IRS Form 4461-A "Application for Approval of Standardized or Nonstandardized Pre-approved Defined Benefit Plan"

What Is IRS Form 4461-A?

This is a tax form that was released by the Internal Revenue Service (IRS) - a subdivision of the U.S. Department of the Treasury on November 1, 2019. As of today, no separate filing guidelines for the form are provided by the IRS.

Form Details:

  • A 5-page form available for download in PDF;
  • Actual and valid for filing 2020 taxes;
  • Additional instructions and information can be found on page 3 of the document;
  • Editable, printable, and free;

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Download IRS Form 4461-A "Application for Approval of Standardized or Nonstandardized Pre-approved Defined Benefit Plan"

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4461-A
Application for Approval of Standardized or
OMB No. 1545-0169
Form
Nonstandardized Pre-Approved Defined
(Rev. November 2019)
Benefit Plan
This Form Is Open to Public Inspection
Department of the Treasury
Go to www.irs.gov/Form4461A for the latest information.
Internal Revenue Service
For IRS Use Only
File This Form With the Internal Revenue Service
File folder number
Section references are to the Internal Revenue Code unless otherwise noted.
Complete every applicable item on this form and Attachment 1-A. (See Rev. Proc. 2017-41, 2017-29 I.R.B. 92.)
See instructions before completing this form.
1
Enter amount of user fee submitted
$
2b File folder number
2c Date of last letter issued
2 a Approval requested:
Initial application
Amendment—Enter file folder number in line 2b
and date of last letter issued in line 2c .
.
3b Employer identification number
3 a Name of applicant
(EIN) of applicant
Address (number, street, room or suite no.) (If a P.O. box, see instructions.)
City
State
ZIP code
3c Applicant’s telephone number
3 d Type of applicant (see Definitions in the instructions):
Provider
Mass submitter
4a Name of person to be contacted
4c Fax number
4b Telephone number
4 d Email address
4e If a power of attorney is attached, check box
.
.
5a Basic plan document or single document plan number
5b Adoption agreement number, if applicable
6
Form of plan:
Adoption agreement plan
Single document plan
7
Type of plan (select all that apply):
Without permitted disparity
With permitted disparity
Governmental
Nonelecting church
Without cash balance features
With cash balance features
8
Filing status of plan:
Standardized plan
Nonstandardized plan
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
Date
Title
4461-A
For Privacy Act and Paperwork Reduction Act Notice, see the instructions.
Form
(Rev. 11-2019)
Cat. No. 11416U
4461-A
Application for Approval of Standardized or
OMB No. 1545-0169
Form
Nonstandardized Pre-Approved Defined
(Rev. November 2019)
Benefit Plan
This Form Is Open to Public Inspection
Department of the Treasury
Go to www.irs.gov/Form4461A for the latest information.
Internal Revenue Service
For IRS Use Only
File This Form With the Internal Revenue Service
File folder number
Section references are to the Internal Revenue Code unless otherwise noted.
Complete every applicable item on this form and Attachment 1-A. (See Rev. Proc. 2017-41, 2017-29 I.R.B. 92.)
See instructions before completing this form.
1
Enter amount of user fee submitted
$
2b File folder number
2c Date of last letter issued
2 a Approval requested:
Initial application
Amendment—Enter file folder number in line 2b
and date of last letter issued in line 2c .
.
3b Employer identification number
3 a Name of applicant
(EIN) of applicant
Address (number, street, room or suite no.) (If a P.O. box, see instructions.)
City
State
ZIP code
3c Applicant’s telephone number
3 d Type of applicant (see Definitions in the instructions):
Provider
Mass submitter
4a Name of person to be contacted
4c Fax number
4b Telephone number
4 d Email address
4e If a power of attorney is attached, check box
.
.
5a Basic plan document or single document plan number
5b Adoption agreement number, if applicable
6
Form of plan:
Adoption agreement plan
Single document plan
7
Type of plan (select all that apply):
Without permitted disparity
With permitted disparity
Governmental
Nonelecting church
Without cash balance features
With cash balance features
8
Filing status of plan:
Standardized plan
Nonstandardized plan
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
Date
Title
4461-A
For Privacy Act and Paperwork Reduction Act Notice, see the instructions.
Form
(Rev. 11-2019)
Cat. No. 11416U
2
Form 4461-A (Rev. 11-2019)
Page
9
Procedural requirements:
Yes
No
a Have the following been submitted as required by instructions:
(1)
Adoption agreement, if applicable?
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(2)
Copy of plan?
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(3)
Copy of Certification of Interim Amendments? .
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b Do you have a procedure in place for the adoption and distribution of interim amendments made on behalf of
adopting employers? .
