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Federal housing law

1119 Form 5306-A (PDF)

Federal housing law as enacted — verbatim and citable.

Edition
2026-10-03
Last updated
2026-10-04
Jurisdiction
United States

Official source: IRS Forms, Instructions & Publications (https://www.irs.gov/pub/irs-pdf/f5306a.pdf), retrieved 2026-10-03. U.S. Government work (17 U.S.C. § 105).


(1) Prototype simplified employee pension (SEP) under section 408(k) (2) Prototype savings incentive match plan for employees of small employers (SIMPLE IRA plan) under section 408(p) b Initial application c Amendment—Enter ▶ (1) Latest letter serial number (2) Date letter issued (3) File folder number

Number, street, and room or suite no. (if a P.O. box, see instructions)

City or town, state, and ZIP code

5a Name of person to be contacted 5b Telephone number

5c Email address

5d If a power of attorney is attached, check box . . ▶ 6 Type of submission (check one box): a Not a mass submitter b Mass submitter c Identical adoption of a mass submitter d Minor modification of a mass submitter 7a If box 6c or 6d is checked, enter the mass submitter’s name: b File folder number of the mass submitter’s SEP or SIMPLE IRA plan on which this submission is based: 8 Type of sponsoring organization: a Insurance company e Regulated investment company b Trade or professional organization f Federally insured credit union c Savings and loan association that qualifies as a bank g Approved non-bank trustee (attach copy of approval

d Bank letter) Part II SEP Information

Attach a copy of the SEP documents and indicate the article or section and the page number where
the following provisions appear. If any item does not apply, write “N/A.” Sample language, or a listing
of required modifications (LRMs), is available at_www.irs.gov/LRMS._Sponsors are encouraged to use
LRM language.


Plan Article or
Section
Reference
Plan
Page
Number
For
IRS Use
Only
9a


Does the SEP cover all employees who have attained age 21, performed service
for the employer in 3 of the immediately preceding 5 years, and received at least
$600* in compensation from the employer for the year, other than employees who
may be excluded under section 410(b)(3)(A) or (C)? .
.
.
.
.
.
.
.
.
.
**b **Does the SEP provide that all eligible employees will share in an allocation? .
.
cDoes the SEP contain a definite allocation formula that does not discriminate in
favor of highly compensated employees? .
.
.
.
.
.
.
.
.
.
.
.
.
**d **Does the SEP require that it be used only with pre-approved traditional IRAs? .
eDoes the SEP prohibit restrictions on withdrawals (other than restrictions
permitted under section 408(d)(7)(A) in the case of a salary reduction SEP)? .
.
f

Does the SEP define “compensation” in a manner that satisfies one of the safe
harbor definitions under section 414(s) and limit compensation under section
408(k)(3)(C)? .
.
.
.
.
.
.
.
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.
**1 **
9a


Does the SEP cover all employees who have attained age 21, performed service
for the employer in 3 of the immediately preceding 5 years, and received at least
$600* in compensation from the employer for the year, other than employees who
may be excluded under section 410(b)(3)(A) or (C)? .
.
.
.
.
.
.
.
.
.
**b **Does the SEP provide that all eligible employees will share in an allocation? .
.
cDoes the SEP contain a definite allocation formula that does not discriminate in
favor of highly compensated employees? .
.
.
.
.
.
.
.
.
.
.
.
.
**d **Does the SEP require that it be used only with pre-approved traditional IRAs? .
eDoes the SEP prohibit restrictions on withdrawals (other than restrictions
permitted under section 408(d)(7)(A) in the case of a salary reduction SEP)? .
.
f

Does the SEP define “compensation” in a manner that satisfies one of the safe
harbor definitions under section 414(s) and limit compensation under section
408(k)(3)(C)? .
.
.
.
.
.
.
.
.
.
.
.
.
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.
**2 **
9a


