Free Form 8905 (Rev. April 2006) - Federal

Form

8905

Certification of Intent To Adopt a Pre-approved Plan
Eligibility for the six (6) year remedial amendment cycle as described in Part IV of IRS Revenue Procedure 2005-66
Attach to Form 5300, 5307, 5310

OMB No. 1545-2011 For IRS Use Only

(April 2006)
Department of the Treasury Internal Revenue Service

Part I

Plan Sponsor Information - Enter all requested information

1a Employer name

1b Employer Identification Number (EIN) 1c Employer's plan name

1d Plan number

1e Plan type - Enter 1 for DCP or 2 for DBP

Part II

Master and Prototype (M&P) Sponsor or Volume Submitter Practitioner Information - Enter all requested information

2a Name of M&P sponsor or volume submitter practitioner

2b M&P sponsor or volume submitter practitioner EIN 2c Plan name of M&P sponsor or volume submitter practitioner (see instructions)

Part III

Certifications

This certification must be signed and dated by both parties before the end of the employer's applicable five-year remedial amendment cycle as determined under Part III of Revenue Procedure 2005-66 (see instructions regarding who must sign).

3 Under penalties of perjury the employer identified in line 1a, certifies that it intends to adopt the plan identified in line 2c.

Signature / Title of employer

Date

4 The M&P sponsor or volume submitter practitioner, listed above, certifies that an application for an opinion or advisory letter for the M&P or volume submitter specimen plan identified above was filed with the IRS by

MM

DD

Y YY Y
Date
Cat. No. 37714B Form

Preparer's signature / Title of M&P sponsor or volume submitter practitioner
For Paperwork Reduction Act Notice, see instructions.

8905

(4-2006)

*37714B04200601*

Form 8905 (4-2006)

Page

2

General Instructions
Purpose of Form
Use Form 8905 to treat an employer as eligible for the 6-year remedial amendment cycle under Part IV of Rev. Proc. 2005-66, 2005-37 I.R.B. 509.

Line 1b ­ Employer Identification Number (EIN). Enter the 9-digit EIN assigned to the plan sponsor/employer. Do not use a social security number or the EIN of the trust.
CAUTION

Line 4. Enter the date by which the opinion or advisory letter application for the M&P or volume submitter specimen plan being adopted by the employer must be submitted as determined under Part IV of Rev. Proc. 2005-66. Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. You are required to give us the information. 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. 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 required by Internal Revenue Code section 6103. The time needed to complete and file this form will vary depending on individual circumstances. The estimated average time is: Recordkeeping 3 hr., 21 mins. Learning about the law or the form 12 mins. Preparing, copying, assembling, and sending the form to the IRS 15 mins. 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 write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave., NW, IR-6406, Washington, DC 20224. Do not send Form 8905 to this address; instead, see the instructions for the application with which this form is filed.

Who May File
An adopter of an individually designed plan or pre-approved plan (not otherwise entitled to the 6-year remedial amendment cycle) files this form to request that their 5-year remedial amendment cycle be converted to the 6-year remedial amendment cycle (as described under Parts III and IV of Rev. Proc. 2005-66).

Line 1c ­ Employer's plan name. Enter the name of the employer's plan which will be amended or restated by the adoption of a pre-approved plan. Line 1e ­ Plan Type. Enter "1" for a defined contribution plan (DCP). Enter "2" for a defined benefit plan (DBP).

When To Complete
Complete Form 8905 before the end of the employer's 5-year remedial cycle as determined under Part III of Rev. Proc. 2005-66.

Part II ­ M&P Sponsor or Volume Submitter Practitioner
Line 2a ­ Name of M&P sponsor or volume submitter practitioner. Enter the name of the sponsor of the M&P or volume submitter practitioner whose plan you will be adopting. Line 2b ­ M&P sponsor or volume submitter practitioner EIN. Enter the 9-digit EIN assigned to the M&P sponsor or volume submitter practitioner. Line 2c ­ Plan name of the M&P sponsor or volume submitter practitioner. Enter the plan name of the M&P plan or volume submitter specimen plan. Example. Volume Submitter Profit Sharing Plan.

How to File
File the completed Form 8905 by attaching it to one of the following applications. Form 5300, Application for Determination for Employee Benefit Plan Form 5307, Application for Determination for Adopters of Master or Prototype or Volume Submitter Plans Form 5310, Application for Determination for Terminating Plan

Filing a Complete Certification
Certifications are screened for completeness. The certification must be signed and dated by the employer and the pre-approved plan sponsor or practitioner. You must retain a complete certification until it is filed with the appropriate application.
CAUTION

Part III ­ Certifications
The employer and the M&P sponsor or volume submitter practitioner must sign and date this certification before the end of the employer's applicable 5-year remedial amendment cycle as determined under Part III, sections 9.03 and 12.01 of Rev. Proc. 2005-66. Stamped signatures will not be accepted.

Specific Instructions
Part I ­ Plan Sponsor Information
Line 1a ­ Employer name. Enter the company (employer's) complete name.