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الاستمارة 5310-A

Instructions for Form 5310-A, Notice of Plan Merger or Consolidation, Spinoff, or Transfer of Plan Assets or Liabilities; Notice of Qualified Separate Lines of Business

Rev. December 2020

النماذج ذات الصلة

  • الاستمارة 5310-A - Notice of Plan Merger or Consolidation, Spinoff, or Transfer of Plan Assets or Liabilities; Notice of Qualified Separate Lines of Business
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Department of the Treasury  
Internal Revenue Service  
Instructions for  
Form 5310-A  
(Rev. December 2020)  
Notice of Plan Merger or Consolidation, Spinoff, or Transfer of Plan Assets or  
Liabilities; Notice of Qualified Separate Lines of Business  
Section references are to the Internal Revenue  
Code unless otherwise noted.  
the plan merger and plans that cease to  
exist after the plan merger. In the case  
of a plan spinoff, file Form 5310-A only  
for the plan in existence before the  
spinoff.  
treated as the only notice filed for the  
2019 testing year (see Part III).  
Future Developments  
Example Three - Revocation  
For the latest information about  
The facts are the same as in Example  
Two. Assume that Employer A timely  
filed a new notice for the 2019 testing  
year. During 2020, Employer A elects  
not to treat itself as operating QSLOBs  
for the 2020 testing year. Employer A  
must revoke the last notice it filed (that  
is, the notice for the 2019 testing year).  
Employer A must revoke the notice filed  
for the 2019 testing year by filing Form  
5310-A for the 2020 testing year and  
indicating on line 9 of the Form 5310-A  
that it is revoking a previously filed  
notice and is no longer testing on a  
QSLOB basis. If such notice is not filed  
on or before the notification date for the  
2020 testing year, the notice filed for the  
2019 testing year will be treated as the  
only notice filed for the 2020 testing  
year (see Part III).  
developments related to Form 5310–A  
and it’s instructions, such as legislation  
enacted after they were published, go to  
Qualified separate lines of  
business. The employer must file  
notice that it elects to be treated as  
operating QSLOBs or that it either  
modifies or revokes a previously filed  
notice. Only one notice per employer,  
within the meaning of sections 414(b),  
(c), and (m) is required.  
General Instructions  
Purpose of Form  
Examples  
Example One - Initial Notice  
Form 5310-A is used by employers to  
give notice of:  
A plan merger or consolidation that is  
Employer A is composed of four  
the combining of two or more plans into  
a single plan.  
separate corporations that are treated  
as one employer within the meaning of  
section 414(b). Employer A treats each  
corporation as a separate line of  
A plan spinoff that is the splitting of a  
single plan into two or more spinoff  
plans.  
business. The 2018 testing year is the  
first year for which Employer A elects to  
be treated as operating QSLOBs for the  
purpose of section 410(b) (see When  
To File for a definition of “testing year”).  
Employer A must file Form 5310-A and  
provide information on each of the four  
QSLOBs on or before the notification  
date for the 2018 testing year (see  
When To File for a definition of  
A plan transfer of plan assets or  
liabilities to another plan that is the  
splitting off of a portion of the assets or  
liabilities of the transferor plan and the  
concurrent acquisition or assumption of  
these split-off assets or liabilities by the  
transferee plan.  
Exceptions From Filing  
Notice of Plan Merger or  
Consolidation, Spinoff, or  
Transfer of Plan Assets or  
Liabilities  
Direct rollover. Do not file Form  
5310-A for an eligible rollover  
distribution that is paid directly to an  
eligible retirement plan in a direct  
rollover as described in section 401(a)  
(31).  
Plan merger or consolidation or  
spinoff. Do not file Form 5310-A if the  
plan merger or consolidation or the  
spinoff complies with Regulations  
section 1.414(l)-1(d), (h), (m), or (n)(2).  
Generally, these requirements will be  
satisfied in the following four situations:  
1. Two or more defined contribution  
plans are merged and all of the  
following conditions are met:  
Qualified separate lines of business  
(QSLOBs).  
“notification date”). If the notice is not  
timely filed, Employer A is not treated as  
operating QSLOBs for purposes of the  
coverage rules for the 2018 testing year  
(see Part III ).  
Note. An IRS determination letter will  
not be issued when a Form 5310-A is  
filed.  