Does the SEP cover all employees who have attained age 21, performed service
for the employer in 3 of the immediately preceding 5 years, and received at least
$600* in compensation from the employer for the year, other than employees who
may be excluded under section 410(b)(3)(A) or (C)? .
.
.
.
.
.
.
.
.
.
**b **Does the SEP provide that all eligible employees will share in an allocation? .
.
cDoes the SEP contain a definite allocation formula that does not discriminate in
favor of highly compensated employees? .
.
.
.
.
.
.
.
.
.
.
.
.
**d **Does the SEP require that it be used only with pre-approved traditional IRAs? .
eDoes the SEP prohibit restrictions on withdrawals (other than restrictions
permitted under section 408(d)(7)(A) in the case of a salary reduction SEP)? .
.
f

Does the SEP define “compensation” in a manner that satisfies one of the safe
harbor definitions under section 414(s) and limit compensation under section
408(k)(3)(C)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
**3 **
9a


Does the SEP cover all employees who have attained age 21, performed service
for the employer in 3 of the immediately preceding 5 years, and received at least
$600* in compensation from the employer for the year, other than employees who
may be excluded under section 410(b)(3)(A) or (C)? .
.
.
.
.
.
.
.
.
.
**b **Does the SEP provide that all eligible employees will share in an allocation? .
.
cDoes the SEP contain a definite allocation formula that does not discriminate in
favor of highly compensated employees? .
.
.
.
.
.
.
.
.
.
.
.
.
**d **Does the SEP require that it be used only with pre-approved traditional IRAs? .
eDoes the SEP prohibit restrictions on withdrawals (other than restrictions
permitted under section 408(d)(7)(A) in the case of a salary reduction SEP)? .
.
f

Does the SEP define “compensation” in a manner that satisfies one of the safe
harbor definitions under section 414(s) and limit compensation under section
408(k)(3)(C)? .
.
.
.
.
.
.
.
.
.
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.
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.
.
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.
**5 **

d Bank letter) Part II SEP Information

9a


Does the SEP cover all employees who have attained age 21, performed service
for the employer in 3 of the immediately preceding 5 years, and received at least
$600* in compensation from the employer for the year, other than employees who
may be excluded under section 410(b)(3)(A) or (C)? .
.
.
.
.
.
.
.
.
.
**b **Does the SEP provide that all eligible employees will share in an allocation? .
.
cDoes the SEP contain a definite allocation formula that does not discriminate in
favor of highly compensated employees? .
.
.
.
.
.
.
.
.
.
.
.
.
**d **Does the SEP require that it be used only with pre-approved traditional IRAs? .
eDoes the SEP prohibit restrictions on withdrawals (other than restrictions
permitted under section 408(d)(7)(A) in the case of a salary reduction SEP)? .
.
f

Does the SEP define “compensation” in a manner that satisfies one of the safe
harbor definitions under section 414(s) and limit compensation under section
408(k)(3)(C)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**6 **
9a


Does the SEP cover all employees who have attained age 21, performed service
for the employer in 3 of the immediately preceding 5 years, and received at least
$600* in compensation from the employer for the year, other than employees who
may be excluded under section 410(b)(3)(A) or (C)? .
.
.
.
.
.
.
.
.
.
**b **Does the SEP provide that all eligible employees will share in an allocation? .
.
cDoes the SEP contain a definite allocation formula that does not discriminate in
favor of highly compensated employees? .
.
.
.
.
.
.
.
.
.
.
.
.
**d **Does the SEP require that it be used only with pre-approved traditional IRAs? .
eDoes the SEP prohibit restrictions on withdrawals (other than restrictions
permitted under section 408(d)(7)(A) in the case of a salary reduction SEP)? .
.
f

Does the SEP define “compensation” in a manner that satisfies one of the safe
harbor definitions under section 414(s) and limit compensation under section
408(k)(3)(C)? .
.
.
.
.
.
.
.
.
.
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.
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**7 **
  • This is the amount for 2019 and 2020. The amount may be increased in future years for cost-of-living adjustments.

Sign Here

Under penalties of perjury, I declare that I have examined this application, including accompanying statements, and, to the best of my knowledge and belief, it is true, correct, and complete.

