IRS Form 5500 "Annual Return/Report of Employee Benefit Plan"

What Is Form 5500?

IRS Form 5500, Annual Return/Report of Employee Benefit Plan, is a document used to report information about Direct Filing Entities, or DFEs (investment arrangements that manage funds from various plans), and employee benefit plans. Each sponsor or administrator of an employee benefit plan subject to the Employee Retirement Income Security Act of 1974 (ERISA) has to report information about benefit plans every year. This form is the outcome of cooperation between the Internal Revenue Service (IRS), the Department of Labor (DOL), and the Pension Benefit Guaranty Corporation (PBGC). These agencies consolidated several report forms and returns to reduce the burden of filing for employers and plan administrators.

The latest version of the form was jointly released by the IRS, DOL, and the PBGC in 2019 with all previous editions obsolete. A fillable Form 5500 sample is available for download below.

Unlike many other documents, this form cannot be filed by mail or another delivery service. 5500 Forms are to be filed electronically via the DOL's Employee Retirement Income Security Act Filing Acceptance System, and a Form 5500 mailing address does not exist.

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IRS Form 5500 Schedules

To comply with the IRS Form 5500 filing requirements, you must file it with certain schedules. Schedules depend on whether the form is filed for a «large plan» (100 or more participants at the beginning of the year) or a «small plan» (under 100 participants at the beginning of the year). You need to know what particular plan of the DFE is involved - pension plan, welfare plan, group insurance arrangement (GIA), etc.

Pension Schedules

General Schedules

IRS Form 5500 Instructions

  1. Part I - Annual Report Identification:
    • Describe the type of plan - a multi-employer, a single-employer, a DFE;
    • State if it is a first, amended, final, or a short plan year return/report;
    • Indicate if the plan is a collectively-bargained plan;
    • Check the appropriate box if you file under Form 5558, automatic extension, or special extension.
  2. Part II - Basic Plan Information:
    • Enter the formal name of the plan, its number and effective date;
    • Write down the plan sponsor's name, employer's identification number, the mailing address, the telephone number, and the business code;
    • Sign and date the form, and enter the name of the individual who signs the document (a plan administrator, an employer, a plan sponsor, a DFE);
    • Enter the required numbers of participants that meet certain conditions;
    • Write down the number of employers obligated to contribute to the plan. Indicate the applicable pension/welfare feature codes;
    • State the plan funding and plan benefit arrangements;
    • Check the appropriate boxes to show which schedules are attached.
  3. Part III - Form M-1 Compliance Information (for welfare benefit plans):
    • State if the plan was subject to the Form M-1 filing requirements if it is in compliance with these requirements;
    • Enter the Receipt Confirmation Code for the Form M-1 annual report.

When Is Form 5500 Due?

Form 5500 due date is the last day of the seventh month after the end of the plan year. It is possible to extend the deadline by filing a Form 5558, Application for Extension of Time to File Certain Employee Plan Returns, therefore, submitting the report of employee benefit plan 2.5 months later. There is a penalty for late filing from the IRS and the DOL: $25 per day and $1100 per day respectively.


IRS 5500 Related Forms:

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Download IRS Form 5500 "Annual Return/Report of Employee Benefit Plan"