Who Must File  
Pension plan, profit-sharing plan,  
Example Two - Modification  
or other deferred compensation  
plan. Any sponsor or plan administrator  
of a pension, profit-sharing, or other  
deferred compensation plan (except a  
multi-employer plan covered by Public  
Benefit Guaranty Corporation (PBGC)  
insurance) should file this form for a  
plan merger or consolidation, a spinoff,  
or a transfer of plan assets or liabilities  
to another plan. See section 6058(b).  
The facts are the same as in Example  
One. During the 2019 testing year,  
Employer A sold QSLOB four. Also,  
assume that Employer A timely filed  
Form 5310-A for the 2018 testing year.  
For the 2019 testing year, Employer A  
intends to treat QSLOBs one and two as  
a single QSLOB. Employer A must  
modify its initial notice by filing Form  
5310-A on or before the notification date  
for the 2019 testing year, including a  
revised list of QSLOBs for line 11 of the  
form. If Employer A does not timely  
provide a new notice, the initial notice  
filed for the 2018 testing year will be  
Note. This form must be filed for each  
plan with a separate employer  
a. The sum of the account balances  
in each plan prior to the merger  
identification and plan number if that  
plan is involved in a merger or transfer  
of plan assets or liabilities. This includes  
plans that were not in existence before  
(including unallocated forfeitures, an  
unallocated suspense account for  
excess annual additions, and an  
Oct 19, 2020  
Cat. No. 12899J  
unallocated suspense account for an  
ESOP) equals the fair market value of  
the entire plan assets.  
on Form 5310-A. Enter the date of the  
second merger on line 6g.  
spinoff occurring during the current plan  
year.  
Also, mergers occurring in previous  
plan years are taken into account in  
determining the percentage of assets  
above if the series of mergers is, in  
substance, one transaction with the  
merger occurring during the current plan  
year.  
Aggregating spinoffs may cause a  
spinoff, for which a Form 5310-A was  
not initially required to be filed, to  
become reportable as a result of a  
subsequent spinoff. In this case, report  
the spinoff(s) on the Form 5310-A filed  
for the subsequent spinoff. Enter the  
date of the subsequent spinoff on  
line 6g.  
Transfer of Plan Assets or Liabilities.  
A transfer of plan assets or liabilities is  
considered a combination of separate  
plan spinoffs and mergers.  
Example. Neither plan has an  
outstanding section 412(d) waiver  
balance.  
b. The assets of each plan are  
combined to form the assets of the plan  
as merged.  
c. Immediately after the merger,  
Aggregating mergers may cause a  
each participant in the plan has an  
merger, for which a Form 5310-A was  
account balance equal to the sum of the not initially required to be filed, to  
account balances the participant had in  
the plans immediately prior to the  
merger.  
become reportable as a result of a  
subsequent merger. In this case, the  
merger(s) must be reported on the Form  
5310-A filed for the subsequent merger.  
2. There is a spinoff of a defined  
contribution plan and all of the following  
conditions are met:  
Do not file Form 5310-A for:  
b. The provisions of the larger plan  
that allocate assets at the time of  
termination must provide that, in the  
event of a spinoff or termination of the  
plan within 5 years following the merger,  
plan assets will be allocated first for the  
benefit of the participants in the other  
plan(s) to the extent of their benefits on  
a termination basis just prior to the  
merger.  
4. There is a spinoff of a defined  
benefit plan into two or more defined  
benefit plans and both of the following  
conditions are met:  
a. For each plan that results from  
the spinoff, other than the spunoff plan  
with the greatest value of plan assets  
after the spinoff, the value of the assets  
spun off is not less than the present  
value of the benefits spun off (whether  
or not vested).  
The transferor plan in a transfer  
a. The sum of the account balances  
in the plan prior to the spinoff equals the  
fair market value of the entire plan  
assets.  
transaction if the assets transferred  
satisfy the spinoff conditions in 2 or 4  
above.  
The transferee plan in a transfer  
Example. The plan does not have an  
outstanding section 412(d) waiver  
balance.  
transaction if the plan liabilities  
transferred satisfy the merger conditions  
in 1 or 3 above.  
b. The sum of the account balances  
for each of the participants in the  
resulting plan(s) equals the account  
balances of the participants in the plan  
before the spinoff.  
Note. In some situations, the transferor  
plan may have to file Form 5310-A but  
not the transferee plan, or the transferee  
plan may have to file but not the  
transferor plan.  
c. The assets in each of the plans  
immediately after the spinoff equal the  
sum of the account balances for all  
participants in that plan.  
Examples  
Transfer of Plan Assets or  
Liabilities  
Example. The plan does not have  
unallocated accounts.  
