Form 14568-I - Model Vcp Compliance Statement Schedule 9 Limited Safe Harbor Correction By Plan Amendment Page 4

Download a blank fillable Form 14568-I - Model Vcp Compliance Statement Schedule 9 Limited Safe Harbor Correction By Plan Amendment in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 14568-I - Model Vcp Compliance Statement Schedule 9 Limited Safe Harbor Correction By Plan Amendment with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

Page 4
Plan name
EIN
Plan number
Who had completed the plan’s minimum age or service requirements were treated as eligible participants prior to
the applicable plan entry date and were entitled to the same benefits under the plan to which they would have
been entitled had they entered the plan timely.
The plan’s minimum age or service requirements and plan entry date, as applicable, for the years of the failure were
Enter the plan years in which the failure occurred and the number of participants affected by the failure, broken down
by type of employee (HCE or NHCE) respectively, for each plan year.
Number of NHCEs Affected by
Number of HCEs Affected by
Plan Year
the Failure During the Plan Year
the Failure During the Plan Year
Description of the Proposed Correction Method
The failure was (or will be) corrected by having the plan sponsor retroactively amend the plan to provide for the
inclusion of the ineligible employees. The effective date of the corrective amendment is
.
Section II - Change in Administrative Procedures
Include an explanation of how and why the failures arose and a description of the measures that will be (or have
been) implemented to ensure that the same failures will not recur.
14568-I
Catalog Number 66156F
Form
(Rev. 9-2017)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 5