Form 14568-C - Model Vcp Compliance Statement Schedule 3 Seps And Sarseps Page 6

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Page 6
Plan name
EIN
Plan number
Description of the Proposed Method of Correction (check all correction methods that apply)
Distribution of excess elective deferrals (SARSEPs only)
The plan sponsor has effected (or will effect) a corrective distribution of the excess amounts, adjusted for
earnings through the date of correction, to the affected participant(s). The earnings adjustment will be based on
the actual rates of return of the participant’s SARSEP IRA from the date(s) that the excess deferrals were made
through the date of correction.
Affected participants were (or will be) informed that the corrective distribution of an excess amount is not eligible
for favorable tax treatment accorded to distributions from a SARSEP and, specifically, is not eligible for tax-free
rollover.
The total corrective distribution (before adjusting for earnings) for each affected year is as follows:
Year
Corrective Distribution
Number of Participants Affected
Distribution of excess employer contributions
The plan sponsor has effected (or will effect) the return of excess employer contributions, adjusted for earnings
through the date of correction, to the plan sponsor. The earnings adjustment will be based on the actual rates of
return of the SEP or SARSEP from the date(s) that the excess employer contributions were made through the
date of correction. The amount returned to the plan sponsor is not includible in the gross income of the affected
participant(s). The plan sponsor is not entitled to a deduction for the excess employer contributions. The amount
returned is reported on Form 1099-R as a distribution issued to the affected participant(s), indicating the taxable
amount as zero.
The amount to be returned to the plan sponsor (before adjusting for earnings) for each affected year is
Year
Return of Excess Employer Contributions
Number of Participants Affected
F. Written Arrangement Not Timely Updated for Tax Law Changes
The SEP or SARSEP plan was not timely updated for tax law changes associated with the Economic Growth and
Tax Relief Reconciliation Act of 2001 (EGTRRA) as required by Revenue Procedure 2002-10.
Description of Proposed Method of Correction
The plan sponsor has adopted a new version of the SEP or SARSEP plan that includes the EGTRRA tax law changes
retroactive to 2002. A copy of the signed and dated plan is enclosed with this VCP submission.
14568-C
Catalog Number 66147U
Form
(Rev. 9-2017)

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