Form 8950 - Application For Voluntary Correction Program (Vcp) Page 4
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Form 8950 (1-2013)
Page
Procedural Requirements Checklist
You do not have to use this checklist, but it may help prevent delayed IRS processing caused by an incomplete submission.
1 Is Form 8951, Compliance Fee for Application for Voluntary Correction Program (VCP) Under the Employee Plans
Compliance Resolution System (EPCRS), attached to Form 8950?
2 Is the appropriate compliance fee for your submission (and a photocopy of the compliance fee check) attached to Form
8951?
3 If appropriate, is Form 2848, Power of Attorney and Declaration of Representative, and/or Form 8821, Tax Information
Authorization, attached? For more information, see Disclosure Request by Taxpayer in the instructions and Rev. Proc.
2013-4 (or its successor).
4 Is the employer identification number (EIN) of the plan sponsor/employer (NOT the trust's EIN, or an individual's SSN)
entered on line 1i? See Line 1i in the instructions.
5 Is the application signed and dated? It generally must be signed by an authorized employee or the owner of the plan
sponsor. See Who Must Sign in the instructions for situations where the signer may be a different person.
6 If you are submitting Appendix C, Part I, Model VCP Compliance Statement or Appendix C, Part II, Schedules, have you
used the official versions of these documents that are located at
The format of these documents may not be modified in any way. See Rev. Proc. 2013-12, sections 11.01 and 11.02.
7 If you answered “Yes” to line 7a, have you answered lines 7b and 7c and supplied the requested information?
8 If you answered “No” to line 7b, have you included a written explanation as requested by line 7b?
9 If you answered “Yes” to line 7a, have you included: a separate determination letter application that includes a Form 8717;
a Form 5300, 5307, or 5310; a separate check for the user fee; and separate copies of plan documents, amendments, etc.,
required by the Form 5300 series application instructions? See Rev. Proc. 2013-12, sections 6.05 and 11.04.
10 If this is an anonymous VCP submission, have you included a signed statement from the plan sponsor's representative
indicating the representative has the legal authorization to make this submission and is willing and able to submit Form
2848 to the IRS upon disclosure of the taxpayer's identity? See instructions and Rev. Proc. 2013-12, sections 10.10 and
11.08.
11 If this VCP submission involves an orphan plan, have you included appropriate documentation that establishes that this
submission is being made by an eligible party? See instructions and Rev. Proc. 2013-12, sections 5.03 and 11.10.
NOTE. If you answered “Yes” to line 6, then items 12 through 19 on this checklist do not apply (as they have been incorporated into
Schedules described in Rev. Proc. 2013-12, Appendix C, Part II). All applicable items on each of the Schedules need to be completed,
and you must include the enclosure items listed on each applicable Schedule with your VCP submission. The Schedules may be used
as part of a Model VCP Submission Compliance Statement described in Rev. Proc. 2013-12, Appendix C, Part I, to resolve certain
qualification failures. If you combine the Schedules with the model compliance statement, you must specify in each section of the
model compliance statement the Schedules being submitted in that section.
8950
Form
(1-2013)
*37769K01201304*
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