Form 14568-E - Appendix C Part Ii Schedule 5 - Plan Loan Failures (Qualified Plans And 403(B) Plans)

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Department of the Treasury - Internal Revenue Service
14568-E
Form
OMB Number
Appendix C Part II Schedule 5
1545-1673
(January 2014)
Plan Loan Failures (Qualified Plans and 403(b) Plans)
Please include the plan name, Applicant’s EIN, and plan number information on each page of the submission, including attachments
Plan name
EIN
Plan number
Section I - Identification of Failure
The plan identified above did not comply with the requirements of § 72(p)(2) of the Internal Revenue Code. (Note: The conditions of §
72(p)(2) must be satisfied for a participant loan to be exempt from being treated as a distribution to the participant under § 72(p)(1).)
The failure occurred for the following reason(s) (check applicable boxes and provide the information requested):
A. The loan(s) exceeded the limit under § 72(p)(2)(A)
Plan Year
Number of Participants Affected
Total Number of Loans Issued That Violated § 72(p)(2)(A)
B. Loan terms did not satisfy the limits on the duration of the loan under § 72(p)(2)(B)
Plan Year
Number of Participants Affected
Total Number of Loans Issued That Violated § 72(p)(2)(B)
C. Loan terms did not satisfy § 72(p)(2)(C) relating to the frequency and amortization of payments
Plan Year
Number of Participants Affected
Total Number of Loans Issued That Violated § 72(p)(2)(C)
D. Defaulted loan(s) (where the loan terms satisfied the requirements of § 72(p)(2), but default(s) occurred because loan
payments were not made in accordance with the terms of the loan)
Plan Year
Number of Participants Affected
Total Number of Loans in Default
14568-E
Catalog Number 66149Q
Form
(1-2014)
For Paperwork Reduction Act information see Revenue Procedure 2013-12.

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