Form 14568-B - Model Vcp Compliance Statement Schedule 2 Other Nonamender Failures And Failure To Adopt A 403(B) Plan Timely
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1
2Department of the Treasury - Internal Revenue Service
Model VCP Compliance Statement - Schedule 2:
14568-B
OMB Number
Form
Other Nonamender Failures and Failure to Adopt
1545-1673
(September 2017)
a 403(b) Plan Timely
Include the plan name, Applicant’s EIN and plan number on each page of the compliance statement, including attachments.
Plan name
EIN
Plan number
Section I - Identification of Failures
A. Qualified Plans: The plan identified above was not amended to comply with the applicable provisions of the following
legislative and regulatory requirements by the applicable deadlines in accordance with Internal Revenue Code (IRC)
Section 401(b) and the regulations thereunder:
The Tax Reform Act of 1986 (TRA ’86)
The Unemployment Compensation Amendments of 1992 (UCA)
The Omnibus Budget Reconciliation Act of 1993 (OBRA)
GUST (includes the Uruguay Round Agreements Act, the Uniformed Services Employment and Reemployment
Rights Act of 1994, the Small Business Job Protection Act of 1996, the Taxpayer Relief Act of 1997, the Internal
Revenue Service Restructuring and Reform Act of 1998 and the Community Renewal Tax Relief Act of 2000)
The changes required by the 2004 Cumulative List (Notice 2004-84) for an eligible employer using a pre-approved
defined contribution plan who failed to adopt the pre-approved plan by April 30, 2010, as required by
Announcement 2008-23.
The changes required by the 2005 Cumulative List (Notice 2005-101) for Cycle A individually designed plans.
The changes required by the 2006 Cumulative List (Notice 2007-3) for Cycle B individually designed plans, and any
eligible employer using a pre-approved defined benefit plan who failed to adopt the pre-approved plan by April 30,
2012, as required by Announcement 2010-20).
The changes required by the 2007 Cumulative List (Notice 2007-94) for Cycle C individually designed plans.
The changes required by the 2008 Cumulative List (Notice 2008-108) for Cycle D individually designed plans.
The changes required by the 2009 Cumulative List (Notice 2009-98) for Cycle E individually designed plans.
The changes required by the 2010 Cumulative List (Notice 2010-90) for Cycle A individually designed plans and
any eligible employer using a pre-approved defined contribution plan who failed to adopt the pre-approved plan by
April 30, 2016, as required by Announcement 2014-16).
The changes required by the 2011 Cumulative List (Notice 2011-97) for Cycle B individually designed plans.
The changes required by the 2012 Cumulative List (Notice 2012-76) for Cycle C individually designed plans.
The changes required by the 2013 Cumulative List (Notice 2013-84) for Cycle D individually designed plans.
The changes required by the 2014 Cumulative List (Notice 2014-77) for Cycle E individually designed plans.
The changes required by the 2015 Cumulative List (Notice 2015-84) for Cycle A individually designed plans.
Amendments required as a condition for a favorable determination letter. If this item was selected answer the
following questions by checking the applicable boxes:
Is this the sole failure for the VCP submission?
Yes
No
Were the amendments signed within three months of the expiration of the remedial amendment period for adopting
Yes
No
the amendments?
14568-B
Catalog Number 66146J
Form
(Rev. 9-2017)
For Paperwork Reduction Act information see current EPCRS Revenue Procedure.
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