Specific Instructions

Line 1 — Reason for filing.   Enter the appropriate code that describes the reason you are filing Form 5310-A.

  Enter 1 for a notice of qualified separate lines of business.

  Enter 2 for a notice of a plan merger or consolidation.

  Enter 3 for a notice of a plan spinoff.

  Enter 4 for a notice of a transfer of plan assets or liabilities to another plan.

Part I — All Filers Must Complete Part I

Lines 2a and 2b.   Enter the name and address of the employer or plan sponsor. A plan sponsor means:
  1. In the case of a plan that covers the employees of one employer, the employer;

  2. In the case of a plan sponsored by two or more entities required to be aggregated under sections 414(b), (c), or (m), one of the members participating in the plan; or

  3. In the case of a plan that covers the employees and/or partners of a partnership, the partnership.

  The name of the plan sponsor/employer should be the same name that was or will be used when the Form 5500, Annual Return/Report of Employee Benefit Plan, series returns/reports are filed for the plan.

Address.   Include the suite, room, or other unit number after the street address. If the Post Office does not deliver mail to the street address and the plan has a P.O. box, show the box number instead of the street address. This address should be the address of the sponsor/employer.

Line 2g.   Enter the 9-digit employer identification number (EIN) assigned to the plan sponsor/employer. This should be the same EIN that was or will be used when the Form 5500 series annual returns/reports are filed for the plan. For a multiple employer plan, the EIN should be the same EIN that was or will be used when Form 5500 is filed.

  Do not use a social security number or the EIN of the trust.

  The plan sponsor/employer must have an EIN. A plan sponsor/employer without an EIN can apply for one.
  • Online—Generally, a plan sponsor/employer can receive an EIN by Internet and use it immediately to file a return. Go to the IRS website at www.irs.gov/businesses/small and click on Employer ID Numbers.

  • By telephone—Call 1-800-829-4933.

  • By mail or fax—Send in a completed Form SS-4, Application for Employer Identification Number, to apply for an EIN.

Note.

Form SS-4 can be obtained at Social Security Administration (SSA) offices or by calling 1-800-TAX-FORM.

   For the plan of a group of entities required to be combined under sections 414(b), (c), or (m), whose sponsor is more than one of the entities required to be combined, enter the EIN of only one of the sponsoring members. This EIN must be used in all subsequent filings of determination letter requests, and for filing annual returns/reports unless there is a change of sponsor.

Line 3.   The contact person will receive copies of all correspondence as authorized in a Form 2848, or Tax Information Authorization, Form 8821. Either complete the contact's information on this line, or check the box and attach a completed Form 2848 or Form 8821.

Part II—Plan Merger, Consolidation, Spinoff, or Transfer

Line 4a.   Enter the name you designated for your plan. Due to space restrictions, this field is limited to 70 characters, including spaces. Due to this restriction, “Employee” and “Trust” are not necessary in the plan name.

Line 4b.   Enter the 3-digit number, beginning with “001” and continuing in numerical order for each plan you adopt (001–499). The number assigned to a plan must not be changed or used for any other plan. This should be the same number that was or will be used when the Form 5500 series returns/reports are filed for the plan.

Lines 5a.   Attach an actuarial statement of valuation showing compliance with section 414(l). The statement must (1) identify the type of transaction involved (for example, merger or consolidation, spinoff, or transfer of plan assets or liabilities), and (2) provide information verifying compliance with the requirements of sections 401(a)(12) and 414(l). This statement need not be signed by an actuary.

Line 5b.   Enter the code that describes your plan.

  Enter 1 for a profit-sharing plan.

  Enter 2 for a stock bonus plan.

  Enter 3 for a money purchase plan.

  Enter 4 for a target benefit plan.

  Enter 5 for a profit-sharing/401(k) plan.

  Enter 6 for an ESOP plan.

  Enter 7 for other and specify the type of plan.

