Form 14568-D - Model Vcp Compliance Statement Schedule 4 Simple Iras Page 3

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Page 3
Plan name
EIN
Plan number
C. Failure to Provide Eligible Employees with the Opportunity to Make Elective Deferrals.
The plan sponsor did not provide employee(s) who satisfied the applicable eligibility requirements with the opportunity
to make elective deferrals to the SIMPLE IRA plan. The failure occurred for the following plan year(s)
Description of the Proposed Method of Correction
The plan sponsor has contributed (or will contribute) additional amounts to the plan on behalf of each affected
employee. The corrective contribution will be made to compensate the affected employee(s) for the missed deferral
opportunity. The corrective contribution on behalf of each affected employee is equal to 50% of what the employee’s
deferral might have been had he or she been provided with the opportunity to make elective deferrals to the plan.
Since the employee’s deferral decision is not known, the deferral amount is estimated by assuming that the excluded
employee would have made an elective deferral equal to 3% of his or her compensation. (Example: N, a nonhighly
compensated employee was erroneously excluded from the plan. During the year of exclusion, N made $10,000 in
compensation. N’s missed deferral is estimated to be: 3% times $10,000 or $300. The required corrective contribution
on behalf of N, before adjusting for earnings, is 50% of $300 or $150). Thus, the required corrective contribution for an
employee who was erroneously excluded from making elective deferrals from a SIMPLE IRA plan is equal to 1.5% of
compensation (adjusted for earnings).
The total corrective contribution (before adjusting for earnings) on behalf of the affected employees for each plan
year is
Year
Corrective Contribution
The corrective contribution made on behalf of each affected employee will also be adjusted for earnings. Earnings will
be calculated from the date(s) that the contribution(s) should have been made through the date of the corrective
contribution. The corrective contribution (adjusted for earnings) will be made to each affected employee’s SIMPLE
IRA. If an affected employee does not have a SIMPLE IRA, a SIMPLE IRA will be established for that employee.
Earnings will be calculated on the basis of one of the following methods (check one)
Actual investment results of the affected employee’s SIMPLE IRA.
The interest rate incorporated in the VFCP Online Calculator, since the actual earnings of the affected employee’s
IRA cannot be ascertained.
Actual investment results for years in which data for the affected employee is available, and the rate incorporated
in the VFCP Online Calculator for years in which the actual investment results of the affected employee’s IRA
cannot be ascertained. The VFCP Online Calculator was or will be used for the following year(s)
14568-D
Catalog Number 66148F
Form
(Rev. 9-2017)

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