Form 5300 Draft - Application For Determination For Employee Benefit Plan Page 6
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125
Form 5300 (Rev. 2-2011)
Page
7
(continued)
j
(i) If line 7h is “Yes,” enter the EIN of the employer submitting the lead plan.
(ii) If line 7h is “Yes,” enter the plan number of the lead plan.
k
Is this a multi-employer plan as described in section 414(f)?
l
Is this a request for a ruling under section 401(h) or section 420?
m
Is this considered a foreign plan or is the trust a foreign trust?
If 7f, 7g, 7h, 7k, 7l, or 7m is “Yes,” see instructions.
Yes
No
Do you maintain any other qualified plan(s) under section 401(a)? If “Yes,” attach required statement per
8a
instructions. If “No,” skip to line 8d.
Do you maintain another plan of the same type (for example, both this plan and the other plan are defined
b
contribution plans or both are defined benefit plans) that covers non-key employees who are also covered under
this plan?
If “Yes,” when the plan is top-heavy, do the non-key employees covered under both plans receive the required
top-heavy minimum contribution or benefit under (see instructions):
(1) This plan?
(2) The other plan?
If this is a defined contribution plan, do you maintain a defined benefit plan (or if this is a defined benefit plan, do
c
you maintain a defined contribution plan) that covers non-key employees who are also covered under this plan?
If “Yes,” when the plan is top-heavy, do the non-key employees covered under both plans receive (see instructions):
(1) The top-heavy minimum benefit under the defined benefit plan?
(2) At least a 5% minimum contribution under the defined contribution plan?
(3) The minimum benefit offset by benefits provided by the defined contribution plan?
(4) Benefits under both plans that, using a comparability analysis, are at least equal to the minimum benefit?
Does the plan prevent the possibility that the section 415 limitations will be exceeded for any employee who is
d
(or was) a participant in this plan and any other plan of the employer?
5300
Form
(Rev. 2-2011)
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