Line 6a.   Enter the total number of plans, other than the plan named on line 4a, involved in this transaction.

Lines 6c through 6h.   Complete lines 6c through 6h for the other plan(s) involved in the merger or consolidation, spinoff, or transfer of plan assets or liabilities with the plan named on line 4a. If there is more than one other plan, attach a separate statement showing the information requested for lines 6c through 6h.

Example:   Plans A, B, and C are merging with Plan D. Plan D would complete a Form 5310-A, reporting information about itself on line 4. Plan D would then complete the line 6 information for Plan A and attach two statements showing the line 6 information for Plans B and C. In addition, Plans A, B, and C must each file a separate Form 5310-A (see the example of a plan merger).

Line 6h.   Enter the code that describes the other plan.

  Enter 1 for a defined benefit plan.

  Enter 2 for a profit-sharing plan.

  Enter 3 for a profit-sharing/401(k) plan.

  Enter 4 for a stock bonus plan.

  Enter 5 for an ESOP plan.

  Enter 6 for a money purchase plan.

  Enter 7 for a target benefit plan.

Part III—Qualified Separate Lines of Business

Rev. Proc. 93-40, 1993-2 C.B. 535, contains procedures relating to the notification requirements of section 414(r)(2)(B).

Notice given by an employer applies to all plans maintained by the employer for plan years beginning in the testing year. Once the notification date (see When To File) for a testing year has passed, the employer is deemed to have irrevocably elected to apply the specified section(s) on the basis of QSLOBs for all plan years beginning in the testing year.

In addition, after the notification date, notice cannot be modified, withdrawn, or revoked, and will be treated as applying to subsequent testing years unless the employer takes timely action to provide new notice (see examples under Who Must File). Timely action will be deemed to have been taken any time prior to the notification date for any subsequent testing year.

Line 7a.   If you previously filed a notice of QSLOB for a testing year, enter the first testing year for which such notice applied on line 7b. Enter the date the notice was filed on line 7c.

Line 8.   Enter the first testing year for which this notice applies. See When To File for the definition of “testing year.

Line 9.   Indicate whether you are filing this form to give notice that you are no longer testing on a QSLOB basis. If your answer to line 9 is “Yes,” complete line 10 and skip lines 11 and 12. Answer line 10 based on the previously filed notice that you are now revoking. If your answer to line 9 is “No,” complete lines 10 through 12. See Who Must File for an example of a revocation.

  

Line 10.   Section 414(r) provides rules for determining whether an employer operates QSLOBs for purposes of applying sections 410(b) (relating to minimum coverage), 401(a)(26) (relating to minimum participation rules), and 129(d)(8) (relating to dependent care assistance programs). If you are treated as operating QSLOBs under section 414(r), you will be permitted to apply the aforementioned Code provisions separately for the employees in each QSLOB. Check the appropriate box(es) for the section(s) you are testing on a QSLOB basis. See instructions for line 9 to determine how to answer this question if you answered "Yes" to line 9.

Line 11.   Attach a list identifying the part or parts of the employer that make up each QSLOB of the employer. The list should include, for example, the type of business or industry in which the QSLOB is involved, the business unit (such as corporation, partnership, or division) the qualified line of business comprises, and the name (formal or informal) of the QSLOB.

Line 12.   Enter the information requested on lines 12a through 12e. If there is more than one plan, attach a separate statement showing the information requested on lines 12a through 12e for each plan.

Line 12b.   Enter the date of the determination letter, if any. Otherwise, leave blank.

Line 12c.   If the plan is a master or prototype or volume submitter plan, enter the date of the letter and the serial number or the advisory letter number, as applicable.

Line 12d.   Enter the appropriate date of any pending letter request. If this question is not applicable, leave blank.

Line 12e.   List on this line the QSLOBs identified on line 11 that have employees benefiting under the plan. If you need additional space to list the QSLOBs, use the area below line 12e.


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