Internal Revenue Bulletin 2017-29 (PDF rendition): IRS Notices

Preserve advance releases and the authoritative Internal Revenue Bulletin rendition; directory timestamps are file-publication metadata, not legal effective dates. HTML bulletins begin June 2003; earlier available issues require full PDF parsing. Whole bulletin rendition: numbered items are identified below; other legal material and publisher context remain included. This is not a new standalone advance release.

# INTERNAL REVENUE BULLETIN

IRS

## HIGHLIGHTS OF THIS ISSUE

These synopses are intended only as aids to the reader in
identifying the subject matter covered. They may not be
relied upon as authoritative interpretations.

## EMPLOYEE PLANS

### Notice 2017-37, page 89.

This notice contains the Cumulative List of Changes in Plan
Qualification Requirements for Pre-Approved Defined Contribu-
tion Plans for 2017 (2017 Cumulative List). The 2017 Cumu-
lative List identifies changes in the qualification requirements of
the Internal Revenue Code that are required to be taken into
account in a plan document submitted to the IRS under the
pre-approved plan program for purposes of receiving an opin-
ion letter.

### Rev. Proc. 2017-41, page 92.

This revenue procedure modifies and supersedes, in part, Rev.
Proc. 2015-36, 2015-27 I.R.B. 20, which sets forth the
procedures for issuing opinion and advisory letters on the form
of qualified retirement plans submitted under the pre-approved
plan program. The revenue procedure simplifies the current
program by restructuring the current master and prototype
and volume submitter pre-approved programs into a single
program that increases the types of eligible plans and permits
additional plan design options.

Bulletin No. 2017-29
July 17, 2017

## ADMINISTRATIVE

### Rev. Proc. 2017-42, page 124.

This procedure provides specifications for the private printing
of red-ink substitutes for the 2017 Forms W-2 and W-3. This
procedure will be produced as the next revision of Publication
1141. Rev. Proc. 2016-54 is superseded.

## EXEMPT ORGANIZATIONS

### T.D. 9819, page 85.

These final regulations allow the Commissioner of Internal
Revenue to adopt a streamlined application process that eligi-
ble organizations may use to apply for recognition of tax-
exempt status under section 501(c)(3) of the Internal Revenue
Code.

Finding Lists begin on page ii.

## The IRS Mission

Provide America's taxpayers top-quality service by helping
them understand and meet their tax responsibilities and en-
force the law with integrity and fairness to all.

## Introduction

The Internal Revenue Bulletin is the authoritative instrument of
the Commissioner of Internal Revenue for announcing official
rulings and procedures of the Internal Revenue Service and for
publishing Treasury Decisions, Executive Orders, Tax Conven-
tions, legislation, court decisions, and other items of general
interest. It is published weekly.

It is the policy of the Service to publish in the Bulletin all
substantive rulings necessary to promote a uniform application
of the tax laws, including all rulings that supersede, revoke,
modify, or amend any of those previously published in the
Bulletin. All published rulings apply retroactively unless other-
wise indicated. Procedures relating solely to matters of internal
management are not published; however, statements of inter-
nal practices and procedures that affect the rights and duties
of taxpayers are published.

Revenue rulings represent the conclusions of the Service on
the application of the law to the pivotal facts stated in the
revenue ruling. In those based on positions taken in rulings to
taxpayers or technical advice to Service field offices, identify-
ing details and information of a confidential nature are deleted
to prevent unwarranted invasions of privacy and to comply with
statutory requirements.

Rulings and procedures reported in the Bulletin do not have the
force and effect of Treasury Department Regulations, but they
may be used as precedents. Unpublished rulings will not be
relied on, used, or cited as precedents by Service personnel in
the disposition of other cases. In applying published rulings and
procedures, the effect of subsequent legislation, regulations,
court decisions, rulings, and procedures must be considered,
and Service personnel and others concerned are cautioned

against reaching the same conclusions in other cases unless
the facts and circumstances are substantially the same.

The Bulletin is divided into four parts as follows:

### Part I .- 1986 Code.

This part includes rulings and decisions based on provisions of
the Internal Revenue Code of 1986.

### Part II .- Treaties and Tax Legislation.

This part is divided into two subparts as follows: Subpart A, Tax
Conventions and Other Related Items, and Subpart B, Legisla-
tion and Related Committee Reports.

Part III .- Administrative, Procedural, and Miscellaneous.
To the extent practicable, pertinent cross references to these
subjects are contained in the other Parts and Subparts. Also
included in this part are Bank Secrecy Act Administrative Rul-
ings. Bank Secrecy Act Administrative Rulings are issued by
the Department of the Treasury's Office of the Assistant Sec-
retary (Enforcement).