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Annual Return/Report of Employee Benefit Plan
OMB Nos. 1210-0110
Form 5500
1210-0089
This form is required to be filed for employee benefit plans under sections 104
and 4065 of the Employee Retirement Income Security Act of 1974 (ERISA) and
Department of the Treasury
sections 6057(b) and 6058(a) of the Internal Revenue Code (the Code).
2019
Internal Revenue Service
Department of Labor
 Complete all entries in accordance with
Employee Benefits Security
the instructions to the Form 5500.
Administration
This Form is Open to Public
Pension Benefit Guaranty Corporation
Inspection
Part I
Annual Report Identification Information
For calendar plan year 2019 or fiscal plan year beginning
and ending
a multiemployer plan
a multiple-employer plan (Filers checking this box must attach a list of
A
This return/report is for:
participating employer information in accordance with the form instructions.)
a single-employer plan
a DFE (specify)
the first return/report
the final return/report
B
This return/report is:
an amended return/report
a short plan year return/report (less than 12
months)
C
If the plan is
a collectively-bargained plan, check here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
D
Form 5558
automatic extension
the DFVC program
Check box if filing under:
special extension (enter description)
Part II
Basic Plan Information
—enter all requested information
1a
1b
Name of plan
Three-digit plan
number (PN) 
1c
Effective date of plan
2a
2b
Plan sponsor’s name (employer, if for a single-employer plan)
Employer Identification
Mailing address (include room, apt., suite no. and street, or P.O. Box)
Number (EIN)
City or town, state or province, country, and ZIP or foreign postal code (if foreign, see instructions)
2c
Plan Sponsor’s telephone
number
2d
Business code (see
instructions)
Caution: A penalty for the late or incomplete filing of this return/report will be assessed unless reasonable cause is established.
Under penalties of perjury and other penalties set forth in the instructions, I declare that I have examined this return/report, including accompanying schedules,
statements and attachments, as well as the electronic version of this return/report, and to the best of my knowledge and belief, it is true, correct, and complete.
SIGN
HERE
Signature of plan administrator
Date
Enter name of individual signing as plan administrator
SIGN
HERE
Signature of employer/plan sponsor
Date
Enter name of individual signing as employer or plan sponsor
SIGN
HERE
Signature of DFE
Date
Enter name of individual signing as DFE
For Paperwork Reduction Act Notice, see the Instructions for Form 5500.
Form 5500 (2019)
v. 190130
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001
YYYY-MM-DD
012345678
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI
D/B/A ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI
ABCDEFGHI
c/o ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI
123456789 ABCDEFGHI ABCDEFGHI ABCDE
123456789 ABCDEFGHI ABCDEFGHI ABCDE
CITYEFGHI ABCDEFGHI AB, ST 012345678901
UK
0123456789
012345
YYYY-MM-DD
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDE
YYYY-MM-DD
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDE
YYYY-MM-DD
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDE
Annual Return/Report of Employee Benefit Plan
OMB Nos. 1210-0110
Form 5500
1210-0089
This form is required to be filed for employee benefit plans under sections 104
and 4065 of the Employee Retirement Income Security Act of 1974 (ERISA) and
Department of the Treasury
sections 6057(b) and 6058(a) of the Internal Revenue Code (the Code).
2019
Internal Revenue Service
Department of Labor
 Complete all entries in accordance with
Employee Benefits Security
the instructions to the Form 5500.
Administration
This Form is Open to Public
Pension Benefit Guaranty Corporation
Inspection
Part I
Annual Report Identification Information
For calendar plan year 2019 or fiscal plan year beginning
and ending
a multiemployer plan
a multiple-employer plan (Filers checking this box must attach a list of
A
This return/report is for:
participating employer information in accordance with the form instructions.)
a single-employer plan
a DFE (specify)
the first return/report
the final return/report
B
This return/report is:
an amended return/report
a short plan year return/report (less than 12
months)
C
If the plan is
a collectively-bargained plan, check here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
D
Form 5558
automatic extension
the DFVC program
Check box if filing under:
special extension (enter description)
Part II
Basic Plan Information
—enter all requested information
1a
1b
Name of plan
Three-digit plan
number (PN) 
1c
Effective date of plan
2a
2b
Plan sponsor’s name (employer, if for a single-employer plan)
Employer Identification
Mailing address (include room, apt., suite no. and street, or P.O. Box)
Number (EIN)
City or town, state or province, country, and ZIP or foreign postal code (if foreign, see instructions)
2c
Plan Sponsor’s telephone
number
2d
Business code (see
instructions)
Caution: A penalty for the late or incomplete filing of this return/report will be assessed unless reasonable cause is established.
Under penalties of perjury and other penalties set forth in the instructions, I declare that I have examined this return/report, including accompanying schedules,
statements and attachments, as well as the electronic version of this return/report, and to the best of my knowledge and belief, it is true, correct, and complete.
