Form 5307 - Application For Determination For Adopters Of Modified Volume Submitter Plans Page 3
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63
Form 5307 (Rev. 6-2014)
Page
4a Name of plan (Plan name cannot exceed 70 characters, including spaces.)
b Enter 3-digit plan number
c Enter the month on which the plan year ends (MM)
d Enter plan’s original effective date
e Enter number of participants
(If 100 or less, go to line 4f. Otherwise, go to line 5a.)
Yes
No
Does the plan sponsor have no more than 100 employees who received at least $5,000 of compensation for
f
the preceding year?
If "Yes," go to line 4g.
If "No," go to line 5a.
g
Is at least one employee a nonhighly compensated employee?
Indicate the type of plan by entering the number from the list below.
5 a
(Use the lowest number from the list below applicable to the plan.)
1 — defined benefit but not cash balance
3 — money purchase
5 — 401(k)
2 — cash balance
4 — target benefit
6 — profit sharing plan
Yes
No
b
If the response to 5a was "1," "2," "3," or "4," was the plan's normal retirement age below 62 any time after
May 22, 2007?
If "Yes," file Form 5300.
If "No," go to line 6a.
Is the plan sponsor a member of an affiliated service group, controlled group of corporations, or a group of
6 a(1)
trades or businesses under common control within the meaning of section 414(b), (c), or (m)?
If "Yes," attach the required statement.
a(2)
Is the plan sponsor a foreign entity or is the plan sponsor a member of an affiliated service group, controlled
group of corporations, or a group of trades or businesses under common control within the meaning of section
414(b) or (c) that includes a foreign entity?
b
Is this a governmental plan under section 414(d)?
c(1)
Is this a church plan under section 414(e)?
If "Yes," go to line 6(c)(2).
If "No," go to line 6d.
Was an election made by the church to have participation, vesting, funding, etc. provisions apply in accordance
c(2)
with section 410(d)? If "No," file Form 5300.
d
Does this plan benefit any collectively bargained employees under Regulations section 1.410(b)-6(d)(2)?
e
Is this an insurance contract plan under section 412(e)(3)?
7
Have interested parties been given the required notification of this application?
5307
Form
(Rev. 6-2014)
*11832Y06201403*
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