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c Is the plan patterned after, and substantially the same as, another plan submitted? (If “Yes,” see Specific
Instructions.) .
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d Provider (non-mass submitter) request.
Do you have at least 15 employer-clients which are reasonably expected to adopt this plan’s basic plan
(1)
document and adoption agreement or single document plan? .
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(2)
If you have more than one pre-approved plan, do you have at least 30 employer-clients in the aggregate
which are reasonably expected to adopt at least one of the plans? (If you don’t have more than one
pre-approved plan, skip this question.)
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e Mass submitter request.
(1)
Are applications on behalf of the requisite number of providers who are adopting the same basic plan
document on a word-for-word identical basis included? If “No,” complete (2)
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(2)
If “No” to (1), enter the file folder number of the basic plan document for which the requisite number
of adopting providers requirement is met:
(3)
Is this a flexible plan? If “Yes,” answer (a) and (b). If “No,” skip (a) and (b) .
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(a) Have you bracketed and identified the optional provisions of the plan?
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(b) Have you included a copy of the written representation describing the choices available to providers
and the coordination of optional provisions?
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Note: This application is designed to be used in conjunction with Rev. Proc. 2017-41. A List of Required Modifications (LRMs) is also
recommended for use and may be obtained from the IRS website at www.irs.gov/lrms.
4461-A
Form
(Rev. 11-2019)
3
Form 4461-A (Rev. 11-2019)
Page
General Instructions
For approval, file this application and
Disclosure requested by taxpayer. A
each applicable document listed on line
taxpayer may request the IRS to
Section references are to the Internal
9a. A mass submitter should also file
disclose and discuss the return or return
Revenue Code unless otherwise noted.
Form(s) 4461-B, Application for Approval
information with any person(s) the
of Standardized or Nonstandardized Pre-
taxpayer designates in a written request.
Future Developments
Approved Plans, as needed.
If you want to designate a person(s) to
assist in an application for approval, you
For the latest information about
Multiple adoption agreement plans. A
must provide the IRS office of
developments related to Form 4461-A,
provider may use one basic plan
jurisdiction with a written request that
such as legislation enacted after the
document for several plans. A provider
contains the following.
form was published, go to
may, for example, use one basic plan
www.irs.gov/Form4461A.
document with a standardized plan with
• The taxpayer’s name, address, EIN,
or without permitted disparity as well as
and plan number(s).
Purpose of Form
a nonstandardized plan with or without
• The name, address, social security
permitted disparity. Submit a separate
Form 4461-A is used to apply for
number, and telephone number(s) of the
adoption agreement and completed
approval of standardized or
person or persons whom you are
application for each such defined benefit
nonstandardized pre-approved defined
authorizing to receive return information.
plan. See section 9.06 of Rev. Proc.
benefit plans.
• A paragraph that clearly describes the
2017-41 for more details, including the
Be sure to submit a complete and
return or return information that you
special rules for governmental and
accurate application, including Form
authorize the IRS to disclose.
nonelecting church plans. In the case of
4461-A and Attachment 1-A (see
simultaneous submissions of plans using
• An authorized signature (see above).
www.irs.gov/retirement-plans/
the same basic plan document, submit
As an alternative to providing the
preapproved-plan-submission-
only one copy of the basic plan
procedures or Rev. Proc. 2017-41,
above statement, you may submit
document. If the requests aren’t
2017-29 I.R.B. 92). Complete every
Form 2848, Power of Attorney and
simultaneous, submit separate basic
applicable line on the application. If an
Declaration of Representative.
plan documents and include a cover
item on the Attachment 1-A doesn’t
letter identifying the original submission.
Definitions
apply, check the “N/A” box or enter
The number assigned to the basic plan
“N/A” on the line where indicated as an
document of a standardized or
Adoption agreement. An adoption
option. If your application isn’t complete,
nonstandardized pre-approved plan
agreement is the portion of the plan
we will return it without processing it.
must remain the same as in the prior
containing all the options that the
The first page must be typed. Unless
submission. One basic plan document
adopting employer may select. The
otherwise noted, the questions on Form
may not be used for both defined benefit
adoption agreement may include blanks
4461-A and Attachment 1-A apply to
and defined contribution plans.
or fill-in provisions for the employer to
both standardized and nonstandardized
complete if it also includes parameters
Two or more single document plans. A
pre-approved defined benefit plans.
on these provisions that preclude an
provider may not combine different
employer from completing them in a
Requests for additional information. If
categories in a single document plan or
manner that could violate the
a letter requesting additional information
application. See section 9.07 of Rev.
qualification requirements. Each
or changes to plan documents is sent to
Proc. 2017-41 for more details, including
separate adoption agreement is treated
the pre-approved plan provider, or an
the special rules for governmental and
as a separate plan and will receive its
authorized representative, such
nonelecting church plans.
own opinion letter.
information and/or changes must be
Where To File
received no later than 30 days from the
Basic plan document. A basic plan
date of the letter. Failure to respond
document is the portion of the plan
Send Form 4461-A to:
timely may result in the application being
containing all the nonelective provisions
considered withdrawn. An extension of
Internal Revenue Service
applicable to all adopting employers. No
the 30-day time limit will be granted only
Attn: Pre-Approved Plans
options (including blanks to be
for good cause.
