Form 5304-Simple - Savings Incentive Match Plan For Employees Of Small Employers (Simple) - Not For Use With A Designated Financial Institution Page 2
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Form 5304-SIMPLE (Rev. 3-2012)
Page
Article IV—Other Requirements and Provisions
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Contributions in General. The Employer will make no contributions to the SIMPLE IRAs other than salary reduction contributions (described in
Article III, item 1) and matching or nonelective contributions (described in Article III, items 2a and 2b).
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Vesting Requirements. All contributions made under this SIMPLE IRA plan are fully vested and nonforfeitable.
No Withdrawal Restrictions. The Employer may not require the employee to retain any portion of the contributions in his or her SIMPLE IRA
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or otherwise impose any withdrawal restrictions.
Selection of IRA Trustee. The Employer must permit each eligible employee to select the financial institution that will serve as the trustee,
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custodian, or issuer of the SIMPLE IRA to which the Employer will make all contributions on behalf of that employee.
Amendments To This SIMPLE IRA Plan. This SIMPLE IRA plan may not be amended except to modify the entries inserted in the blanks or
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boxes provided in Articles I, II, III, VI, and VII.
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Effects Of Withdrawals and Rollovers
a
An amount withdrawn from the SIMPLE IRA is generally includible in gross income. However, a SIMPLE IRA balance may be rolled over or
transferred on a tax-free basis to another IRA designed solely to hold funds under a SIMPLE IRA plan. In addition, an individual may roll over or
transfer his or her SIMPLE IRA balance to any IRA or eligible retirement plan after a 2-year period has expired since the individual first
participated in any SIMPLE IRA plan of the Employer. Any rollover or transfer must comply with the requirements under section 408.
b If an individual withdraws an amount from a SIMPLE IRA during the 2-year period beginning when the individual first participated in any
SIMPLE IRA plan of the Employer and the amount is subject to the additional tax on early distributions under section 72(t), this additional tax is
increased from 10% to 25%.
Article V—Definitions
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Compensation
a
General Definition of Compensation. Compensation means the sum of the wages, tips, and other compensation from the Employer subject
to federal income tax withholding (as described in section 6051(a)(3)), the amounts paid for domestic service in a private home, local college
club, or local chapter of a college fraternity or sorority, and the employee’s salary reduction contributions made under this plan, and, if
applicable, elective deferrals under a section 401(k) plan, a SARSEP, or a section 403(b) annuity contract and compensation deferred under a
section 457 plan required to be reported by the Employer on Form W-2 (as described in section 6051(a)(8)).
b Compensation for Self-Employed Individuals. For self-employed individuals, compensation means the net earnings from self-employment
determined under section 1402(a), without regard to section 1402(c)(6), prior to subtracting any contributions made pursuant to this plan on
behalf of the individual.
Employee. Employee means a common-law employee of the Employer. The term employee also includes a self-employed individual and a
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leased employee described in section 414(n) but does not include a nonresident alien who received no earned income from the Employer that
constitutes income from sources within the United States.
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Eligible Employee. An eligible employee means an employee who satisfies the conditions in Article I, item 1 and is not excluded under
Article I, item 2.
SIMPLE IRA. A SIMPLE IRA is an individual retirement account described in section 408(a), or an individual retirement annuity described in
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section 408(b), to which the only contributions that can be made are contributions under a SIMPLE IRA plan and rollovers or transfers from
another SIMPLE IRA.
Article VI—Procedures for Withdrawals (The Employer will provide each employee with the procedures for withdrawals
of contributions received by the financial institution selected by that employee, and that financial institution’s name and
address (by attaching that information or inserting it in the space below) unless: (1) that financial institution’s procedures
are unavailable, or (2) that financial institution provides the procedures directly to the employee. See Employee
Notification in the instructions.)
Article VII—Effective Date
This SIMPLE IRA plan is effective
. See
instructions.
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Name of Employer
By:
Signature
Date
Address of Employer
Name and title
5304-SIMPLE
Form
(Rev. 3-2012)
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