SECTION 15. PAPERWORK — Internal Revenue Bulletin 2024-34

REDUCTION ACT

The collection of information included in this revenue procedure has been reviewed and approved by the Office of Management and Budget in accordance with the Paperwork Reduction Act (44 U.S.C. section 3507) under control number 1545-2073.

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the

collection of information displays a valid OMB control number.

The collection of information in this revenue procedure is in sections 3 through 11 of this revenue procedure. This collection of information is required to provide sufficient information to enable the IRS to evaluate, process, and rule on the request for approval to use substitute mortality tables. This information will be used to make determinations under § 430(h)(3) of the Code. The likely respondents are businesses or other forprofit institutions and nonprofit institutions.

The estimated total annual reporting/ recordkeeping burden is 4,000 hours.

The estimated burden per respondent/ recordkeeper varies from 167 to 900 hours, depending on individual circumstances, with an estimated average burden of 267 hours. The estimated average number of expected respondents/recordkeepers is 15 per year.

The estimated frequency of responses is once every 10 years.

Books or records relating to a collection of information must be retained as long as their contents may become material in the administration of any internal revenue law. Generally, tax returns and tax return information are confidential, as required by 26 U.S.C. section 6103.

DRAFTING INFORMATION

The principal author of this revenue procedure is Arslan Malik of the Office of the Associate Chief Counsel, Employee Benefits, Exempt Organizations, and Employment Taxes (CC:EEE). For further information regarding the submission of a request for approval to use substitute mortality tables, please contact Christopher Denning at (202) 317-5755.

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Appendix A

REQUEST FOR APPROVAL TO USE SUBSTITUTE MORTALITY TABLES CHECKLIST

Instructions

You must include a completed copy of this checklist with your submission. Answer each question in the checklist by circling Yes, No, or N/A; explanations must be provided for “No” or “N/A” responses. If a completed checklist is not included, or if explanations are not provided for “No” and “N/A” responses, then your submission will be considered incomplete for purposes of section 4.02 of this revenue procedure.

Sign and date the checklist (as plan sponsor or authorized representative) and place it on top of your request.

Page number Response Item number Description of item in application Yes 1. Have you included the user fee required under Rev. Proc. 2024-4 or its No successors? (See section 3.02) N/A

Yes No N/A

If you are designating an authorized representative, have you included a properly executed Form 2848 (Power of Attorney)? (See section 3.03(1))

Yes 3. Have you satisfied all the requirements of Rev. Proc. 2024-4 or its sucNo cessors (especially concerning original signatures, penalties of perjury N/A statement, and statement of proposed deletions)? (See section 3.03(2)

and (3)) Yes 4. If any separate application for approval to use substitute mortality tables No will be made for other plans maintained within the applicant’s controlled N/A group, have you requested that the 180-day review period be extended?

Yes 4. If any separate application for approval to use substitute mortality tables No will be made for other plans maintained within the applicant’s controlled N/A group, have you requested that the 180-day review period be extended?

(See section 4.03) Yes 5. For a request for approval to use substitute mortality tables submitted for No a plan year beginning during 2025 less than 7 months before the first day N/A of the plan year, and no later than October 31, 2024, have you included

Yes 5. For a request for approval to use substitute mortality tables submitted for No a plan year beginning during 2025 less than 7 months before the first day N/A of the plan year, and no later than October 31, 2024, have you included

a request for a 90-day extension of the 180-day review period? (See section 4.04) Yes 6. Have you identified the first day of the first plan year for which approval No to use substitute mortality tables is requested and the number of years N/A for which the substitute mortality tables would be used? (See section

Yes 6. Have you identified the first day of the first plan year for which approval No to use substitute mortality tables is requested and the number of years N/A for which the substitute mortality tables would be used? (See section

5.03) Yes 7. Have you included a description of the populations for which approval No to use substitute mortality tables is requested? (See section 5.04) N/A

Have you included a description of the populations for which approval to use substitute mortality tables is requested? (See section 5.04)

Yes No N/A

Yes 8. Have you included the identification information required under section No 6.01 for the Plan (or for each plan in the Aggregated Group) for which N/A approval to use substitute mortality tables is requested?

Yes 9. Have you provided the information required for each plan for which No substitute mortality tables are not intended to be used? (See section 6.02) N/A

Have you provided the information required for each plan for which substitute mortality tables are not intended to be used? (See section 6.02)

Yes No N/A

Have you provided the information required for each other plan for which substitute mortality tables are being used or are intended to be

used? (See section 6.03)

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Yes No N/A

Yes 11. If the applicant is a plan sponsor of a multiple-employer plan, have No you provided either (1) a statement that none of the employers whose N/A employees participate in the plan are treated as maintaining the plan

under § 1.430(h)(3)-2(c)(7)(ii); or (2) if one or more of the participating employers is treated as maintaining the plan under § 1.430(h)(3)-2(c)(7) (ii), the information specified in section 6.02 and 6.03 of this revenue procedure, as applicable, treating each such employer as the applicant? (See section 6.04) Yes 12. Have you provided the required information for any plans that were No spun off from another plan maintained by the applicant or a member of N/A the applicant’s controlled group within the past 5 years? (See section

Yes 12. Have you provided the required information for any plans that were No spun off from another plan maintained by the applicant or a member of N/A the applicant’s controlled group within the past 5 years? (See section

6.05) Yes 13. Have you identified the Experience Study Period and the base year for No the Substitute Base Tables? (See section 7.01) N/A

Have you identified the Experience Study Period and the base year for the Substitute Base Tables? (See section 7.01)

Yes No N/A

Yes 14. Have you provided the full credibility threshold and the number of No actual deaths during the Experience Study Period for each population N/A within the Plan (or Aggregated Group) for which approval to use substi tute mortality tables is requested (see section 7.02)? Yes 15. Have you identified whether the applicant used either or both of the No optional rules specified in section 7.03? N/A

Have you identified whether the applicant used either or both of the optional rules specified in section 7.03?