Coordinator
completed) may be provided in the
Room 6-403, Group 7521
basic plan document except for options
Inadequate submissions. We will
P.O. Box 2508
in flexible plans.
return, without further action, plans that
Cincinnati, OH 45201-2508
aren’t in substantial compliance with the
Single document plan. A single
qualification requirements or plans that
If using Express Mail or a private
document plan may contain alternate
are so deficient that they can’t be
delivery service, use this address:
paragraphs and options that may be
reviewed in a reasonable amount of time.
selected by an adopting employer. A
Internal Revenue Service
single document plan may include
Who May File
Attn: Pre-Approved Plans
blanks or fill-in provisions for the
Coordinator
A provider or mass submitter of a pre-
employer to complete only if the plan
Room 6-403, Group 7521
approved defined benefit plan may file a
also includes parameters on these
550 Main Street
provisions that preclude an employer
Form 4461-A. See Definitions, later.
Cincinnati, OH 45202
from completing them in a manner that
What To File
Signature. The application must be
could violate the qualification
signed by a partner or officer of the
requirements.
Submit one copy of Form 4461-A and
applicant who is authorized to sign, or
Attachment 1-A for each separate
other person authorized by a power of
adoption agreement or for each single
attorney. The power of attorney should
document plan where no adoption
be filed with the application.
agreement is used.
4
Form 4461-A (Rev. 11-2019)
Page
Flexible plan. A flexible plan is a plan
A provider also includes any person
If multiple adoption agreements are
submitted by a mass submitter which
that has an established place of
linked to the same basic plan document,
contains certain optional provisions as
business in the United States where it is
the same two-digit basic plan document
allowed by section 10.03(1) of Rev. Proc.
accessible during every business day
number should be used for all
2017-41. Providers that adopt a flexible
and offers a plan as a word-for-word
applications.
plan may include or delete any optional
identical adopter or minor modifier
Line 5b. Enter the three-digit number
provision designated as such in the
adopter of a plan of a mass submitter,
you have assigned to the adoption
mass submitter’s plan. A flexible plan
regardless of the number of employers
agreement for which this application is
adopted by a provider which differs from
that are expected to adopt the plan.
submitted. Each different adoption
the mass submitter plan only because of
Standardized plan. A standardized plan
agreement designed to accompany a
the deletion of certain optional
is a pre-approved plan (other than a
single basic plan document should be
provisions will be treated as a plan that
statutory hybrid plan) that meets the
given a different three-digit number
is word-for-word identical to the mass
requirements set forth in section 5.16 of
beginning with “001.” For example, if the
submitter plan.
Rev. Proc. 2017-41.
first basic plan document of a sponsor
Mass submitter. As set forth in Rev.
has four different adoption agreements,
Nonstandardized plan. A
Proc. 2017-41, any entity that submits
they should be numbered “001” through
nonstandardized plan is a pre-approved
applications on behalf of at least 30
“004,” and the provider should submit
plan that isn’t a standardized plan and
unaffiliated providers each of which is
four separate Forms 4461-A. Adoption
that satisfies section 5.15 of Rev. Proc.
sponsoring, on a word-for-word identical
agreements submitted with the second
2017-41.
basis, the same plan is a mass
or any subsequent basic plan
Statutory hybrid plan. A statutory
documents (that aren’t word-for-word
submitter. A mass submitter is treated as
hybrid plan is a defined benefit plan that
a mass submitter with respect to all of its
identical to a previously submitted basic
contains a statutory hybrid benefit
plans, provided the 30-unaffiliated-
plan document) should be similarly
formula, as defined in Regulations
provider requirement is met with respect
numbered beginning with “001.”
section 1.411(a)(13)-1(d)(4). Section 6.03
to at least one plan.
