Form 5310 - Application For Determination For Terminating Plan Page 3
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133
Form 5310 (Rev. 12-2013)
Page
(Line 3 continued)
Yes
No
e
Do any amendments not considered in a prior DL have any discretionary provisions?
If “Yes,” and the amendment contains only discretionary provisions, mark an "X" in column (v) in the
table.
If “Yes,” and the amendment contains both interim and discretionary provisions, mark an "X" in columns
(iv) and (v) in the table.
Complete the following table (for (iv), (v), and (vi) mark with an “X” in the applicable boxes). If additional space is
f
needed, attach a separate sheet of paper the same size, label it “Attachment to 3f” using the same format as below.
Type of Amendment
(ii)
(iii)
(vii)
(vi)
(i)
Effective
Adoption
Due Date of Tax Return
Power to Amend
(iv)
Amendment ID
Date
Date
(v)
(including extensions)
on Behalf of
Interim
(MMDDYYYY)
(MMDDYYYY)
(MMDDYYYY)
Discr.
Amnd.
Amnd.
3f(1)
3f(2)
3f(3)
3f(4)
3f(5)
3f(6)
3f(7)
3f(8)
3f(9)
3f(10)
g
List total amendments on line 3f
h
Designate the specific tax return that the employer uses to file its return
5310
Form
(Rev. 12-2013)
11840Y12201303
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