Signature of officer Date

Title

For Paperwork Reduction Act Notice, see the instructions. Cat. No. 32621R Form 5306-A (Rev. 11-2019)

Form 5306-A (Rev. 11-2019) Part III SIMPLE IRA Plan Information Page 2
Attach a copy of the SIMPLE IRA plan documents and indicate the article or section and the page
number where the following provisions appear. If an item does not apply, enter “N/A.” Sample
language, or a listing of required modifications (LRMs), is available at_www.irs.gov/LRMS._Sponsors
are encouraged to use LRM language.


Plan Article or
Section
Reference
Plan
Page
Number
For
IRS Use
Only
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**1 **
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**2 **
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**3 **
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**4 **
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**5 **
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**6 **
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**7 **
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**8 **
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**9 **
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
10
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
11
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
12
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
13
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
14
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
15
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
16
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
.
**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
.
.
**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
.

mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
.
.
.
.
.
.
.
.
.
**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
.
.
.
.
.
.
.
.
.
.
**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
.
**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
.
**q **Does the plan prohibit restrictions on withdrawals? .
.
.
.
.
.
.
.
.
.
**r **

Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
17
10aDoes the plan define the term “employer” to include all members of such groups
or entities required to be aggregated with the employer? .
.
.
.
.
.
.
.
b

Does the plan limit adoption to employers that have 100 or fewer employees who
earned $5,000 or more in compensation from the employer during the preceding
calendar year? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**c **Does the plan limit adoption to employers that do not maintain another qualified
plan to which contributions are made or benefits accrued?
.
.
.
.
.
.
.
**d **Does the plan define the term “employee” to include leased employees and
employees described in section 401(c)(1)? .
.
.
.
.
.
.
.
.
.
.
.
.
**e **Does the plan cover all employees except those who may be excluded under
section 408(p)(4)? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
**f **

Does the plan provide that each eligible employee may make or modify a salary
reduction agreement during the 60-day period immediately preceding the
calendar year after receiving proper notice?
.
.
.
.
.
.
.
.
.
.
.
.
**g **Does the plan provide that salary reduction contributions may not exceed the
statutory limits? .
.
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**h **Under the plan, is an eligible employee permitted to terminate a salary reduction
election at any time? .
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**i **
Is the interest of an eligible employee in the plan nonforfeitable at all times? .
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**j **


Does the plan provide that the employer will make matching contributions to each
eligible employee’s SIMPLE IRA equal to the employee’s salary reduction
contribution, up to a limit of 3% of the employee’s compensation for the calendar
year? .
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**k **Does the plan provide that the employer will make a 2% nonelective contribution
to each eligible employee’s SIMPLE IRA in lieu of matching contributions?
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**l **

Does the plan require that the employer will make salary reduction contributions
to eligible employees’ SIMPLE IRAs no later than 30 days after the month in which
the amounts would otherwise have been payable to the employee in cash? .
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mUnless the employer has chosen, does the plan allow each eligible employee to
select the financial institution for their SIMPLE IRA? .
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**n **

If the employer has selected the financial institution, does the plan require the
financial institution to meet the notification requirements of section 408(p)(7) and
limited in accordance with section 408(p)(2)(B)? .
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**o **Does the plan define “compensation” as described in section 408(p)(6)(A)? .
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**p **Does the plan require that it be used only with pre-approved SIMPLE IRAs? .
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**q **Does the plan prohibit restrictions on withdrawals? .
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Does the plan provide that amendments will become effective only at the
beginning of a calendar year and will conform to the content of the plan notice for
the calendar year? .
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18

Form 5306-A (Rev. 11-2019)

Form 5306-A (Rev. 11-2019) Page 3

General Instructions

Section references are to the Internal Revenue Code unless otherwise noted. Future Developments

For the latest information about developments related to Form 5306-A and its instructions, such as legislation enacted after they were published, go to www.irs.gov/Form5306A .

Purpose of form. Form 5306-A is used by sponsors who want to get IRS approval of their prototype simplified employee pension (SEP) agreements or savings incentive match plans for employees of small employers (SIMPLE IRA plans).

