Form 5624 - Employee Benefit Plan Defined Benefit Plans Minimum Vesting Standards (Page 3 of 6) in pdf

Plan Reference

Yes No N/A

Is the value of the employee’s accrued benefit restored when the employee

repays the full amount of the distribution as provided by regulations? [2035]

Does the plan disregard service only for which an employee receives payment?

[2036]

Is the interest rate for valuing accrued benefits and determining the amount of

distributions specified by the plan? [2037, 2038]

For plans adopted or first effective on or after December 8, 1994 or if the plan is an

existing plan that is eligible to and has elected to amend for RPA ‘94, complete V.j. - l.

For all other plans, complete V.g. - i.

Does the plan satisfy the section 417 interest rate limitations as amended by

section 1139 of TRA ‘86? [2037, 2038]

Does the plan determine the section 417 interest rate limitation as of the date of

distribution or the first day of the plan year? [2039]

If the plan uses an interest rate in addition to the section 417 rate, does it provide

that the present value of vested accrued benefits and the amount of distributions will

be determined using the rate which results in the greatest benefit? [2040]

Does the plan satisfy the section 417 interest and mortality table limitations as

amended by section 767 of RPA ‘94? [2043, 2044]

Does the plan define the stability period and look-back period used to determine

the section 417 interest rate limitation? [2045]

If the plan uses an interest rate or mortality table in addition to the section 417

rate, does it provide that the present value of vested accrued benefits and the amount

of distributions will be determined using the rate which results in the greater benefit?

[2046]

m. Are immediate distributions, where the present value of the vested accrued

benefit has ever exceeded $5,000, precluded unless the participant consents? [2047]

VI. Vesting Schedule

At all times does the plan’s vesting schedule satisfy the requirements of a

particular one of the two minimum vesting schedules described in Code section

411(a)(2)(A) or (B), as amended by the TRA ‘86, for all years of service? [2042]

If a plan’s vesting schedule is changed by a plan amendment, does the new

vesting schedule satisfy any particular one of the vesting schedules described in Code

section 411(a)(2)(A) or (B) for all years of service? [2042]

VII. Accrued Benefits

Insured Plans

Is the plan funded exclusively with insurance contracts, satisfying the

requirements of Code section 412(i)? (If the answer is “Yes,” complete only

questions b.(i) and f. of this worksheet.)

5624

Form

(Rev. 12-98) (page 3)

Department of the Treasury - Internal Revenue Service

Form 5624 - Employee Benefit Plan Defined Benefit Plans Minimum Vesting Standards Page 3