Instructions For Form 8955-Ssa - Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits - 2017 Page 7
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7plan administrator may enter Code A (a single sum) in
However, section 6103 authorizes disclosure of the
column (d) and Code A (a lump sum) in column (e).
information to others. Pursuant to section 6057(d), we will
disclose this information to the Social Security Administration
For a multiemployer plan, if the amount of the periodic
for use in administering the Social Security Act. This
payment cannot be accurately determined because the plan
information may also be disclosed to the Department of
administrator does not maintain complete records of covered
Justice for civil or criminal litigation, to the Department of
service, enter an estimated amount.
Labor or the Pension Benefit Guarantee Corporation for use
Line 9, column (g). For defined contribution plans, enter
in administering ERISA, and to cities, states, the District of
the value (in whole dollars) of the participant's account.
Columbia, and U.S. commonwealths and possessions for
use in administering their tax laws. It may also be disclosed
Line 9, columns (h) and (i). Show the EIN and plan
to other countries under a tax treaty, to federal and state
number of the plan under which the participant was
agencies to enforce federal nontax criminal laws, or to
previously reported.
federal law enforcement and intelligence agencies to combat
terrorism.
Privacy Act and Paperwork Reduction Act Notice. We
ask for the information on this form to carry out the Internal
The time needed to complete and file this form will vary
Revenue laws. Sections 6057 and 6109 require you to
depending on individual circumstances. The estimated
provide the information requested on this form. We need it to
average time is 49 minutes.
determine whether the plan properly accounts for the
deferred vested retirement benefits of separated participants.
If you have suggestions for making this form simpler, we
Failure to provide this information, or providing false or
would be happy to hear from you. You can send us
fraudulent information, may subject you to penalties.
comments from IRS.gov/FormComments. Or you can send
your comments to the Internal Revenue Service, Tax Forms
You are not required to provide the information requested
and Publications Division, 1111 Constitution Ave. NW,
on a form that is subject to the Paperwork Reduction Act
IR-6526, Washington, DC 20224. Do not send the form to
unless the form displays a valid OMB control number. Books
this address. Instead, see Where To File, earlier.
and records relating to a form or its instructions must be
retained as long as their contents may become material in
the administration of the Internal Revenue Code. Generally,
tax returns and return information are confidential, as
required by section 6103.
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