Form 14035 - Pilot Questionnaire For Governmental Plans Initiative Page 6
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24Pilot Questionnaire for Governmental Plans Initiative
6.
Indicate the type of plan:
Defined Contribution
Defined Benefit
Hybrid Defined Benefit
A defined contribution plan is a plan that allocates all employer and employee contributions to separate
participant accounts and the ultimate benefit a participant receives is based upon that account balance. A
defined benefit plan provides for the payment of definitely determinable benefits for employees or their
beneficiaries over a period of years, usually for life, after retirement based on a specific formula in the plan.
A hybrid plan refers to a type of defined benefit plan that has attributes of both a defined benefit and a
defined contribution plan. For purposes of this questionnaire, the term hybrid plan means a plan under
which normal and early retirement benefits are primarily based on a hypothetical account balance and
credited interest.
7.
The Internal Revenue Service (IRS), Department of Labor (DOL), and the Pension Benefit Guaranty
Corporation (PBGC) have issued rulings on whether a plan or system is a "governmental plan" (i.e.,
whether the plan is sponsored by an organization which may sponsor a governmental plan). These rulings
should be distinguished from a "determination letter" which is the subject of question 15. A determination
letter is available to any qualified plan, whether or not characterized as a "governmental plan" and relates
solely to whether that plan satisfies the applicable tax-qualification requirements. The following questions
relate solely to rulings on whether your Plan or System is a governmental plan.
Has your Plan or System ever received (check all that apply and show the date of the letter):
A letter ruling issued by the IRS that it is a governmental plan under section 414(d) of the Code;
Date
(Use mm/dd/yyyy)
An advisory opinion issued by DOL that it is a governmental plan under section 3(32) of ERISA;
Date
(Use mm/dd/yyyy)
An administrative determination or opinion letter issued by the PBGC that it is a governmental plan
under section 4021(b) of ERISA
Date
(Use mm/dd/yyyy)
If your Plan or System has received such a letter, did the letter apply to the:
Plan
System
8.
Give the following information about the employers that participate in the Plan:
Are the employers that participate in the Plan:
a.
State employers only
Local employers only
Both state and local employers
Other
(please explain):
b. Attach a list of the employers that participate in the Plan.
14035
Form
(Rev. 02-2009)
Catalog Number 52098A
Page 6
Department of the Treasury - Internal Revenue Service
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