Form 14568-E - Appendix C Part Ii Schedule 5 - Plan Loan Failures (Qualified Plans And 403(B) Plans) Page 3

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Plan name
EIN
Plan number
2. To reduce the excess loan amount to the extent of the interest thereon, with the remainder of the repayments applied to
reduce the portion of the loan that did not exceed the maximum loan amount under § 72(p)(2)(A). Result: The
corrective repayment would equal the excess loan amount.
3. Pro rata against the excess loan amount and the maximum loan amount under § 72(p)(2)(A). Result: The corrective
repayment would equal the outstanding balance remaining on the excess loan amount on the date that corrective
repayment is made.
Prior loan payments were not made in accordance with an amortization schedule that complied with the requirements of
§72(p)(2)(B) or (C).
Methodology for determining the excess loan amount that will be repaid and the remaining outstanding balance of the loan that
will be amortized over the remaining period of the loan:
After the corrective repayment is made: (Check one of the two options listed below)
Option 1: The remaining loan balance will be repaid according to the original amortization schedule. (This option is
available only if the original amortization schedule would result in the loan being repaid within the maximum
period permitted under §72(p)(2)(B) determined from the original date of the loan.)
Option 2: The loan will be reformed to amortize the remaining principal balance as of the date of repayment over the
remaining period of the original loan, provided that the recalculated payments over the remaining period comply
with the requirements of § 72(p)(2)(B) determined from the original date of the loan.
B. Correction for loans with terms that: (i) provided for a repayment period that exceeded the period permitted under § 72(p)
(2)(B) and/or (ii) provided for payments that did not provide for substantially level amortization with payments not less
frequently than quarterly, as provided under § 72(p)(2)(C): (check the box that applies)
1. The loan balance will be reamortized with payments made on a substantially level basis (per § 72(p)(2)(C)), made at least
quarterly.
2. The reamortized loan balance will be paid over a remaining period that does not extend beyond five years from the date of
the original loan (per § 72(p)(2)(B)).
C. Correction for defaulted loans with terms that complied with the requirements of § 72(p)(2)(A), (B), and (C): (check the box
that applies)
1. A lump sum repayment will be made to the plan in an amount equal to the additional repayments that the affected
participant would have made to the plan if there had been no failure to repay the plan, plus interest accrued on the missed
repayments.
2. The outstanding balance of the loan, including accrued interest, will be reamortized over a remaining period that does not
extend beyond five years from the date of the original loan.
3. The Applicant will use a combination of the methods described in #1 and #2 above, as follows:
Determination of Interest Accrued on Missed Repayments: (check the box that applies)
{insert rate}
Plan loan rate
{insert rate}
Rate of return of investments under plan
Note: This option may only be used if the rate of investment return under the plan equals or exceeds the plan loan rate.
14568-E
Catalog Number 66149Q
Form
(1-2014)

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