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Form 5306-A Application For Approval Of Prototypes Simplified Employee Pension (SEP) 5306-A - Official Federal Forms
| Form 5306-A Application For Approval Of Prototypes Simplified Employee Pension (SEP) Form. This is a national form and can be used in Department Of Treasury . |
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Form 5306-A (Rev. September 2004) Department of the Treasury Internal Revenue Service Application for Approval of Prototype Simplified Employee Pension (SEP) or Savings Incentive Match Plan for Employees of Small Employers (SIMPLE IRA Plan) (Under Section 408(k) or (p) of the Internal Revenue Code) For IRS Use Only OMB No. 1545-0199 Enter amount of user fee submitted (see Specific Instructions) $ Identifying Information (see instructions before completing this part) Part I 1 2 Approval requested for: a Type of plan-- (1) Prototype simplified employee pension (SEP) under section 408(k) (2) Prototype savings incentive match plan for employees of small employers (SIMPLE IRA plan) under section 408(p) b Initial application Amendment--Enter (1) Latest letter serial number (2) Date letter issued (3) File folder number c 3 If the SEP contains elective deferral provisions, check this box 4a Name of applicant 4b Applicant's employer identification number Number, street, and room or suite no. (If a P.O. box, see instructions on page 3.) City or town, state, and ZIP code 5a Name of person to contact 6 5b Telephone number ( ) Type of submission (check one box): a Not a mass submitter b Mass submitter c Identical adoption of a mass submitter d Minor modification of a mass submitter 7a If 6c or 6d is checked, enter the mass submitter's name b File folder number of the mass submitter's SEP or SIMPLE IRA plan on which this submission is based: 8 a b c d Type of sponsoring organization: Insurance company Trade or professional organization Savings and loan association that qualifies as a bank Bank e f g Regulated investment company Federally insured credit union Approved non-bank trustee (attach copy of approval letter) Part II SEP Information Plan Article or Plan Section Page Reference Number For IRS Use Only Attach a copy of the SEP documents and indicate the article or section and the page number where the following provisions appear. If any item does not apply, write "N/A." Sample language, or a listing of required modifications (LRMs), is available on the IRS website at www.irs.gov. Type in "LRM" in the box under "Search IRS Site for," then click on "Listing of Required Modifications (LRMs)." Sponsors are encouraged to use LRM language. 9a Does the SEP cover all employees who have attained age 21, performed service for the employer in 3 of the immediately preceding 5 years, and received at least $450 * in compensation from the employer for the year, other than employees who may be excluded under section 410(b)(3)(A) or (C)? b Does the SEP provide that all eligible employees will share in an allocation? c Does the SEP contain a definite allocation formula that does not discriminate in favor of highly compensated employees? d Does the SEP require that it be used only with pre-approved traditional IRAs? e Does the SEP prohibit restrictions on withdrawals (other than restrictions permitted under section 408(d)(7)(A) in the case of a salary reduction SEP)? f Does the SEP define "compensation" in a manner that satisfies one of the safe harbor definitions under section 414(s) and limit compensation under section 408(k)(3)(C)? 1 2 3 5 6 7 * This is the amount for 2004. The amount may be increased in future years for cost-of-living adjustments. Please Sign Here Under penalties of perjury, I declare that I have examined this application, including accompanying statements, and to the best of my knowledge and belief, it is true, correct, and complete. Signature of officer Date Cat. No. 32621R Title Form For Paperwork Reduction Act Notice, see the instructions. 5306-A (9-2004) Form 5306-A (9-2004) Page 2 Part III SIMPLE IRA Plan Information Plan Article or Section Reference Plan Page Number For IRS Use Only 1 Attach a copy of the SIMPLE IRA plan documents and indicate the article or section and the page number where the following provisions appear. If an item does not apply, enter "N/A." Sample language, or a listing of required modifications (LRMs), is available on the IRS website at www.irs.gov. Type in "LRM" in the box under "Search IRS Site for," then click on "Listing of Required Modifications (LRMs)." Sponsors are encouraged to use LRM language. 10a Does the plan define the term "employer" to include all members of such groups or entities required to be aggregated with the employer? b Does the plan limit adoption to employers that have 100 or less employees who earned $5,000 or more in compensation from the employer during the preceding calendar year? c Does the plan limit adoption to employers that do not maintain another qualified plan to which contributions are made or benefits accrued? d Does the plan define the term "employee" to include leased employees and employees described in section 401(c)(1)? e Does the plan cover all employees except those that may be excluded under section 408(p)(4)? f Does the plan provide that each eligible employee may make or modify a salary reduction agreement during the 60-day period immediately preceding the calendar year after receiving proper notice? g Does the SEP define "compensation" in a manner that satisfies one of the safe harbor definitions under section 414(s) and limit compensation under section 408(k)(3)(C)? h Under the plan, is an eligible employee permitted to terminate a salary reduction election at any time? i Is the interest of an eligible employee in the plan nonforfeitable at all times? j Does the plan provide that the employer will make matching contributions to each eligible employee's SIMPLE IRA equal to the employee's salary reduction contribution, up to a limit of 3% of the employee's compensation for the calendar year? k Does the plan provide that the employer will make a 2% nonelective contribution to each eligible employee's SIMPLE IRA in lieu of matching contributions? l Does the plan require that the employer will make salary reduction contributions to eligible employees' SIMPLE IRAs as of the earliest date on which these contributions can reasonably be segregated from the employer's general assets? m Unless the employer has chosen, does the plan allow each eligible employee to select the financial institution for their SIMPLE IRA? n If the employer has selected the financial institution, does the plan require the financial institution to meet the notification requirements of section 408(p)(7)? o Does the plan define "compensation" as described in section 408(p)(6)(A)? p Does the plan require that it be used only with pre-approved
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