Form 4461-A - Application For Approval Of Master Or Prototype Or Volume Submitter Defined Benefit Plan Page 2
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122
Form 4461-A (Rev. 3-2008)
Page
Yes
No
9
Procedural requirements:
a If this is an initial request, have the following been submitted as required by instructions—
(1)
Adoption agreement?
(2) Copy of plan?
(3)
Copy of trust indenture or custodial agreement?
b
Amended or restated plans:
(1) If the amendment is not incorporated into the plan document, have the following been submitted?
(a)
A copy of the amendment?
(b)
A description of the amendment and its effect on the plan?
(c)
A working copy of the plan currently in effect?
(2) If the amendment is incorporated into the plan document, has a copy of the restated plan with
amendments highlighted been submitted?
(3) For all M&P sponsors and those VS practitioners who are choosing to include a provision in their specimen
plans that allows them to amend on behalf of their adopting employers, will you advise those employers
who cannot or do not adopt the amended or restated plan providing for such authority, that they may
not continue to participate under the M&P plan or the VS plan?
c
Is the plan and trust (or custodial agreement) patterned after and substantially the same as another plan and
trust (or custodial agreement) on which a favorable letter has been received? (If “Yes,” see specific
instructions.)
d
Non-mass submitter request (M&P complete (1) and (2). VS complete (3)):
(1)
Do you have at least 30 employer-clients which are reasonably expected to adopt this plan’s basic plan
document and one or more of the adoption agreements associated with this basic plan document? If
“No,” complete (2)
(2)
If “No” to (1), enter the file folder number of the basic plan document for which the requisite number of
adopting employer-clients requirement is met:
If you are a VS (non-mass submitter) practitioner, do you have at least 30 employer-clients reasonably
(3)
expected to adopt a plan that is substantially similar to the VS practitioner specimen plan?
e
Mass submitter or national sponsor request (M&P mass submitter complete (1), (2) and (3); VS mass submitter
complete (4); national sponsor complete (5)):
Are applications on behalf of the requisite number of sponsors who are adopting the same basic plan
(1)
document on a word-for-word identical basis included? If “No,” complete (2)
(2)
If “No,” to (1), enter the file folder number of the basic plan document for which the requisite number of
adopting sponsors requirement is met:
(3)
If this is a flexible plan, answer (a) and (b):
(a)
Have you bracketed and identified the optional provisions of the plan?
(b)
Have you included a copy of the written representation describing the choices available to
sponsoring organizations and the coordination of optional provisions?
(4)
For a VS mass submitter, are applications on behalf of at least 30 unaffiliated practitioners sponsoring
the same specimen plan on a word-for-word identical basis included?
If this is a national sponsor request, do you maintain a list of: (a) 30 or more adopting employers in each
(5)
of 30 or more states, or (b) 3,000 or more adopting employers that have adopted any master or prototype
plan of the sponsor or any VS specimen plan of the practitioner which has a GUST opinion or advisory
letter? (The determination as to whether there are 30 or more adopting employers or 3,000 or more
adopting employers may be made on any one date during the 12-month period ending April 1, 2007)
4461-A
Form
(Rev. 3-2008)
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