Plans A, B, and C are separate plans  
within the meaning of section 414(l). A  
portion of the assets and liabilities of  
both Plan B and Plan C will be  
3. Two or more defined benefit  
plans are merged into one defined  
benefit plan and both of the following  
conditions are met:  
b. The value of the assets spun off  
to all the resulting spunoff plans (other  
than the spunoff plan with the greatest  
value of plan assets after the spinoff)  
plus other assets previously spun off  
(including transfers to another plan)  
during the plan year in which the spinoff  
occurs is less than 3% of the assets of  
the plan before the spinoff as of at least  
1 day in that plan's plan year.  
transferred to Plan A. None of the plans  
are excluded from filing under the  
exceptions from filing listed above. In  
this situation all 3 plans must:  
a. The total liabilities (the present  
value of benefits whether or not vested)  
that are merged into the larger plan  
involved in the merger are less than 3%  
of the assets of the larger plan. This  
condition must be satisfied on at least 1  
day in the larger plan's plan year during  
which the merger occurs. All previous  
mergers (including transfers from  
another plan) occurring in the same plan  
year are taken into account in  
File a completed Form 5310-A.  
Enter code 4 (notice of a transfer of  
plan assets or liabilities) as the reason  
for filing.  
Example. Assume that a spinoff  
Complete all parts of Part I and II of  
involving almost 3% of the assets of the  
plan occurs in the first month of the plan  
year. In the fourth month of the plan  
year a second spinoff occurs involving  
liabilities equal to 2% of the assets of  
the plan. The total of both spinoffs  
exceeds 3% of the plan assets. As a  
result of the second spinoff, Form  
5310-A must be filed to report both  
spinoffs. Enter the date of the second  
spinoff on line 6g.  
the form.  
For Plan A, line 6 of the form will show  
information regarding Plan B and an  
attached statement with the line 6  
information for Plan C. Plan B and Plan  
C will each enter the information  
regarding Plan A on line 6.  
determining the percentage of assets  
described above.  
Example. Assume that a merger  
involving almost 3% of the assets of the  
larger plan occurs in the first month of  
the larger plan's plan year. In the fourth  
month of the larger plan's plan year, a  
second merger occurs involving  
Plan Merger  
Plans A, B, and C are separate plans  
within the meaning of section 414(l).  
Plans A, B, and C are being merged.  
Assets and liabilities from each plan will  
be merged into Plan D, a new plan that  
was established for the purpose of  
effecting the merger. None of the plans  
liabilities equal to 2% of the assets of  
the larger plan. The total of both  
Spinoffs occurring in previous or  
subsequent plan years are taken into  
account in determining the percentage  
mergers exceeds 3% of the assets of  
the larger plan. As a result of the second of assets spun off if such spinoffs are, in  
merger, both mergers must be reported  
substance, one transaction with the  
-2-  
are excluded from filing under the  
exceptions from filing above.  
Internal Revenue Service  
7940 Kentucky Drive  
Florence, KY 41042  
How To Complete the  
Notice  
Form 5310-A is screened for  
In this situation, four separate Forms  
5310-A must be filed. Because Plan D is  
receiving assets from Plans A, B, and C,  
Plan D must file a complete Form  
completeness. Incomplete notices will  
be returned. Here are some tips to help  
you complete the form correctly.  
1. The notice has formatted fields  
that will limit the number of characters  
entered per field.  
Private delivery services. In addition  
to the United States mail, you can use  
certain private delivery services  
designated by the IRS to meet the  
“timely mailing as timely filing/paying”  
rule for tax returns and payments.  
These private delivery services include  
only the following.  
5310-A, enter code 2 (notice of a plan  
merger) as the reason for filing, and  
complete all of Parts I and II of the form.  
Line 6 of the form will show information  
regarding Plan A and an attached  
2. All data input will need to be  
entered in Courier size 10 font.  
statement with the line 6 information for  
Plans B and C. Plans A, B, and C are  
merging with Plan D. Plans A, B, and C  
will each file a separate Form 5310-A  
completed as follows: Enter code 2 as  
the reason for filing, complete all of  
Parts I and II, and enter the information  
regarding Plan D on line 6.  
DHL Express (DHL): DHL Same Day  
3. Alpha characters should be  
entered in all capital letters.  
Service.  
Federal Express (FedEx): FedEx  
4. Enter spaces between any  
Priority Overnight, FedEx Standard  
Overnight, FedEx 2Day, FedEx  
International Priority, and FedEx  
International First.  
words. Spaces will count as a character.  
