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Form 8717 User Fee For Employee Plan Determination 8717 - Official Federal Forms
| Form 8717 User Fee For Employee Plan Determination Form. This is a national form and can be used in Department Of Treasury . |
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Form (Rev. February 2013) Attach to determination letter application. Department of the Treasury Internal Revenue Service For the latest information about this form, go to www.irs.gov/form8717. 1 Name of plan sponsor (employer if single-employer plan) 8717 User Fee for Employee Plan Determination Letter Request For IRS Use Only OMB No. 15451772 Amount paid 2 Sponsor's employer identification number 3 Plan number 4 Plan name Caution. If you qualify for the exemption from user fees for small business employers, complete only the certification below (see the instructions on page 2 for details). For all other applications, leave the certification blank and check the appropriate box in column B of line 5. Certification I certify that the application for a determination letter on the qualified status of the plan listed above meets the conditions for exemption from user fees described in section 7528(b)(2)(B) of the Internal Revenue Code. Sign Here Type or print name and title Date Fee Schedule A Form Submitted 5a b c d e Form 5300: Form 5307: Form 5310: B no Demo 5 and no Demo 6: $ 2,500 $ 300 $ 2,000 Multiple employer plans (Form 5300): (1) 2 to 10 Forms 5300 submitted . . . . (2) 11 to 99 Forms 5300 submitted . . . (3) 100 to 499 Forms 5300 submitted . . . (4) Over 499 Forms 5300 submitted . . . f Multiple employer plans (Form 5310): (1) 2 to 10 employers maintaining the plan . (2) 11 to 99 employers maintaining the plan (3) 100 to 499 employers maintaining the plan (4) Over 499 employers maintaining the plan g Reserved (1a) . . . . . . . . . . . . . . (1b) . . . . . . . . . . . . . . (2a) . . . . . . . . . . . . . . (2b) . . . . . . . . . . . . . . (3) .............. (4) .............. h Reserved (1a) . . . . . . . . . . . . . . (1b) . . . . . . . . . . . . . . (2) .............. (3) .............. (4a) . . . . . . . . . . . . . . (4b) . . . . . . . . . . . . . . (5) .............. (6) .............. .............. (7) i Form 5316 (Group trusts) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (1) (2) (3) (4) (1) (2) (3) (4) $ $ $ $ $ $ $ $ 3,000 3,000 15,000 15,000 3,000 3,000 15,000 15,000 Attach Check or Money Order Here $ 1,000 Form 8717 (Rev. 2-2013) Cat. No. 64727O American LegalNet, Inc. www.FormsWorkFlow.com Form 8717 (Rev. 2-2013) Page 2 What's New The user fees were updated by Rev. Proc. 2013-8, 2013-1 I.R.B. 237. Form 8717 has been updated to reflect modifications to the determination letter program which were described in Announcement 2011-82, 2011-52 I.R.B. 1052 and set forth in Rev. Proc. 2013-6, 2013-1 I.R.B. 198. The determination letter program was modified to eliminate the option of plan sponsors to request a determination relating to minimum participation, coverage, and nondiscrimination requirements of the Code, effective for applications filed on or after February 1, 2012 in the case of plans under a 5-year remedial amendment cycle (other than terminating plans) and May 1, 2012, in the case of terminating plans and plans under a 6-year remedial amendment cycle. Column A (with Demo 5 and/or Demo 6) of the Fee Schedule has been deleted from Form 8717. The determination letter program was also modified to limit the ability to file a Form 5307, Application for Determination of Adopters of Modified Volume Submitter (VS) Plans, to adopters of certain Volume Submitter plans who modify the terms of an approved specimen plan, effective for applications filed on or after May 1, 2012. Form 8717 has been renamed, User Fee for Employee Plan Determination Letter Request. Information previously on Form 8717 relating to opinion or advisory letter requests for Volume Submitter and Master or Prototype plans has been deleted. This information may now be found on new Form 8717-A, User Fee for Employee Plan Opinion or Advisory Letter Request. Note. Please do not use any of the form that is grayed out. Those portions of the form are no longer functional on this form. Where To File (Include Form 8717 and user fee with your request or application.) IF you have this type of request or application . . . THEN use this address if you send it by: US mail Express Mail or private delivery service Internal Revenue Service 201 West Rivercenter Blvd. Attn: Extracting Stop 312 Covington, KY 41011 Determination letter Internal Revenue Service (Form 5307, 5300, 5310, 5310-A, P.O. Box 12192 and group trust applications) Covington, KY 41012-0192 Instructions (Section references are to the Internal Revenue Code unless otherwise noted.) Generally, a user fee is required with each application for a determination letter. The user fees are shown on page 1. For more information, see Rev. Proc. 2013-6, 2013-1 I.R.B. 198. (2) the plan was first in effect no earlier than January 1 of the tenth calendar year immediately before the year in which the submission period for the plan's current remedial amendment cycle begins. (If the plan was first in effect before this date, but the application is still filed within a remedial amendment period that began within the first 5 plan years and you are an eligible employer, complete only the Certification and attach an explanation of how your application qualifies for exemption under section 7528(b)(2)(B).) Example. An employer maintains an individually designed plan first effective on July 1, 2001. Assume that the plan's 5 year remedial amendment cycle is Cycle A. Therefore, the submission period for the plan's current cycle ends on January 31, 2012. Assume that the employer files a determination letter application for the plan on January 31, 2012. If the employer is an eligible employer, the application is exempt from the user fee requirement because the application is filed by the last day of the submission period for the plan's current remedial amendment cycle and the date the plan was first in effect (July
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