SECTION 22. EFFECT ON OTHER

DOCUMENTS

.01 The definition of “opinion letter” in section 3.05 of Rev. Proc. 2013–4 is modified to provide that an opinion letter also includes a written statement issued by Employee Plans Rulings and Agreements to a prototype plan sponsor as to the acceptability, for purposes of § 403(b), of the form of a § 403(b) prototype plan. See Rev. Proc. 2013–22.

.02 The definition of “advisory letter” in section 3.11 of Rev. Proc. 2013–4 is modified to provide that an advisory letter also includes a written statement issued by Employee Plans Rulings and Agreements to a volume submitter practitioner as to the acceptability, for purposes of § 403(b), of the form of a § 403(b) specimen plan. See Rev. Proc. 2011–49 and Rev. Proc. 2013–22. .03 Rev. Proc. 2013–8 is modified to provide that the user fee for an application for an opinion or advisory letter for a § 403(b) pre-approved plan is the fee that would apply under section 6.03 or 6.04 of

April 29, 2013 1001 2013–18 I.R.B.

regarding this revenue procedure, please contact the Employee Plans taxpayer assistance answering service at 1–877–829–5500 (a toll-free number) or e-mail Ms. Carrington or Mr. Flannery at RetirementPlanQuestions@irs.gov .

the administration of any internal revenue law. Generally tax returns and tax return information are confidential, as required by 26 U.S.C. 6103.

DRAFTING INFORMATION

The principal authors of this revenue procedure are Angelique Carrington and James P. Flannery of the Employee Plans, Tax Exempt and Government Entities Division. For further information

2013–18 I.R.B. 1002 April 29, 2013

APPENDIX Application for Approval of § 403(b) Pre-approved Plan

1. Enter amount of user fee submitted: $

2. Name of applicant: a. EIN: b. Address: c. Phone:

3. Person to contact: a. Phone: b. Email address: c. Power of attorney attached?

4. Type of applicant (check one): a . Prototype sponsor b . Prototype mass submitter c . Volume submitter practitioner d . Volume submitter mass submitter e . Identical adopter of mass submitter plan f . Minor modifier of mass submitter prototype plan

5. Form of plan (check one); a . Prototype plan b . Volume submitter specimen plan without adoption agreement c . Volume submitter specimen plan with adoption agreement

6. If the plan is a prototype plan, indicate whether the plan is a (check one): a . Standardized plan b . Nonstandardized plan

7.a. Prototype plan basic plan document number (Each of the prototype sponsor’s or prototype mass submitter’s basic plan documents must be assigned a 2-digit number, starting with 01. Enter the number you have assigned to the basic plan document that is associated with the adoption agreement for which this application is filed.):

7.b. Prototype plan adoption agreement number (Each different adoption agreement associated with a single basic plan document must be assigned a 3-digit number, beginning with 001. Enter the number you have assigned to the adoption agreement for which this application is filed.):

7.c. Volume submitter specimen plan number (Each of the volume submitter practitioner’s or volume submitter mass submitter’s specimen plans must be assigned a 2-digit number, starting with 01. Enter the number you have assigned to the specimen plan for which this application is filed.):

7.d. Volume submitter plan adoption agreement number, if applicable (Each different adoption agreement associated with a single specimen plan must be assigned a 3-digit number, beginning with 001. Enter the number you have assigned to the adoption agreement for which this application is filed.):

8. If 4e or 4f is checked, complete the following information for the mass submitter’s plan on which this application is based, to the extent the information is available when this application is filed: a. Name of mass submitter: b. File folder number: c. Letter serial number: d. Date of letter: e. Basic plan document number or specimen plan number (if b, c, and d not available): f. Adoption agreement number, if applicable (if b, c, and d not available)

9. Investment arrangement(s) permitted under the prototype or specimen plan: a . Annuity contracts issued by an insurance company b . Custodial accounts c . Retirement income account

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10. Type(s) of contributions permitted under the prototype or specimen plan: a . Elective deferrals (other than Roth) b . Roth elective deferrals c . After-tax employee contributions d . Matching contributions e . Other nonelective employer contributions

11. Are the following documents included with the application: a. Basic plan document or specimen plan? b. Adoption agreement (if the application is for a prototype plan or for a specimen plan that uses an adoption agreement)?

12. If 4a or 4c is checked, do you expect at least 30 eligible employers to adopt your § 403(b) prototype plan basic plan documents(s) or volume submitter specimen plan(s)?

13. If 4b or 4d is checked, are applications on behalf of at least 30 prototype sponsors or volume submitters who are sponsoring the identical basic plan document or specimen plan included with this application?

14. If the answer to 13 is “no,” enter the enter the number of the basic plan document or specimen plan for which the requirement described in 13 is met:

15. Applicant’s signature under penalties of perjury (required if 4a, b, c, or d checked):

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: Title: Date:

16. Prototype sponsor’s or volume submitter’s and mass submitter’s signatures under penalties of perjury (required if 4e or 4f checked):

Under penalties of perjury, I declare that the prototype sponsor or volume submitter practitioner identified in line 2 of this application has adopted a prototype plan or a specimen plan that is identical to the mass submitter plan identified in line 7 or, in the case of a prototype plan, is a minor modifier of the mass submitter plan identified in line 7.

Prototype sponsor’s or volume submitter’s signature: Title: Date:

Mass submitter’s signature: Title: Date:

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