5. All data fields are entered as an 8  
digit field in MMDDYYYY format.  
United Parcel Service (UPS): UPS  
6. If a number is requested, a  
number must be entered.  
7. For questions regarding this form,  
call the Employee Plans Customer  
Service at 1-877-829-5500.  
Next Day Air, UPS Next Day Air Saver,  
UPS 2nd Day Air, UPS 2nd Day Air  
A.M., UPS Worldwide Express Plus,  
and UPS Worldwide Express.  
When To File  
File Form 5310-A at least 30 days  
prior to a plan merger or consolidation,  
spinoff, or transfer of plan assets or  
liabilities to another plan.  
The private delivery service can tell  
you how to get written proof of the  
mailing date.  
The IRS may, at its discretion,  
If you are filing Form 5310-A to notify  
require additional information or the  
submission of a Form 5300, Application  
for Determination for Employee Benefit  
Plan, when it is deemed necessary.  
the IRS that the employer treats itself as  
operating QSLOBs or the employer is  
modifying or revoking a previously filed  
notice, file Form 5310-A on or before the  
notification date for the testing year. The  
“notification date” for a testing year is  
the later of: (a) October 15 of the year  
following the testing year, or (b) the 15th  
day of the 10th month after the close of  
the plan year of the plan of the employer  
that begins earliest in the testing year.  
“Testing year” means the calendar year.  
Signature  
Stamped signatures are not  
acceptable; see Rev. Proc.  
!
Specific Instructions  
CAUTION  
2020-4, which is on page 251 of  
Internal Revenue Bulletin 2020-1 at  
Line 1 — Reason for filing. Enter the  
appropriate code that describes the  
reason you are filing Form 5310-A.  
In general, the employer or plan  
administrator must sign the form. For  
single employer plans the plan  
Enter 1 for a notice of qualified  
separate lines of business.  
administrator and the employer are  
generally the same person. When the  
plan administrator is a joint employer —  
union board or committee — at least  
one employer representative and one  
union representative must sign. A Form  
5310-A filed with the IRS by a  
Enter 2 for a notice of a plan merger  
or consolidation.  
Penalties  
Enter 3 for a notice of a plan spinoff.  
There is a penalty for the late filing of a  
Form 5310-A to report a plan merger or  
consolidation, spinoff, or transfer of plan  
assets or liabilities. The penalty is $250  
a day for each day the Form 5310-A is  
late (up to a maximum of $150,000).  
The form is late if it is not filed at least  
30 days before the plan merger or  
consolidation, spinoff, or transfer of plan  
assets or liabilities.  
Enter 4 for a notice of a transfer of  
plan assets or liabilities to another plan.  
Part I — All Filers Must  
Complete Part I  
Lines 2a and 2b. Enter the name and  
address of the employer or plan  
sponsor. A plan sponsor means:  
1. In the case of a plan that covers  
the employees of one employer, the  
employer;  
2. In the case of a plan sponsored  
by two or more entities required to be  
aggregated under sections 414(b), (c),  
or (m), one of the members participating  
in the plan; or  
representative on behalf of an employer  
or plan administrator must be  
accompanied by:  
1. A power of attorney specifically  
authorizing such representation in this  
matter (you may use Form 2848, Power  
of Attorney and Declaration of  
Where To File  
Representative), or  
File Form 5310-A at the address  
indicated below:  
2. A written declaration that the  
representative is a currently qualified  
attorney, certified public accountant,  
enrolled actuary, or is currently enrolled  
to practice before the IRS (include either  
the enrollment number or the expiration  
date of the enrollment card) and is  
authorized to represent the employer or  
plan administrator.  
Internal Revenue Service  
TE/GE Stop 31A Team 105  
P.O. Box 12192  
Covington, KY 41012-0192  
3. In the case of a plan that covers  
the employees and/or partners of a  
partnership, the partnership.  
Requests shipped by Express Mail or  
a delivery service should be sent to:  
The name of the plan sponsor/  
employer should be the same name that  
was or will be used when the Form  
-3-  
5500, Annual Return/Report of  
Employee Benefit Plan, series returns/  
reports are filed for the plan.  
addition, Plans A, B, and C must each  
file a separate Form 5310-A (see the  
example of a plan merger).  
Part II—Plan Merger,  
Consolidation, Spinoff, or  
Transfer  
Address. Include the suite, room, or  
other unit number after the street  
address. If the Post Office does not  
deliver mail to the street address and  
the plan has a P.O. box, show the box  
number instead of the street address.  
This address should be the address of  
the sponsor/employer.  
