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Form 5306 Application For Approval Of Prototype Or Employer Sponsored Individual Retirement Account 5306 - Official Federal Forms
| Form 5306 Application For Approval Of Prototype Or Employer Sponsored Individual Retirement Account Form. This is a national form and can be used in Department Of Treasury . |
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Form 5306 (Rev. October 2006) Department of the Treasury Internal Revenue Service Application for Approval of Prototype or Employer Sponsored Individual Retirement Arrangement (IRA) (Under Section 408(a), (b), (c), or (p) or section 408A of the Internal Revenue Code) OMB No. 1545-0390 1 2 Enter amount of user fee submitted (see Specific Instructions) $ For IRS Use Only Part I Identifying Information (see instructions before completing this part) Approval requested for: a Type of individual retirement arrangement-- (1) (2) Prototype traditional IRA under section 408(a) or 408(b) (4) (3) Prototype SIMPLE IRA under section 408(p) Initial application b c Amendment--Enter (1) Latest letter serial number (2) Date letter Prototype Roth IRA under section 408A Roth or traditional IRA established by employer or employee association under section 408(c) issued (3) File folder number 3a Name of applicant 3b Employer identification number of applicant Number, street, and room or suite no. (If a P.O. box, see instructions on page 2.) City or town, state, and ZIP code 4a Name of person to contact 5 a b c d 6 4b Telephone number ( ) Type of sponsoring organization (if you are applying for a ruling under section 408(c), do not complete this item): e Regulated investment company Insurance company f Federally insured credit union Trade or professional association Savings and loan association that qualifies as a bank g Approved non-bank trustee (attach copy of approval Bank letter) Name of trustee or custodian Number, street, and room or suite no. (If a P.O. box, see instructions on page 2.) City or town, state, and ZIP code 7 a b Type of funding entity: Trust Custodial account c Insurance company Annuity contract number Part II Plan Information Article or Section Reference Page Number For IRS Use Only Attach a copy of the plan documents (trust agreement, custodial account, annuity contract, etc.) and indicate the article or section reference 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 "LRM" in the search box, then click on "Listing of Required Modifications (LRMs)." Sponsors are encouraged to use LRM language. 8a Does the IRA provide that the trust is created for the exclusive benefit of the participant or his or her beneficiaries, or that the annuity contract must be owned only by the annuitant? b Does the IRA describe the type of allowable contributions (that is, only cash except for rollovers) and maximum limitation? c Does the IRA prohibit the investment of trust assets in collectibles, or contain a statement informing individuals that an investment in collectibles, except for investments in certain coins and precious metals, will be treated as a taxable distribution? d Does the IRA prohibit investment in life insurance contracts? e Does the IRA provide the rules on required distributions commencing before death? f Does the IRA provide the rules on required distributions commencing after death? 1/13 2/14 3 4 5/15 6/16 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. 11830C Title Form For Paperwork Reduction Act Notice, see back of form. 5306 (Rev. 10-2006) Form 5306 (Rev. 10-2006) Page 2 8 (continued from page 1) Article or Section Reference Page Number For IRS Use Only g Does the IRA provide that the account is nonforfeitable? h Does the IRA provide that the contract is nontransferable? i Does the IRA provide for application of premium refund (other than refunds attributable to excess contributions) before the end of the calendar year following the year of the refund toward the payment of future premiums or the purchase of additional benefits? j Does the IRA prohibit commingling assets of trusts? k Does the IRA provide that annuity contracts must have flexible premiums? l Does the IRA provide for a separate accounting for the interest of each employee or member of the association? m Does the IRA provide for annual calendar-year reports by trustees or issuers? n Does the IRA require substitution of non-bank trustee or custodian when notified by the Commissioner of the Internal Revenue Service? o Does the IRA define compensation? 9 a 7/17 18 19 8 20 9 10/21 11 12/22 Disclosure statement (check either a or b): Attached is a copy of the disclosure statement that will be used to inform participants of the restrictions and limitations imposed by law on individual retirement programs such as: eligibility for deductions, excise tax on excess contributions, penalty taxes on premature distributions, the consequences of prohibited transactions, and other required topics; or Each participant will be furnished a copy of Pub. 590, Individual Retirement Arrangements (IRAs). (Do not submit a copy of Pub. 590 with this application.) Service. These model forms, issued by the Service, contain language that, if followed, will satisfy the applicable statutory requirements. What to file. File Form 5306 and a copy of the trust, custodial account, or annuity contract and all other applicable documents. If you are requesting an opinion letter for an amendment, attach a copy of the amendment and an explanation of its effect on the trust, custodial account, or annuity contract. Where to file. File Form 5306 with the Internal Revenue Service, Attention: EP Opinion Letter, P.O. Box 27063, McPherson Station, Washington, DC 20038. Address. Include the suite, room, or other unit number after the street number. If the Post Office does not deliver mail to the street address and you have a P.O. box, show the box number instead of the street address. Signature. An officer who is authorized to sign or another person authorized under a power of attorney must sign this application. Send the power of attorney with this application when you file it. Line 2c. If you are amending your plan, enter the file folder number, letter serial number, and date from the latest opinion letter you received for your plan. b General Information Section references are to the Internal Revenue Code. Purpose of form. Sponsoring organizations, employers, or employee associations, use Form 5306 to request an opinion letter as to: Whether a prototype trust or custodial account agreement meets th
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