Form 8950 - Application For Voluntary Correction Program (Vcp) Page 3
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Form 8950 (1-2013)
Page
Yes
No
6
Are all qualification failures and correction methods in this VCP submission being resolved by the use of the
Appendix C, Part II schedules in Rev. Proc. 2013-12?
If “Yes,” please indicate the specific schedules you are submitting.
Schedule 1
Schedule 6
Schedule 11
Schedule 2
Schedule 7
Schedule 12
Schedule 3
Schedule 8
Schedule 4
Schedule 9
Schedule 5
Schedule 10
7a
If you are proposing to correct any section 401(a) qualification failure, does the correction include a
retroactive plan amendment (see instructions)?
7b
If 7a is “Yes,” have you concurrently submitted a Form 5300 series, Application for Determination for
Employee Benefit Plan (see instructions)?
If 7b is “No,” attach an explanation as to why such determination letter application was not submitted.
7c
If 7a is “Yes,” indicate the plan's remedial amendment cycle as determined by Rev. Proc. 2007-44 (or
successor) that was in effect as of the date of this VCP submission (see instructions):
8
Has the plan or plan sponsor been party to an abusive tax avoidance transaction
(see Rev. Proc. 2013-12, section 4.13(2))?
If “Yes,” attach an explanation that provides details of the transaction (see instructions).
9
Does the VCP submission relate to the diversion or misuse of plan assets (see Rev. Proc. 2013-12, section
4.12)?
10
As of the date this VCP submission is mailed to the IRS, is the plan sponsor or the plan under examination, as
defined in Rev. Proc. 2013-12, section 5.09? If “Yes,” you are ineligible for VCP (see instructions).
11
As of the date this VCP submission is mailed to the IRS, is the plan being considered in an unrelated Form
5300 series determination letter application?
If “Yes,” include an attachment indicating the date the application was filed with the IRS and the
determination letter application case number.
12
Have you previously filed a Form 5300 series determination letter application for this plan with the IRS that was
subsequently closed or withdrawn as a result of a failure to respond to a request for additional information?
If “Yes,” attach an explanation (see instructions).
8950
Form
(1-2013)
*37769K01201303*
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