Who may file. Use Form 5306-A to request a favorable opinion letter if:

  • You are a bank, federally insured credit union, savings and loan association that qualifies as a bank, insurance company, regulated investment company, or trade or professional society or association (other than an employee association); and

  • You want to get a favorable opinion letter that a SEP agreement or SIMPLE IRA plan to be used by more than one employer is acceptable in form.

Who does not need to file. Instead of designing their own SEP or SIMPLE IRA plan, sponsors may use one of the Form 5304 or 5305 series of model forms to establish a SEP or a SIMPLE IRA plan. Sponsors who use one of these forms with individual retirement accounts or annuities for which the IRS has issued a favorable opinion or ruling letter, or with model individual retirement accounts issued by the IRS, are considered to have established a SEP or SIMPLE IRA plan that meets the requirements of section 408(k) or 408(p). Do not file Form 5306-A if you use a model form.

Note: The IRS will not issue an opinion letter on a document submitted with Form 5306-A that is a combination of a prototype SEP or SIMPLE IRA plan and a prototype individual retirement account or annuity.

What to file. File this application and one copy of all documents that make up the SEP agreement or SIMPLE IRA plan.

If this is an amendment, include a copy of the amendment and an explanation of its effect on the SEP agreement or SIMPLE IRA plan.

Where to file. File Form 5306-A at this address.

Internal Revenue Service Attn: EP Opinion Letters TE/GE Stop 31A Team 105 P.O. Box 12192 Covington, KY 41012-0192

Private delivery services (PDSs). PDSs can't deliver to the address shown above. If you choose to use a PDS, send Form 5306-A to this address.

Internal Revenue Service Attn: EP Opinion Letters 7940 Kentucky Drive TE/GE Stop 31A Team 105 Florence, KY 41042

Go to www.irs.gov/PDS for the current list of designated services.

Signature. An officer who is authorized to sign or another person authorized under a power of attorney must sign this application. (Send the power of attorney with this application when you file it.)

Exceptions & meaning →

Specific Instructions

User fee. All applications must be accompanied by the appropriate user fee. Applications submitted without the proper user fee will not be processed and will be returned to the applicant.

To determine the proper user fee, see Rev. Proc. 2019-4, 2019-1 I.R.B. 146, available at www.irs.gov/ irb/2019-01_IRB#RP-2019-04, or the latest annual update.

Line 2c. If you are amending your previously approved SEP or SIMPLE IRA plan, enter the letter serial number, date, and file folder number from the latest opinion letter you received for your SEP or SIMPLE IRA plan.

Line 3. If the application is for a SEP that provides for elective deferrals intended to meet the requirements of section 408(k)(6), check the box.

The Small Business Job Protection Act of 1996 (P.L. 104-188) repealed section 408(k)(6), effective December 31, 1996, except with respect to a SEP of an employer if the terms of the SEP of such employer, as in effect on December 31, 1996, provided for elective deferrals.

Line 4a. Include the suite, room, or other unit number after the street number. If the Post Office does not deliver mail to the street address and you have a P.O. box, show the box number instead of the street address.

Paperwork Reduction Act Notice

We ask for the information on this form to carry out the Internal Revenue laws of the United States. We need it to ensure that you are complying with these laws and to allow us to figure and collect the right amount of tax. This information is needed to process your application and to determine whether your prototype SEP or SIMPLE IRA plan meets the requirements of section 408(k) or 408(p). You are not required to apply for approval; however, if you want to receive an opinion letter from the IRS regarding your prototype SEP or SIMPLE IRA plan, you are required to provide the information requested on this form.

You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as stated in section 6103.

The time needed to complete and file this form will vary depending on individual circumstances. The estimated average time is:

Recordkeeping . . . 15 hr., 46 min.

Learning about the law or the form . . . . . 1 hr., 23 min.

Preparing, copying, assembling, and sending the form to the IRS . . . . . . 1 hr., 42 min.

If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we would be happy to hear from you. You can send us comments from www.irs.gov/FormComments . Or you can write to Internal Revenue Service, Tax Forms and Publications Division, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send the form to this address. Instead, see Where to file, earlier.

Exceptions & meaning →

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