Form 5306-A - Application For Approval Of Prototype Simplified Employee Pension (Sep) Or Savings Incentive Match Plan For Employees Of Small Employers (Simple Ira Plan) Page 2

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2
Form 5306-A (Rev. 8-2013)
Page
Part III
SIMPLE IRA Plan Information
Plan Article or
Plan
For
Attach a copy of the SIMPLE IRA plan documents and indicate the article or section and the page
number where the following provisions appear. If an item does not apply, enter “N/A.” Sample
IRS Use
Section
Page
language, or a listing of required modifications (LRMs), is available on the IRS website at IRS.gov.
Reference
Number
Only
Type “LRM” in the search box. Sponsors are encouraged to use LRM language.
10a Does the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
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b Does the plan limit adoption to employers that have 100 or less employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
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c Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
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d Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
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e Does the plan cover all employees except those that may be excluded under
section 408(p)(4)? .
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f
Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
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g Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
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h Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
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Is the interest of an eligible employee in the plan nonforfeitable at all times? .
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Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
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k Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
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Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
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m Unless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
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n If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
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o Does the plan define “compensation” as described in section 408(p)(6)(A)? .
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p Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
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q Does the plan prohibit restrictions on withdrawals? .
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Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
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18
5306-A
Form
(Rev. 8-2013)

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