Line 6h. Enter the code that describes  
Line 4a. Enter the name you  
the other plan.  
designated for your plan. Due to space  
restrictions, this field is limited to 70  
characters, including spaces. Due to  
this restriction, “Employee” and “Trust”  
are not necessary in the plan name.  
Line 4b. Enter the 3-digit number,  
beginning with “001” and continuing in  
numerical order for each plan you adopt  
(001–499). The number assigned to a  
plan must not be changed or used for  
any other plan. This should be the same  
number that was or will be used when  
the Form 5500 series returns/reports  
are filed for the plan.  
Enter 1 for a defined benefit plan.  
Enter 2 for a profit-sharing plan.  
Enter 3 for a profit-sharing/401(k)  
plan.  
Enter 4 for a stock bonus plan.  
Enter 5 for an ESOP plan.  
Enter 6 for a money purchase plan.  
Enter 7 for a target benefit plan.  
Line 2g. Enter the 9-digit employer  
identification number (EIN) assigned to  
the plan sponsor/employer. This should  
be the same EIN that was or will be  
used when the Form 5500 series annual  
returns/reports are filed for the plan. For  
a multiple employer plan, the EIN  
Part III—Qualified  
Separate Lines of  
Business  
should be the same EIN that was or will  
be used when Form 5500 is filed.  
Rev. Proc. 93-40, 1993-2 C.B. 535,  
contains procedures relating to the  
notification requirements of section  
414(r)(2)(B).  
Lines 5a. Attach an actuarial statement  
of valuation showing compliance with  
section 414(l). The statement must (1)  
identify the type of transaction involved  
(for example, merger or consolidation,  
spinoff, or transfer of plan assets or  
liabilities), and (2) provide information  
verifying compliance with the  
Do not use a social security  
number or the EIN of the trust.  
!
CAUTION  
The plan sponsor/employer must  
have an EIN. A plan sponsor/employer  
without an EIN can apply for one.  
Notice given by an employer applies  
to all plans maintained by the employer  
for plan years beginning in the testing  
year. Once the notification date (see  
When To File) for a testing year has  
passed, the employer is deemed to  
have irrevocably elected to apply the  
specified section(s) on the basis of  
QSLOBs for all plan years beginning in  
the testing year.  
Online—Generally, a plan sponsor/  
requirements of sections 401(a)(12) and  
414(l). This statement need not be  
signed by an actuary.  
employer can receive an EIN by Internet  
and use it immediately to file a return.  
Go to the IRS website at www.irs.gov/  
businesses/small and click on Employer  
ID Numbers.  
Line 5b. Enter the code that describes  
your plan.  
By telephone—Call 1-800-829-4933.  
By mail or fax—Send in a completed  
Enter 1 for a profit-sharing plan.  
Enter 2 for a stock bonus plan.  
Enter 3 for a money purchase plan.  
Enter 4 for a target benefit plan.  
In addition, after the notification date,  
notice cannot be modified, withdrawn,  
or revoked, and will be treated as  
applying to subsequent testing years  
unless the employer takes timely action  
to provide new notice (see examples  
under Who Must File). Timely action will  
be deemed to have been taken any time  
prior to the notification date for any  
subsequent testing year.  
Line 7a. If you previously filed a notice  
of QSLOB for a testing year, enter the  
first testing year for which such notice  
applied on line 7b. Enter the date the  
notice was filed on line 7c.  
Form SS-4, Application for Employer  
Identification Number, to apply for an  
EIN.  
Enter 5 for a profit-sharing/401(k)  
Note. Form SS-4 can be obtained at  
Social Security Administration (SSA)  
offices or by calling 1-800-TAX-FORM.  
plan.  
Enter 6 for an ESOP plan.  
Enter 7 for other and specify the type  
For the plan of a group of entities  
required to be combined under sections  
414(b), (c), or (m), whose sponsor is  
more than one of the entities required to  
be combined, enter the EIN of only one  
of the sponsoring members. This EIN  
must be used in all subsequent filings of  
determination letter requests, and for  
filing annual returns/reports unless there  
is a change of sponsor.  
of plan.  
Line 6a. Enter the total number of  
plans, other than the plan named on  
line 4a, involved in this transaction.  
Lines 6c through 6h. Complete lines  
6c through 6h for the other plan(s)  
involved in the merger or consolidation,  
spinoff, or transfer of plan assets or  
liabilities with the plan named on line 4a.  
If there is more than one other plan,  
attach a separate statement showing  
the information requested for lines 6c  
through 6h.  
