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Form 5300 (Rev. 12-2013)
Page
Procedural Requirements Checklist
Use this list to ensure that your submitted package is complete. Failure to supply the appropriate information may result in a delay in
the processing of the application.
Yes
No
1.
Is Form 8717, User Fee for Employee Plan Determination Letter Request, attached to your submission?
2.
Is the appropriate user fee for your submission attached to Form 8717?
If appropriate, is Form 2848, Power of Attorney and Declaration of Representative, Form 8821, Tax Information
3.
Authorization, or a privately designed authorization attached? (For more information, see the Disclosure
Request by Taxpayer in the instructions and Rev. Proc. 2013-4, 2013-1 I.R.B. 126, updated annually.)
4.
Is a copy of your plan’s latest DL, if any, attached?
5.
Have you included a copy of the plan, trust, and all amendments adopted or effective during the current RAC?
6.
Is the EIN of the plan sponsor/employer (NOT the trust’s EIN) entered on line 1f?
7.
If you are requesting a determination for an ASG Status, have you included the information requested in the instructions?
8.
For Partial Termination Requests: Have you included the required information as specified in the instructions?
9.
If line 3g is “Yes” and does not meet one of the exceptions, have you attached an explanation of why the Form 5300 is being filed?
10.
If line 5b (2) is “Yes,” is the required statement attached?
11.
If you answered “Yes” to line(s) 6a, have you included the information requested in the instructions?
12.
For Multiple Employer Plans: Have you included the required information as specified in the instructions?
13.
Have interested parties been given the required notification of this application? Make sure line 7 is completed.
14.
If line 12 is “Yes,” have you attached the required statement?
15.
If line 14 is “Yes,” have you attached the required statement?
16.
If line 15b is “No,” have you attached the required statement?
17.
If line 16a is “Yes,” have you attached the required statement?
18.
If line 17 is “Yes,” have you attached the required statement?
19.
If line 18 is “No,” have you attached the required statement?
20.
If line 19 is ”Yes,” have you attached the required statement?
21.
Is the application signed and dated? (Stamped signatures are not acceptable; see Rev. Proc. 2013-4 updated annually.)
5300
Form
(Rev. 12-2013)
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