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By telephone — Call 1-800-829-4933.

Note. If any amendments that are

2. Retirees and other former

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By mail or fax — Send in a completed

submitted predate the last favorable

employees who have a nonforfeitable

Form SS-4, Application for Employer

determination letter, they will not be

right to benefits under the plan, and

Identification Number. Form SS-4 can

ruled on. Also, if any amendments are

3. The beneficiary of a deceased

be obtained by calling 1-800-829-3676.

made while the application is pending,

employee who is receiving or will in the

it is recommended that you contact the

future receive benefits under the plan.

The plan of a group of entities

Service to associate the amendment(s)

Include one beneficiary for each

required to be combined under section

with the current application. See Rev.

deceased employee regardless of the

414(b), (c), or (m) whose sponsor is

Proc. 2008-6, which is on page 192 of

number of individuals receiving

more than one of the entities required

Internal Revenue Bulletin 2008-1 at

benefits. Payment of a deceased

to be combined should only enter the

employee’s benefit to three children is

EIN of one of the sponsoring members.

considered a payment to one

Line 3i. Section 3001 of ERISA

This EIN must be used in all

beneficiary.

requires the applicants subject to

subsequent filings of determination

section 410 to provide evidence that

letter requests and annual returns/

Line 5. Cash balance plan. For this

each employee who qualifies as an

reports unless there is a change of

purpose, a ‘‘cash balance’’ formula is a

interested party has been notified of the

sponsor.

benefit formula in a defined benefit plan

filing of the application. If “Yes” is

Line 1k. Enter the two digits

by whatever name (for example,

checked, it means that each employee

representing the month the employer’s

personal account plan, pension equity

has been notified as required by

tax year ends. This is the employer

plan, life cycle plan, cash account plan,

Regulations section 1.7476-1. If this is

whose EIN was entered on line 1h.

etc.) that rather than, or in addition to,

a one-person plan or if this plan is not

expressing the accrued benefit as a life

Line 2. The contact person will receive

subject to section 410, a copy of the

annuity commencing at normal

copies of all correspondence as

notice is not required to be attached to

retirement age, defines benefits for

authorized in a Power of Attorney and

this application. If “No” is checked or

each employee in terms more common

Declaration of Representative, Form

this line is blank, your application will

to a defined contribution plan such as a

2848, or Tax Information Authorization,

be returned.

single sum distribution amount (for

Form 8821. Either complete the

Rules defining “interested parties”

example, 10 percent of final average

contact’s information on this line, or

and the form of notification are in

pay times years of service, or the

check the box and attach a power of

Regulations section 1.7476-1. For an

amount of the employee’s hypothetical

attorney or other written designation.

example of an acceptable format, see

account balance). Use Form 5300

Line 3a. Enter the number(s) that

Rev. Proc. 2008-6, which is on page

rather than Form 5307, to request a

correspond to the request(s) being

192 of Internal Revenue Bulletin 2008-1

letter for a cash balance plan.

made.

Lines 6a and 6b. If the plan employer

Enter 1 if the IRS has not issued a

Line 3n. Even if a ruling is not being

is a member of a controlled group of

determination letter for this plan.

requested on Schedule Q, Demo 8,

corporations, trades or businesses

submit a copy of the pertinent plan

Enter 2 if the IRS has previously

under common control, or an affiliated

provisions regarding the offset.

issued a determination letter for this

service group, all employees of the

plan.

Line 4a. Due to space restrictions, this

group will be treated as employed by a

field is limited to 70 characters,

Enter 3 if this is a standardized plan.

single employer for purposes of certain

including spaces. Please complete this

For additional guidance see Section 19

qualification requirements.

item with how the plan name should

of Rev. Proc. 2005-16, which is on

Attach a statement showing in detail:

read on the determination letter to the

page 674 of Internal Revenue Bulletin

extent permitted. Due to this restriction,

1. All members of the group,

2005-10 at

2. The relationship of each member

please keep in mind that “Employees”

irb05-10.pdf.

to the plan sponsor,

and “Trust” are not necessary in the

Line 3c. If more than four

3. The type(s) of plan(s) maintained

plan name.

amendments, list amendments on a

by each employer, and

Line 4b. Enter the three-digit number,

separate piece of paper using the same

4. Plans common to all members.

beginning with ‘‘001’’ and continuing in

format as shown on form and label it as

numerical order for each plan you

an attachment to line 3c.

If you want to apply for a

adopt (001-499). This numbering will

Line 3d. Enter the date(s) the

TIP

determination letter to determine

differentiate your plans. The number

amendment(s) was signed. If an

if you are a member of an

assigned to a plan must not be

amendment is proposed, enter “09/09/

affiliated service group, file Form 5300

changed or used for any other plan.

9999.”

instead of Form 5307.

This should be the same number that

Line 3e. Enter the effective date(s) of

was or will be used when the Form

Line 7d. Answer this ‘‘Yes’’ if you

each amendment listed in line 3d. The

5500 or Form 5500-EZ is filed for the

have selected any choice labeled

term “date amendment effective”

plan.

‘‘Other’’ in the adoption agreement.

means the date the amendment

Line 4c. Plan month means the

becomes operative or takes effect.

Line 8f. If the plan has been involved

two-digit (mm) calendar, policy, or fiscal

in a merger, attach a statement which

Line 3f. If you do not have a copy of

month on which the records of the plan

provides the following:

the latest determination letter, or if no

are kept.

determination letter has ever been

1. Name of plan,

Line 4e. Enter the total number of

received by the employer, submit

2. Type of plan(s) involved,

participants. A “participant” means:

copies of the initial plan (or adoption

3. Date(s) of merger(s),

agreement along with the appropriate

1. The total number of employees

4. Verification that each plan

opinion or advisory letter), or the latest

participating in the plan including

involved was qualified at the time of

plan (or adoption agreement along with

employees under a section 401(k)

merger (copy of prior DL, if any,

the appropriate opinion or advisory

qualified cash or deferred arrangement

otherwise provide a signed and dated

letter), and any subsequent

who are eligible but do not make

copy of the most recent restatement

amendments and/or restatements.

elective deferrals,

and subsequent amendments).

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Instructions For Form 5307 - Application For Determination For Adopters Of Master Or Prototype (M&p) Or Volume Submitter (Vs) Plans Page 3

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