### Part IV .- Items of General Interest.

This part includes notices of proposed rulemakings, disbar-
ment and suspension lists, and announcements.

The last Bulletin for each month includes a cumulative index for
the matters published during the preceding months. These
monthly indexes are cumulated on a semiannual basis, and are
published in the last Bulletin of each semiannual period.

The contents of this publication are not copyrighted and may be reprinted freely. A citation of the Internal Revenue Bulletin as the source would be appropriate.

## Part I. Rulings and Decisions Under the Internal Revenue Code of 1986

26 CFR 1.501(c)(3)-1: Organizations organized and
operated for religious, charitable, scientific, testing
for public safety, literary, or educational purposes ...

T.D. 9819

DEPARTMENT OF THE
TREASURY
Internal Revenue Service
26 CFR Part 1

Guidelines for the
Streamlined Process of
Applying for Recognition of
Section 501(c)(3) Status

AGENCY: Internal Revenue Service
(IRS), Treasury.

ACTION: Final regulations and removal
of temporary regulations.

SUMMARY: This document contains fi-
nal regulations that allow the Commis-
sioner of Internal Revenue to adopt a
streamlined application process that eligi-
ble organizations may use to apply for
recognition of tax-exempt status under
section 501(c)(3) of the Internal Revenue
Code (Code). The final regulations affect
organizations seeking recognition of tax-
exempt status under section 501(c)(3).

DATES: Effective Date: These regula-
tions are effective on June 30, 2017.

Applicability Dates: For dates of appli-
cability, see §§ 1.501(a)-1(f), 1.501(c)(3)-
1(h), and 1.508-1(c).

FOR FURTHER INFORMATION CON-
TACT: Peter A. Holiat at (202) 317-5800
(not a toll-free number).

SUPPLEMENTARY INFORMATION:

### Background

Since 1969, section 508 of the Code
has required an organization seeking tax-
exempt status under section 501(c)(3), as
a condition of its exemption, to notify the
Secretary of the Treasury (or his delegate)
that it is applying for recognition of
exempt status in the manner prescribed
in regulations, unless it is specifically
excepted from the requirement. Long-

standing regulations under §§ 1.501(a)-1,
1.501(c)(3)-1, and 1.508-1 had required
all organizations applying for recognition
of section 501(c)(3) exempt status to sub-
mit a properly completed and executed
Form 1023, "Application for Recognition of
Exemption Under Section 501(c)(3) of the
Internal Revenue Code," (see § 1.508-
1(a)(2) as contained in 26 CFR part 1, re-
vised April 1, 2014) and to submit with,
and as part of, the application, a detailed
statement of its proposed activities (see
§§ 1.501(a)-1(b)(1)(iii) and 1.501(c)(3)-
1(b)(1)(v) as contained in 26 CFR part 1,
revised April 1, 2014). Detailed proce-
dures for applying for recognition of ex-
emption are included in annual revenue
procedures and in the instructions for
Form 1023. See § 601.601(d)(2)(i)(b).

On July 2, 2014, final and temporary
regulations (TD 9674) authorizing the
Commissioner to adopt a streamlined ap-
plication process that eligible organiza-
tions may use to apply for recognition of
tax-exempt status under section 501(c)(3)
were published in the Federal Register
(79 FR 37630). The final and temporary
regulations were effective and applicable on
July 1, 2014. The 2014 final regulations
removed and reserved certain paragraphs of
the longstanding final regulations addressed
by corresponding paragraphs of the new
temporary regulations. Under the tempo-
rary regulations, the IRS instituted the
streamlined application process on Form
1023-EZ, "Streamlined Application for
Recognition of Exemption Under Section
501(c)(3) of the Internal Revenue Code,"
the detailed procedures for which have
been provided in annual revenue proce-
dures, most recently in Rev. Proc. 2017-5,
2017-1 IRB 230, and in the instructions
for Form 1023-EZ.

Also on July 2, 2014, a notice of
proposed rulemaking (REG-110948-14)
cross-referencing the temporary regula-
tions and soliciting public comments and
requests for a hearing was published in the
Federal Register (79 FR 37697). No
comments responding to the notice of pro-
posed rulemaking were received, and no
public hearing was requested or held. The
IRS continues to consider improvements

to Form 1023-EZ based on its own expe-
rience and informal comments received
from the public and other stakeholders on
the form, including whether to require ap-
plicants to submit a brief statement of
actual or proposed activities. Because the
proposed regulations contemplate that
guidance published in the Internal Reve-
nue Bulletin may prescribe the informa-
tion required of Form 1023-EZ filers,
including regarding their proposed activi-
ties, the Department of the Treasury
(Treasury Department) and the IRS have
concluded that the proposed regulations
are sufficiently flexible to allow such a
revision to the Form 1023-EZ at a future
date, as resources permit. Accordingly,
this Treasury decision adopts as final reg-
ulations, without substantive change, the
proposed regulations set forth in the 2014
notice of proposed rulemaking and re-
moves the corresponding temporary regu-
lations.

