).
Line 17m. If ‘‘Yes’’ is checked, attach a
permitted disparity limits. See
Line 17f. If there is a contribution
list for each plan with the following
Regulations section 1.401(l)-5.
receivable that the employer intends to
information:
make by the required due date for
Line 14e. Plans that use a
1. Name of plan,
section 412, and no funding deficiency
nondesign-based safe harbor or a
2. Type of plan,
general test to satisfy section 401(a)(4)
will exist after the contribution is made,
3. Plan number, and
this line should be answered ‘‘No.’’
for the year of termination must attach
4. Indicate if another application is
a Demo 6 (see Guidelines for
simultaneously being submitted with
Line 17h(1). Provide a description of
Demonstrations) unless: (1) the plan
the transaction(s) and attach a
this application.
has received a favorable determination
statement which must include the:
regarding the nondesign-based safe
Line 18. Complete this only for defined
1. Name(s) of the sponsor(s)
harbor or general test in the 3 years
contribution plans. Enter the date of the
involved,
preceding the date of termination, and
current plan year and the prior 5
2. Employer identification number(s)
(2) the plan has not experienced a
plan-years in the columns indicated.
of the sponsor(s),
material change in the facts (including
Line 18b. Enter the amount of
3. Plan administrator’s name(s) and
benefits provided and employee
forfeitures for each of the plan years
EIN, and
demographics) on which the
entered. If these forfeitures resulted
4. Plan name(s) and plan numbers.
determination was based.
from a cashout for a year not listed on
Line 15a(4). A dropped participant
Line 17h(4)(A). All plan liabilities must
line 15a, attach a statement indicating
means any participant who has
be satisfied before assets can revert to
the year of the cashout.
terminated employment even if their
the employer upon termination of the
Line 18c. Enter the amount of
benefits have not been distributed.
plan. All liabilities will not be satisfied if
transfers and rollovers received from
the value of retirement-type subsidies
Line 15a(6). Enter the number of
qualified plans (under section 401(a)
are not provided participants who, after
participants separated from vesting
and/or conduit IRAs) for each of the
the date of the proposed termination,
service with less than 100% vesting in
plan years entered.
satisfy certain pre-termination
their accrued benefit or account
Line 19. Check the box or boxes that
conditions necessary to receive such
balance.
indicate the form(s) of distribution of
benefits. See section 401(a)(2),
Line 15b. Attach a schedule with the
benefits for your plan upon termination.
Regulations section 1.401-2(a)(1) and
following information for each
Submit a statement that all distributions
Rev. Rul. 85-6.
participant who has separated from
have been or will be made in
Line 17h(4)(B). The annuity contracts
vesting service with less than 100%
accordance with plan provisions and
purchased must be guaranteed for
vesting:
proper spousal consents will be
each participant. However, in order to
1. Name of participant,
secured, when applicable.
maintain qualification of a continuing
2. Date of hire,
Line 20. Complete the statement
pension plan, the contracts covering
3. Date of termination,
showing the estimated fair market value
participants’ accrued benefits in the
4. Years of participation,
of the plan assets and liabilities as of
plan must not be distributed except in
5. Vesting percentage,
the proposed date of termination or the
accordance with Regulations section
6. Account balance/account benefit
latest valuation date.
1.401-1(b)(1)(i).
at the time of separation from service,
Include and clearly identify all
Line 17h(7). Answer ‘‘Yes’’ if your plan
7. Amount of distribution,
liabilities (other than liabilities for benefit
is a defined benefit plan and you intend
8. Date of distribution, and
payments due after the date of plan
that any or all of your participants will
9. Reason for termination.
termination) that are unpaid as of the
be covered by a new or existing defined
proposed termination date or that are
If there is a 20% reduction in
benefit plan of the employer.
paid or payable from plan assets after
participants, explain why this would not
Line 17h(10). If the answer to this item
the proposed date of plan termination
constitute a partial termination.
is ‘‘Yes,’’ attach a list that includes the:
under the provisions of the plan.
Line 17b. Regulations section
1. Name(s) of the plan sponsor(s),
Liabilities include expenses, fees, other
1.401(a)-20, Q&A-2 provides, in part,
2. Employer or sponsor’s EINs,
administrative costs, and benefit
that the requirements of sections
3. Administrator’s identification
payments due and not paid before the
401(a)(11) and 417 apply to the
number(s),
proposed termination date or latest
payments under annuity contracts, not
4. Plan number(s), and
valuation date.
to the distributions of annuity contracts.
5. An explanation of the
Line 20c(4). Include investment
Line 17c. The accrued benefits of a
termination(s) including:
securities issued by a corporate entity
plan participant may not be reduced on
a. The amount(s) of the
at a stated interest rate repayable on a
plan termination. A plan amendment
reversion(s),
particular future date such as most
(including an amendment terminating a
b. The date(s) of termination, and
bonds, debentures, convertible
plan) that effectively eliminates or
c. The reason(s) for termination.
debentures, commercial paper and zero
reduces an early retirement benefit or a
coupon bonds. Do not include debt
retirement type subsidy for benefits
Line 17j. For this question only,
securities of governmental units or
attributable to pre-amendment service
‘‘single-sum distribution’’ will mean a
municipalities.
is treated as reducing the accrued
single payment of the value of a
benefit of a participant if subsequent to
participant’s benefits or a series of
Line 20c(7)(A). Include the current
termination the participant could satisfy
payments that do not provide
value of real property owned by the
-5-

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