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attach a sheet showing the information

2. Form 5300 (lines 1 through 8

Do not use a social security

separately in the same format as lines

only) for each employer who adopts the

number or the EIN of the trust.

1a through 1f of the worksheet for each

plan (all employers in each ASG or

CAUTION

benefit computation formula.

controlled group are considered one

The plan sponsor/employer must

4. Submit a description of the

employer). Form 5300 must be signed

have an EIN. A plan sponsor/employer

actions that may have resulted in a

by the respective employers.

without an EIN can apply for one.

partial termination.

•

Note. If the employer has no

Online — Generally, a plan sponsor/

5. Include an explanation of how the

employees, the taxpayer cannot submit

employer can receive an EIN from the

plan meets the requirements of section

as the sponsor of the plan.

Internet and use it immediately to file a

411(d)(3).

•

return. Go to the IRS website at

www.

For a governmental or

•

Termination of Plan. If you are

irs.gov/businesses/small

and click on

non-electing church plan, skip lines

terminating your plan, file Form 5310,

Employer ID Numbers (EINs).

10 and 12a. A non-electing church

Application for Determination for

•

By telephone — Call

plan is a plan for which an election

Terminating Plan, to request a DL for

1-800-TAX-FORM (829-4933).

under section 410(d) has not been

the complete termination of a DBP or a

•

By mail or fax — Send in a completed

made.

DCP. This form should be filed to

•

Form SS-4, Application for Employer

For an Employee Stock Ownership

request a DL involving the complete

Identification Number, to apply for an

Plan (ESOP), attach Form 5309,

termination of a multi-employer plan

EIN.

Application for Determination of

covered by the Pension Benefit

Employee Stock Ownership Plan.

Note. Form SS-4 can also be obtained

Guaranty Corporation (PBGC)

at Social Security Administration (SSA)

insurance program.

offices.

In addition, include:

Specific Instructions

The plan of a group of entities

1. One copy of the plan;

required to be combined under section

2. One copy of the latest DL;

Line 1a. If not applicable, leave blank.

414(b), (c), or (m), whose sponsor is

3. A copy of all actions taken to

more than one of the entities required

Line 1b through 1g. Enter the name,

terminate the plan; and

to be combined, should only enter the

address, and telephone number of the

4. If necessary, Form 6088,

EIN of one of the sponsoring members.

plan sponsor/employer.

Distributable Benefits From Employee

This EIN must be used in all

Pension Benefit Plans. Form 6088 is

A plan sponsor means:

subsequent filings of DL requests, and

required if the plan is a DBP or if the

1. In the case of a plan that covers

for filing annual returns/reports unless

plan is an underfunded DCP that

the employees of one employer, the

there is a change of sponsor.

benefits non-collectively bargained

employer;

Line 1k. Enter the two digits

employees or more than 2% of the

2. In the case of a plan sponsored

representing the month the employer’s

employees who are covered under a

by two or more entities required to be

tax year ends. This is the employer

Collective Bargaining Agreement (CBA)

combined under sections 414(b), (c), or

whose EIN was entered on line 1h.

are professional employees. (See

(m), one of the members participating in

Line 2. The contact person will receive

Regulations section 1.410(b)-9 for

the plan; or

copies of all correspondence as

definitions.)

3. In the case of a plan that covers

authorized in a Form 2848 or Form

If you wish to stop benefit accruals

the employees and/or partner(s) of a

8821. Either complete the contact’s

or stop making contributions to your

partnership, the partnership.

information on this line, or check the

plan, and your plan trust will continue,

box and attach a completed Form 2848

the plan will not be considered

Notes.

•

or Form 8821.

terminated. If you want to receive a DL,

Line 1b is limited to 70 characters.

you must use Form 5300. Do not file

Enter a space between all words.

Line 3a. Enter the number(s) that

•

Form 5310 if the plan trust will

The name of the plan sponsor/

corresponds to the request(s) being

continue.

employer should be the same name

made. The first box must contain a 1 or

that was or will be used when the Form

2. Please use the second box if a

Note. If a DBP is amended to become

5500, Annual Return/Report of

special ruling is requested under 3 - 6

a DCP, or if the merger of a DBP with a

Employee Benefit Plan; Form 5500-EZ,

below.

DCP results solely in a DCP, the DBP

•

Annual Return of One-Participant

Enter 1 if the IRS has not issued a

is considered terminated.

(Owners and Their Spouses)

DL for this plan. Enter the number of

Retirement Plan; or Form 5500-SF,

subsequent amendments signed after

Specific Plans —

Short Form Annual Return/Report of

the initial plan on line 3e. Enter the

Additional Requirements

Small Employee Benefit Plan is filed for

date(s) the amendment(s) was signed

the plan.

along with date(s) the amendment(s)

See the Procedural Requirements

•

Address should include the suite,

was effective on lines 3f and 3g.

Checklist on Form 5300.

•

room, or other unit number after the

Enter 2 if the IRS has previously

•

For a determination on an ASG

street address. If the Post Office does

issued a DL for this plan. Enter the

status, submit:

not deliver mail to the street address

date(s) the restatement was signed

and the plan has a P.O. Box, show the

along with the effective date of the

1. A copy of the appropriate

box number instead of the street

restatement on lines 3b(i) and 3b(ii).

documents, and

address. The address should be the

2. Statements listed in the

Note.

address of the sponsor/employer.

•

instructions for lines 3a and 6.

If amendments are substantial, see

•

For plans of controlled groups of

section 7.04 of Rev. Proc. 2011-6.

Line 1h. Enter the 9-digit employer

•

corporations or trades or businesses

Enter 3 if requesting a letter

identification number (EIN) assigned to

under common control, submit the

concerning the effect of section 414(m),

the plan sponsor/employer. This should

statement specified in the instructions

a change in the ASG membership or if

be the same EIN that was or will be

for line 6.

you are not certain that you are a

used when the Form 5500 series

•

For multiple employer plans that do

member of an ASG, attach the

annual returns/reports are filed for the

not involve collective bargaining,

following information:

plan. For a multiple employer plan, the

submit:

EIN should be the same EIN that was

1. A description of the nature of the

1. One application for the plan and

or will be used by the participating

business of the employer. Specifically

any additional required schedules or

employer when Form 5500 is filed by

state whether it is a service

demonstrations, and

the employer.

organization or an organization whose

-3-

Instructions For Form 5300 - Application For Determination For Employee Benefit Plan - Department Of Treasury Page 3

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