### Explanation of Provisions

The Treasury Department and the IRS
have considered how the process of meet-
ing the notice requirement of section 508
in seeking recognition of tax-exempt sta-
tus may be made more efficient for certain
smaller organizations. The IRS developed
Form 1023-EZ to provide a simplified
application form that relies more heavily
on attestations by the organization that it
meets the section 501(c)(3) organizational
and operational requirements, which are
explained in the accompanying form in-
structions. The new form was made
available for use by eligible small orga-
nizations in July 2014, following the
issuance of the temporary regulations
and a revenue procedure describing
the streamlined application process. The
streamlined application process gener-
ally allows eligible small organizations
to receive IRS determinations of tax-
exempt status more quickly and allows
the IRS to focus resources on more
complex exemption applications and
on compliance programs. This Treasury
decision adopts the 2014 proposed
regulations by amending §§ 1.501(a)-1,
1.501(c)(3)-1, and 1.508-1 to authorize

the continued use of the IRS' streamlined
process by eligible organizations to meet
the notice requirements of section 508.

Specifically, this Treasury decision
amends §§ 1.501(a)-1 and 1.501(c)(3)-1,
as in effect before July 2, 2014, to autho-
rize the Treasury Department and the IRS
to modify, by applicable regulations or
other guidance published in the Internal
Revenue Bulletin, the requirement that
an organization applying for section
501(c)(3) tax-exempt status provide a
detailed statement of its proposed activ-
ities. This document also amends the
§ 1.501(a)-1 provisions relating to the
Commissioner's ability to revoke a deter-
mination because of a change in the law or
regulations, or for other good cause, to
reference the Commissioner's authority
to retroactively revoke a determination
under section 7805(b). No substantive
change is intended by this amendment.
This Treasury decision also amends the
requirement in § 1.501(a)-1(b)(3) that an
organization claiming to be exempted
from filing annual returns file a statement
supporting its claim with and as a part of
its application. As amended, § 1.501(a)-
1(b)(3) allows an organization to file the
statement either in its application, or in a
manner prescribed in guidance published
in the Internal Revenue Bulletin. See Rev.
Proc. 2017-5 for rules for filing this state-
ment on Form 8940, "Request for Miscel-
laneous Determinations."

In addition, this document amends
§ 1.508-1 to provide that eligible organi-
zations may use Form 1023-EZ to notify
the Commissioner of their applications for
tax-exempt status under section 501(c)(3).
This Treasury decision also amends
§§ 1.501(a)-1 and 1.508-1 to state that
the office to which applications should be
submitted will be published in the Internal
Revenue Bulletin or instructions to the
Form 1023 or Form 1023-EZ.

Finally, this Treasury decision incorpo-
rates minor revisions within the portions of
§§ 1.501(a)-1, 1.501(c)(3)-1, and 1.508-1
that are otherwise being amended. In
§ 1.501(a)-1(a)(2), the reference to "internal
revenue district" is removed because such
reference has been made obsolete by the
enactment of the Internal Revenue Service
Restructuring and Reform Act of 1998,
Public Law 105-206, 112 Stat. 685. Refer-
ences to a district director in §§ 1.501(a)-1,

1.501(c)(3)-1, and 1.508-1 are also mod-
ified as appropriate, as those positions no
longer exist within the IRS. Similarly, ref-
erences to obsolete due dates for filing
notices described in section 508 and re-
lated transition relief provisions that are
no longer relevant have been removed
from §§ 1.508-1(a)(2)(i) and (b)(2)(iv).
In addition, § 1.508-1(b)(2)(v) has been
revised to remove a reference to the in-
structions for Form 4653, which is no
longer in use.

### Effective/Applicability Dates

The temporary regulations have ap-
plied since July 1, 2014, and this Treasury
decision adopts the proposed regulations
that cross-referenced the text of those
temporary regulations without substantive
change. Thus, the final regulations apply
on and after July 1, 2014.

### Statement of Availability of IRS Documents

Rev. Proc. 2017-5 is published in the
Internal Revenue Bulletin and is available
from the Superintendent of Documents,
U.S. Government Printing Office, Wash-
ington, DC 20402, or by visiting the IRS
website at http://www.irs.gov.

