Form 14568-C - Model Vcp Compliance Statement Schedule 3 Seps And Sarseps Page 8

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Page 8
Plan name
EIN
Plan number
2) For failures to make required employer contributions and for failures to provide eligible employees with the
opportunity to make elective deferrals:
a) Computations in support of the corrective contribution amounts attributable to each participant. In the case of a
failure to provide eligible employees with the opportunity to make elective deferrals, please include
computations showing how the average deferral percentage, missed deferral and corrective contribution
amount was determined; and
b) Calculations showing how the earnings adjustment and the ultimate corrective contribution on behalf of
affected employees will be determined.
3) For failures involving the contribution of excess amounts:
a) Computations in support of the excess contribution amounts attributable to each participant, and
b) Calculations showing how the earnings adjustment and the ultimate corrective distribution amounts are
determined. (Please use estimates, including an estimated correction date, if corrective distributions have not
been made yet.)
● Explanations in support of requests for excise tax relief.
● Any other information that would be useful for the purpose of understanding the proposals made under the
submission.
● If the plan was not timely updated for EGTRRA, include a copy of the updated document that was adopted by the
plan sponsor.
14568-C
Catalog Number 66147U
Form
(Rev. 9-2017)

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