Yes No N/A

Yes 16. Have you included a table showing the required information for each No applicable population within the Plan (or Aggregated Group), for each N/A 12-month period of the Experience Study Period and also as an aggre gate amount for all 12-month periods in the Experience Study Period? (See section 7.04) Yes 17. Have you included the relevant standard mortality tables (which is the No base mortality table under § 1.430(h)(3)-1(d) projected with mortality N/A improvement to the base year for the Substitute Base Tables)? (See

Yes 17. Have you included the relevant standard mortality tables (which is the No base mortality table under § 1.430(h)(3)-1(d) projected with mortality N/A improvement to the base year for the Substitute Base Tables)? (See

section 7.05(1)) Yes 18. If any 12-month period in the experience study period begins in 2020, No 2021, or 2022, have you included the standard mortality table for the N/A calendar year in which the 12-month period begins reflecting the adjust

Yes 18. If any 12-month period in the experience study period begins in 2020, No 2021, or 2022, have you included the standard mortality table for the N/A calendar year in which the 12-month period begins reflecting the adjust ment provided for in § 1.430(h)(3)-2(d)(4)(iii)(B) for the 12-month period? (See section 7.05(2)) Yes 19. Have you included a description of the methods used to reflect exposure No periods of less than 12 months? (See section 7.06) N/A

Have you included a description of the methods used to reflect exposure periods of less than 12 months? (See section 7.06)

Yes No N/A

Have you included a description of any methods used to adjust the experience study data? (See section 7.07 and 7.08)
Have you included any other relevant information? (See section 7.09)
Have you included a table showing the average number of individuals during the Experience Study Period and the number of individuals within the population as of the last day of the plan year immediately preceding the date of this application, for each population within the Plan (or Aggregated Group) for which the approval to use substitute mortality

tables is requested? (See section 8.01)

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Yes No N/A

Yes 23. Have you provided information and analysis required if the population No has had a significant change in the number of participants, as described N/A in section 8.02?

Yes 24. Have you identified the Demonstration Period for all plans maintained No by the applicant or a member of the applicant’s controlled group other N/A than a plan for which approval to use substitute mortality tables is

requested or used for all populations or a newly-affiliated plan with respect to which the transition period has not ended before the first day of the Requested Efective Plan Year? (See section 9.01(1)) Yes 25. Have you identified the number of deaths during the Demonstration No Period for all plans maintained by the applicant or a member of the N/A applicant’s controlled group (other than a plan for which approval to use

Yes 25. Have you identified the number of deaths during the Demonstration No Period for all plans maintained by the applicant or a member of the N/A applicant’s controlled group (other than a plan for which approval to use

substitute mortality tables is requested or used for all populations or a newly affiliated plan with respect to which the transition period has not ended before the first day of the Requested Effective Plan Year) for any population for which there is a lack of credible mortality information (such that substitute mortality tables may not be used for that population)? (See section 9.01(2)) Alternatively, have you provided other information for a population that demonstrates that the number of deaths during the Demonstration Period would not exceed 100? (See section 9.02) Yes 26. Have you provided the mortality ratio for each population for which No approval to use substitute mortality tables is requested? (See section N/A 10.01)

Yes 26. Have you provided the mortality ratio for each population for which No approval to use substitute mortality tables is requested? (See section N/A 10.01)

Yes 27. For each population within the Plan (or Aggregated Group) whose morNo tality experience has full credibility, have you provided a full copy of the N/A Substitute Base Table? (See section 10.02)

Yes 28. For each population within the Plan (or Aggregated Group) for which No approval to use substitute mortality tables is requested but for which N/A mortality experience does not have full credibility, have you provided a

full copy of the base substitute mortality table constructed as if the population’s mortality information had full credibility, the partial credibility weighting factor, and a full copy of the Substitute Base Table reflecting credibility adjustments? (See section 10.03) Yes 29. Have you included a comparison of hypothetical funding targets deterNo mined using generally applicable mortality tables and the proposed N/A substitute mortality tables? (See section 11.01)

Yes 29. Have you included a comparison of hypothetical funding targets deterNo mined using generally applicable mortality tables and the proposed N/A substitute mortality tables? (See section 11.01)

Yes 30. Have you included the required sample generational mortality tables as No of the Requested Effective Plan Year, developed from each Substitute N/A Base Table? (See section 11.02)

Yes 31. Have you included annuity factors for each Substitute Base Table based No on the substitute mortality table for an individual whose year of birth is N/A 20 years before the base year for the Substitute Base Table? (See section

Have you included annuity factors for each Substitute Base Table based on the substitute mortality table for an individual whose year of birth is 20 years before the base year for the Substitute Base Table? (See section

11.03)

Signature _______________________ Date __________

Title or Authority _____________________________________

Typed or printed name of person signing checklist ____________________________________

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