Line 8. Enter the first testing year for  
which this notice applies. See When To  
File for the definition of “testing year.”  
Line 3. The contact person will receive  
copies of all correspondence as  
authorized in a Form 2848, or Tax  
Information Authorization, Form 8821.  
Either complete the contact's  
Line 9. Indicate whether you are filing  
this form to give notice that you are no  
longer testing on a QSLOB basis. If your  
answer to line 9 is “Yes,” complete  
line 10 and skip lines 11 and 12. Answer  
line 10 based on the previously filed  
notice that you are now revoking. If your  
answer to line 9 is “No,” complete lines  
10 through 12. See Who Must File for  
an example of a revocation.  
Example: Plans A, B, and C are  
merging with Plan D. Plan D would  
complete a Form 5310-A, reporting  
information about itself on line 4. Plan D  
would then complete the line 6  
information on this line, or check the box  
and attach a completed Form 2848 or  
Form 8821.  
information for Plan A and attach two  
statements showing the line 6  
information for Plans B and C. In  
-4-  
business or industry in which the  
QSLOB is involved, the business unit  
(such as corporation, partnership, or  
division) the qualified line of business  
comprises, and the name (formal or  
informal) of the QSLOB.  
Line 12. Enter the information  
requested on lines 12a through 12e. If  
there is more than one plan, attach a  
separate statement showing the  
information requested on lines 12a  
through 12e for each plan.  
Line 12b. Enter the date of the  
determination letter, if any. Otherwise,  
leave blank.  
Line 12c. If the plan is a master or  
prototype or volume submitter plan,  
enter the date of the letter and the serial  
number or the advisory letter number,  
as applicable.  
Line 10. Section 414(r) provides rules  
for determining whether an employer  
operates QSLOBs for purposes of  
applying sections 410(b) (relating to  
minimum coverage), 401(a)(26)  
Line 12d. Enter the appropriate date of  
any pending letter request. If this  
question is not applicable, leave blank.  
Line 12e. List on this line the QSLOBs  
identified on line 11 that have  
(relating to minimum participation rules),  
and 129(d)(8) (relating to dependent  
care assistance programs). If you are  
treated as operating QSLOBs under  
section 414(r), you will be permitted to  
apply the aforementioned Code  
employees benefiting under the plan. If  
you need additional space to list the  
QSLOBs, use the area below line 12e.  
How To Get Forms  
and Publications  
provisions separately for the employees  
in each QSLOB. Check the appropriate  
box(es) for the section(s) you are testing  
on a QSLOB basis. See instructions for  
line 9 to determine how to answer this  
question if you answered "Yes" to line 9.  
Line 11. Attach a list identifying the part  
or parts of the employer that make up  
each QSLOB of the employer. The list  
should include, for example, the type of  
Getting tax forms, instructions, and  
publications. Visit IRS.gov/Forms to  
download current and prior-year forms,  
instructions, and publications. Ordering  
tax forms, Instructions, and  
publications. Go to IRS.gov/Forms to  
order forms, instructions, and  
publications.  
Privacy Act and Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue  
laws of the United States. Our legal right to ask for this information is in sections 401, 403, 410, 411, 412, and 414 and their  
regulations. Section 6109 requires you to provide your identifying number. This form must be filed for any plan with a separate  
employer identification and plan number if that plan is involved in a merger or transfer of plan assets or liabilities. Failure to  
provide all of the information requested may prevent processing of this form. In addition, failing to file this form timely and in  
accordance with its instructions, or providing false information, may subject you to penalties. Routine uses of this information  
include giving it to the Department of Justice for civil and criminal litigation, and to cities, states, the District of Columbia, and  
U.S. commonwealths and possessions for administering their tax laws. We may also disclose this information to federal and  
state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat  
terrorism.  
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless  
the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long  
as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return  
information are confidential, as required by section 6103.  
The time needed to complete and file the form is listed below and will vary depending on individual circumstances. The  
estimated average time is:  
Recordkeeping  
Learning about the  
law or the form  
Preparing, copying,  
assembling, and sending the  
form to the IRS  
Part I  
2 hr., 9 min.  
3 hr., 21 min.  
4 hr., 32 min.  
1 hr., 3 min.  
35 min.  
2 hr., 20 min.  
40 min.  
Part II  
Part III  
35 min.  
42 min.  
If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we  
would be happy to hear from you. You can write to Internal Revenue Service, Tax Products Coordinating Committee,  
SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224.  
Do not send the form to this address. Instead, please see Where To File.  
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