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they fail to receive an allocation of

In this case, the plan must satisfy the

permitted disparity limits. See

contributions and/or forfeitures, or to

average benefit test. A determination

Regulations section 1.401(l)-5.

accrue a benefit, solely because they

regarding the average benefit test

Line 14c. This line provides a list of

are subject to plan provisions that

can be requested using Schedule Q.

the design-based nondiscrimination

uniformly limit plan benefits, such as

safe-harbor regulations.

Design-Based

a provision for maximum years of

How To Get Forms

service, maximum retirement

Nondiscrimination Safe

benefits, application of offsets or

and Publications

Harbors

fresh start wear-away formulas, or

limits designed to satisfy section 415.

Personal computer. You can

Line 14. This question may be used

An employee is treated as benefiting

access the IRS Web Site 24 hours a

by certain plans to request an

under a plan to which elective

day, 7 days a week at to:

optional determination regarding the

•

contributions under section 401(k) or

Download forms, instructions, and

design-based safe harbor under

employee contributions and matching

publications.

section 401(a)(4).

•

contributions under section 401(m)

See answers to frequently asked

may be made if the employee is

If this is a section 401(k) and/or

tax questions.

•

currently eligible to make such

section 401(m) plan that does not

Search publications on-line by topic

elective or employee contributions, or

contain a provision for nonelective

or keyword.

•

to receive a matching contribution,

employer contributions, this option

Send us comments or request help

whether or not the employee actually

should be marked “No.”

by email.

•

makes or receives such contributions,

If any disaggregated plan relies on

(Regulations section 1.401(k)-1(g)(4)

national tax news by e-mail.

a non-design based safe harbor or a

and 1.401(m)-1(f)(4)). However, do

general test this option must be

You can also reach us using file

not apply this rule to determine if an

marked ‘‘No.’’ The Schedule Q may

transfer protocol at ftp.irs.gov.

employee is to be counted as

be used to request a determination

CD-ROM for tax products. You can

benefiting for lines 13i and 13k if, in

regarding a non-design based safe

order Pub. 1796, Federal Tax

accordance with the exception

harbor or a general test.

Products on CD-ROM, and get:

following the instruction for line 13d,

•

If this plan has been restructured

Current year forms, instructions,

the information provided in lines 13e

into component plans, this option

and publications.

through 13k relates to the portion of

•

must be marked “No.” The Schedule

Prior year forms, instructions, and

the plan that is not subject to the rule

Q may be used to request a

publications.

in Regulations section

•

determination regarding how each

Frequently requested tax forms

1.401(a)(4)-1(b)(2)(ii)(B).

restructured component plan satisfies

that may be filled in electronically,

Line 13k. See the instructions for

the nondiscrimination in amount

printed out for submission, and saved

line 13i for the meaning of ‘‘benefiting

requirement of Regulations section

for recordkeeping.

under the plan.’’

•

1.401(a)(4)-1(b)(2).

The Internal Revenue Bulletin.

Line 13l. To obtain the ratio

Buy the CD-ROM on the Internet

If “Yes” is checked, or if “No” is

percentage:

at /cdorders from the

checked but a request for a

Step 1. Divide the number on line

National Technical Information

determination regarding a non-design

13k (nonexcludable NHCEs

Service (NTIS) for $22 (plus a $5

based safe harbor or a general test is

benefiting under the plan) by the

handling fee).

made on Schedule Q, the

number on line 13j (nonexcludable

determination letter for the plan will

By phone and in person. You can

NHCEs).

also be a determination regarding the

order forms and publications by

Step 2. Divide the number on line

section 401(a)(4) requirement that a

calling 1-800-TAX- FORM

13i (nonexcludable HCEs benefiting

plan not discriminate in the amounts

(1-800-829-3676). You can also get

under the plan) by the number on line

of contributions or benefits.

most forms and publications at your

13h (nonexcludable HCEs).

local IRS office.

If “No” is checked, and a request

Step 3. Divide the result from Step

for a determination regarding a

For questions regarding this form,

1 by the result from Step 2.

non-design based safe harbor or a

call the Tax Exempt and Government

general test is not made on Schedule

Line 13m. See the exception

Entities Customer Service, toll-free

Q, the determination letter for the

following the instructions for line 13d.

Monday through Friday, at

plan will not be a determination

To determine the ratio percentages

1-877-829-5500 between 8:00 a.m.

regarding this requirement, unless the

for the section 401(k) and all section

and 6:30 p.m. eastern time.

401(m) (matching and employee

plan is a section 401(k) and/or

contribution) portions of the plan,

section 401(m) plan only.

Privacy Act and Paperwork

follow the steps described in the

Line 14a. Check ‘‘Yes’’ if the plan is

Reduction Act Notice. We ask for

instructions for lines 13d through 13l,

intended to satisfy the permitted

the information on this form to carry

but treat an employee as benefiting

disparity requirements of section

out the Internal Revenue laws of the

under the rules for section 401(k)

401(I).

United States. If you want to have

plans and section 401(m) plans

Line 14b. To satisfy section 401(l), a

your plan approved by the IRS, you

described in the instruction for line

plan must provide that the overall

are required to give us the

13i.

permitted disparity limits are not

information. We need it to determine

If the ratio percentage entered

exceeded and specify how

whether you meet the legal

TIP

on line 13l and/or line 13m is

employer-provided contributions or

requirements for plan approval.

less than 70%, the plan does

benefits under the plan are adjusted,

Section 6109 requires you to provide

not satisfy the ratio percentage test.

if necessary, to satisfy the overall

your taxpayer identification number

-7-

Instructions For Form 5300 - Application For Determination For Employee Benefit Plan - 2004 Page 7

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