SIGN
HERE
Signature of plan administrator
Date
Enter name of individual signing as plan administrator
SIGN
HERE
Signature of employer/plan sponsor
Date
Enter name of individual signing as employer or plan sponsor
SIGN
HERE
Signature of DFE
Date
Enter name of individual signing as DFE
For Paperwork Reduction Act Notice, see the Instructions for Form 5500.
Form 5500 (2019)
v. 190130
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c/o ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI
123456789 ABCDEFGHI ABCDEFGHI ABCDE
123456789 ABCDEFGHI ABCDEFGHI ABCDE
CITYEFGHI ABCDEFGHI AB, ST 012345678901
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Form 5500 (2019)
Page
3a
3b
Plan administrator’s name and address
Same as Plan Sponsor
Administrator’s EIN
3c
Administrator’s telephone
number
4
4b
If the name and/or EIN of the plan sponsor or the plan name has changed since the last return/report filed for this plan,
EIN
enter the plan sponsor’s name, EIN, the plan name and the plan number from the last return/report:
a
4d
Sponsor’s name
PN
c
Plan Name
5
Total number of participants at the beginning of the plan year
5
6
Number of participants as of the end of the plan year unless otherwise stated (welfare plans complete only lines 6a(1),
6a(2), 6b, 6c, and 6d).
a(1)
6a(1)
Total number of active
participants at the beginning of the plan year ...............................................................................
a(2)
6a(2)
Total number of
active participants at the end of the plan year .......................................................................................
b
6b
Retired or
separated participants receiving benefits..............................................................................................................
c
6c
Other retired or separated
participants entitled to future benefits ..........................................................................................
d
6d
Subtotal. Add lines 6a(2), 6b,
and 6c.................................................................................................................................
...
e
6e
Deceased participants
whose beneficiaries are receiving or are entitled to receive benefits. ................................................
f
6f
Total. Add lines 6d and 6e.
..................................................................................................................................................
g
Number of participants with
account balances as of the end of the plan year (only defined contribution plans
6g
complete this item)
.............................................................................................................................................................
h
Number of participants who
terminated employment during the plan year with accrued benefits that were
6h
less than 100% vested
.........................................................................................................................................................
7
Enter the total number of
employers obligated to contribute to the plan (only multiemployer plans complete this item).........
7
8a
If the plan provides pension benefits, enter the applicable pension feature codes from the List of Plan Characteristics Codes in the instructions:
b
If the plan provides welfare benefits, enter the applicable welfare feature codes from the List of Plan Characteristics Codes in the instructions:
9a
9b
Plan funding arrangement (check all that apply)
Plan benefit arrangement (check all that apply)
(1)
Insurance
(1)
Insurance
(2)
Code section 412(e)(3) insurance contracts
(2)
Code section 412(e)(3) insurance contracts
(3)
Trust
(3)
Trust
(4)
General assets of the sponsor
(4)
General assets of the sponsor
10
Check all applicable boxes in 10a and 10b to indicate which schedules are attached, and, where indicated, enter the number attached. (See instructions)
a
b
Pension Schedules
General Schedules
(1)
R (Retirement Plan Information)
(1)
H (Financial Information)
(2)
I (Financial Information – Small Plan)
(2)
MB (Multiemployer Defined Benefit Plan and Certain Money
(3)
___
A (Insurance Information)
Purchase Plan Actuarial Information) - signed by the plan
actuary
(4)
C (Service Provider Information)
(5)
D (DFE/Participating Plan Information)
(3)
SB (Single-Employer Defined Benefit Plan Actuarial
Information) - signed by the plan actuary
(6)
G (Financial Transaction Schedules)
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Form 5500 (2019)
Page
Part III
Form M-1 Compliance Information (to be completed by welfare benefit plans)
11a
If the plan provides welfare benefits, was the plan subject to the Form M-1 filing requirements during the plan year? (See instructions and 29 CFR
2520.101-2.) ........................………..….
Yes
No
If “Yes” is checked, complete lines 11b and 11c.
11b
Is the plan currently in compliance with the Form M-1 filing requirements? (See instructions and 29 CFR 2520.101-2.) …….....
Yes
No
11c
Enter the Receipt Confirmation Code for the 2019 Form M-1 annual report. If the plan was not required to file the 2019 Form M-1 annual report, enter the
Receipt Confirmation Code for the most recent Form M-1 that was required to be filed under the Form M-1 filing requirements. (Failure to enter a valid
Receipt Confirmation Code will subject the Form 5500 filing to rejection as incomplete.)
Receipt Confirmation Code______________________
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