Line 9. Procedural requirements.
of Rev. Proc. 2017-41 (as revised by
Submit a separate application for each
Affiliation is determined under sections
Rev. Proc. 2018-21, 2018-14 I.R.B. 467)
414(b) and (c). Additionally, the following
different plan/adoption agreement
provides a list of areas not covered by
will be considered to be affiliated: any
combination or single document plan.
opinion letters. This list includes
law firm, accounting firm, consulting
Line 9c. If you checked “Yes,” submit a
statutory hybrid plans with certain
firm, etc., with its partners, members,
features, such as a statutory hybrid
copy of such plan with language
associates, etc. For purposes of
differences highlighted. Attach a cover
benefit formula that isn’t a cash balance
determining whether 30 unaffiliated
formula. See section 6.03 of Rev. Proc.
letter that includes the following.
providers sponsor on a word-for-word
2017-41 for the complete list.
• The name and file folder number of the
identical basis the same plan document,
plan, including the name and EIN of the
the mass submitter is treated as an
Specific Instructions
provider.
unaffiliated provider.
• A list of all plans written by the plan
Line 1. All applications submitted must
Pre-approved plan. A pre-approved
drafter that are substantially identical to
be accompanied by the appropriate user
plan is a plan (including a plan covering
the lead plan, including the information
fee and Form 8717-A, User Fee for
self-employed individuals) that is made
described above.
Employee Plan Opinion Letter Request,
available by a provider for adoption by
as determined from the schedule in Rev.
employers. The term pre-approved plan
• A description of each place where the
Proc. 2019-4, 2019-1 I.R.B. 146 (or the
includes both standardized and
plan for which the application is being
latest annual update). Applications
nonstandardized plans. A pre-approved
submitted isn’t word-for-word identical
submitted without the proper user fee
plan may be an adoption agreement plan
to the language of the lead plan,
won’t be processed and will be returned
including an explanation of the purpose
or a single document plan. An adoption
to the applicant.
and effect of each difference.
agreement plan consists of a basic plan
document and an adoption agreement. A
Line 3a. Enter the name and address of
• A certification made under penalty of
single document plan consists of a
the applicant. If the Post Office doesn’t
perjury by the plan drafter that the
single plan document offered by a
deliver mail to the street address and
information describing where the plan
provider without an adoption agreement.
the applicant has a P.O. box number,
language isn’t word-for-word identical is
show the P.O. box number instead of the
true and complete.
Provider. A provider is any person
street address.
(including a mass submitter, if
Line 9e. In addition to filing Form
applicable) that (1) has an established
Line 4a. If the person to be contacted is
4461-A, the mass submitter should use
place of business in the United States
Form 4461-B, when submitting
other than an employee of the applicant,
where it is accessible during every
please enclose an authorized power of
applications on behalf of its adopting
business day; and (2) represents to the
attorney. See Disclosure requested by
providers, and submit Form 8717-A.
IRS that it has at least 15 employer-
taxpayer, earlier.
clients, each of which is reasonably
Line 4c. Enter a fax number to receive
expected to adopt the same pre-
notice of preliminary approval of the
approved plan of the provider.
applicable plan, subject to final approval
A provider may request an opinion
by opinion letter.
letter for more than one plan provided it
Line 5a. Enter the two-digit number you
represents to the IRS that it has at least
have assigned to your single document
30 employer-clients in the aggregate,
plan or basic plan document that
each of which is reasonably expected to
accompanies the adoption agreement
adopt at least one of the provider’s
for which you are requesting approval.
plans.
5
Form 4461-A (Rev. 11-2019)
Page
Privacy Act and Paperwork Reduction
any Internal Revenue law. Generally, tax
If you have comments concerning the
Act Notice. We ask for the information
returns and return information are
accuracy of these time estimates or
on this form to carry out the Internal
confidential, as required by Code section
suggestions for making this form
Revenue laws of the United States. You
6103.
simpler, we would be happy to hear from
are required to give us this information.
you. You can send us comments from
The time needed to complete and file
We need it to determine whether you
www.irs.gov/FormComments. Or you
this form will vary depending on
meet the legal requirements for plan
can write to the Internal Revenue
individual circumstances. The estimated
approval.
Service, Tax Forms and Publications
average time is:
Division, 1111 Constitution Ave. NW,
You aren’t required to provide the
Recordkeeping
.
.
. 42 hr., 5 min.
IR-6526, Washington, DC 20224. Don’t
information requested on a form that is
send Form 4461-A to this address.
Learning about the law
subject to the Paperwork Reduction Act
Instead, see Where To File, earlier.
or the form .
.
.
.
. 5 hr., 55 min.
unless the form displays a valid OMB
control number. Books or records
Preparing the form .
. 7 hr., 48 min.
relating to a form or its instructions must
Copying, assembling, and
be retained as long as their content may
sending the form to the IRS . 16 min.
become material in the administration of