Form 5330 - Return Of Excise Taxes Related To Employee Benefit Plans

Download a blank fillable Form 5330 - Return Of Excise Taxes Related To Employee Benefit Plans in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 5330 - Return Of Excise Taxes Related To Employee Benefit Plans with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

5330
Return of Excise Taxes Related to Employee Benefit Plans
Form
(Under sections 4965, 4971, 4972, 4973(a)(3), 4975, 4976, 4977, 4978, 4979,
OMB No. 1545-0575
(Rev. December 2013)
4979A, 4980, and 4980F of the Internal Revenue Code)
Department of the Treasury
Information about Form 5330 and its instructions is at
Internal Revenue Service
Filer tax year beginning
,
and ending
,
A Name of filer (see instructions)
B Filer’s identifying number (Enter either the
EIN or SSN, but not both. See instructions.)
Employer identification number (EIN)
Number, street, and room or suite no. (If a P.O. box or foreign address, see instructions.)
City or town, state or province, country, and ZIP or foreign postal code
Social security number (SSN)
E Plan sponsor’s EIN
C Name of plan
D Name and address of plan sponsor
F Plan year ending (MM/DD/YYYY)
If this is an amended return, check here
G Plan number
H
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
Taxes. You can only complete one section of Part I for each Form 5330 filed (see instructions).
Part I
Section A. Taxes that are reported by the last day of the 7th month after the end of the tax
FOR
IRS
year of the employer (or other person who must file the return)
USE
ONLY
1
Section 4972 tax on nondeductible contributions to qualified plans (from Schedule A,
line 12) .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1
161
2
Section 4973(a)(3) tax on excess contributions to section 403(b)(7)(A) custodial accounts
(from Schedule B, line 12)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
164
3 a Section 4975(a) tax on prohibited transactions (from Schedule C, line 3) .
.
.
.
.
.
.
3a
159
b Section 4975(b) tax on failure to correct prohibited transactions .
.
.
.
.
.
.
.
.
.
3b
224
4
Section 4976 tax on disqualified benefits for funded welfare plans .
.
.
.
.
.
.
.
.
4
200
5 a Section 4978 tax on ESOP dispositions .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
5a
209
b The tax on line 5a is a result of the application of:
Sec. 664(g)
Sec. 1042
5b
Section 4979A tax on certain prohibited allocations of qualified ESOP securities or ownership
6
of synthetic equity .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
6
203
7
Total Section A taxes. Add lines 1 through 6. Enter here and on Part II, line 17 .
.
.
.
7
Section B. Taxes that are reported by the last day of the 7th month after the end of the employer’s tax year or 8
/
months
1
2
after the last day of the plan year that ends within the filer’s tax year
8 a Section 4971(a) tax on failure to meet minimum funding standards (from Schedule D, line 2) .
8a
.
163
b Section 4971(b) tax for failure to correct minimum funding standards .
8b
.
.
.
.
.
.
.
225
9 a Section 4971(f)(1) tax on failure to pay liquidity shortfall (from Schedule E, line 4)
.
.
.
.
9a
226
b Section 4971(f)(2) tax for failure to correct liquidity shortfall
.
.
.
.
.
.
.
.
.
.
.
9b
227
10 a Section 4971(g)(2) tax on failure to comply with a funding improvement or rehabilitation plan
(see instructions)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
10a
450
b Section 4971(g)(3) tax on failure to meet requirements for plans in endangered or critical
status (from Schedule F, line 1c)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
10b
451
c Section 4971(g)(4) tax on failure to adopt rehabilitation plan (from Schedule F, line 2d)
.
.
10c
452
Section B1. Tax that is reported by the last day of the 7th month after the end of the calendar year in which the excess
fringe benefits were paid to the employer’s employees
11
Section 4977 tax on excess fringe benefits (from Schedule G, line 4)
.
.
.
.
.
.
.
.
11
201
12
Total Section B taxes. Add lines 8a through 11. Enter here and on Part II, line 17 .
.
.
12
Section C. Tax that is reported by the last day of the 15th month after the end of the plan year
13
Section 4979 tax on excess contributions to certain plans (from Schedule H, line 2). Enter
here and on Part II, line 17
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
13
205
5330
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Form
(Rev. 12-2013)
Cat. No. 11870M

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 6