Form 886-A - Explanation Of Items - Department Of Treasury

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Internal Revenue Service
Department of the Treasury
Taxpayer Identification Number:
Date:
Plan Name:
Plan Number:
Form:
5500-EZ
Plan Year Ending:
Person to Contact/ID Number:
Contact Telephone Number:
Fax Number:
Dear Taxpayer:
This letter constitutes a compliance check. A compliance check is not an audit or investigation under
Internal Revenue Code (IRC) Section 7605(b) or an audit under Section 530 of the Revenue Act of 1978.
This letter is being sent to you because our records indicate you have either an unpaid minimum required
contribution or funding deficiency, as reported on the return referenced above.
Please provide the information requested in the attached Form 886-A, Explanation of Items, within 20 days
of the date of this letter. Failure to provide the information regarding the unpaid minimum required
contribution or funding deficiency could result in further action or an examination of your plan. You may
also furnish any other documents or clarifying materials that you believe will be helpful for us to review.
If you would like someone to represent the plan during the compliance check, you must submit a written
power of attorney. Form 2848, Power of Attorney and Declaration of Representative, may be used for this
purpose. This form may be obtained at
You may fax your response to the above referenced fax number or mail it to the address shown above.
Include a daytime telephone number where you can be reached and the best time to contact you. You may
obtain more information about the Employee Plans Compliance Unit (EPCU), compliance checks, our
current compliance projects, and a list of frequently asked questions by visiting our website at
If you have questions, please contact me at the telephone number shown above during the
times referenced.
Thank you for your cooperation.
Sincerely,
Enclosure:
Form 886-A, Explanation of Items
Letter 1562-G (Rev. 6-2011)
Catalog Number 51661J

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