### Special Analyses

Certain IRS regulations, including
these, are exempt from the requirements
of Executive Order 12866, as supple-
mented and reaffirmed by Executive Or-
der 13563. Therefore, a regulatory impact
assessment is not required. It is hereby
certified that this rule will not have a
significant economic impact on a substan-
tial number of small entities. Although
this rule may affect a substantial number
of eligible small entities that choose to use
Form 1023-EZ to apply for recognition of
tax-exempt status under section 501(c)(3),
the Form 1023-EZ streamlines the appli-
cation process, thereby reducing the eco-
nomic impact on these entities. This rule
merely permits use of the streamlined
form of application available to satisfy the
notice requirements under section 508(a).
Therefore, a Regulatory Flexibility Anal-
ysis under the Regulatory Flexibility Act
(5 U.S.C. chapter 6) is not required. Pur-
suant to section 7805(f), the temporary
and proposed regulations preceding these

final regulations were submitted to the
Chief Counsel for Advocacy of the Small
Business Administration for comment on
their impact on small business and no
comments were received.

### Drafting Information

The principal author of these regula-
tions is Peter A. Holiat of the Office of
Associate Chief Counsel (Tax Exempt
and Government Entities). However,
other personnel from the Treasury De-
partment and the IRS participated in their
development.

*****

### Adoption of Amendments to the Regulations

Accordingly, 26 CFR part 1 is
amended as follows:

### PART 1-INCOME TAXES

Paragraph 1. The authority citation for
part 1 continues to read in part as follows:
Authority: 26 U.S.C. 7805 * * *

Par. 2. Section 1.501(a)-1 is amended
by revising paragraphs (a)(2), (b)(1),
(b)(3), and (f) to read as follows:

§ 1.501(a)-1 Exemption from taxation.

(a) * * *

(2) An organization, other than an em-
ployees' trust described in section 401(a),
is not exempt from tax merely because it
is not organized and operated for profit. In
order to establish its exemption, it is nec-
essary that every such organization claim-
ing exemption file an application form as
set forth below with the appropriate office
as designated by the Commissioner in
guidance published in the Internal Reve-
nue Bulletin, forms, or instructions to the
applicable forms. Subject only to the
Commissioner's inherent power to revoke
rulings, including with retroactive effect
as permitted under section 7805(b), be-
cause of a change in the law or regulations
or for other good cause, an organization
that has been determined by the Commis-
sioner (or previously by a district director)
to be exempt under section 501(a) or the
corresponding provision of prior law may
rely upon such determination so long as
there are no substantial changes in the
organization's character, purposes, or

methods of operation. An organization
that has been determined to be exempt
under the provisions of the Internal Rev-
enue Code of 1939 or prior law is not
required to secure a new determination of
exemption merely because of the enact-
ment of the Internal Revenue Code of
1954 unless affected by substantive
changes in law made by such Code.

(b) Additional proof by particular
classes of organizations-(1) Unless oth-
erwise prescribed by applicable regula-
tions or other guidance published in the
Internal Revenue Bulletin, organizations
mentioned below shall submit with and as
a part of their applications the following
information:

(i) Mutual insurance companies shall
submit copies of the policies or certifi-
cates of membership issued by them.

(ii) In the case of title holding compa-
nies described in section 501(c)(2), if the
organization for which title is held has not
been specifically notified in writing by the
Internal Revenue Service that it is held to
be exempt under section 501(a), the title
holding company shall submit the infor-
mation indicated herein as necessary for a
determination of the status of the organi-
zation for which title is held.

(iii) An organization described in sec-
tion 501(c)(3) shall submit with, and as a
part of, an application filed after July 26,
1959, a detailed statement of its proposed
activities.

* * * * *

(3) An organization claiming to be spe-
cifically exempted by section 6033(a)
from filing annual returns shall submit
with and as a part of its application (or in
such other manner as is prescribed in
guidance published in the Internal Reve-
nue Bulletin) a statement of all the facts
on which it bases its claim.

(f) Effective/applicability date. Para-
graphs (a)(2), (b)(1), and (b)(3) of this
section apply on and after July 1, 2014.

Section 1.501(a)-1T [Removed].

Par. 3. Section 1.501(a)-1T is removed.

Par. 4. Section 1.501(c)(3)-1 is amended
by revising paragraphs (b)(1)(v), (b)(6), and
(h) to read as follows:

§ 1.501(c)(3)-1 Organizations organized
and operated for religious, charitable,
scientific, testing for public safety, literary,
or educational purposes, or for the
prevention of cruelty to children or
animals.

* * * * *

(b) * * *

(1) * * *

(v) Unless otherwise prescribed by ap-
plicable regulations or other guidance
published in the Internal Revenue Bulle-
tin, an organization must, in order to es-
tablish its exemption, submit a detailed
statement of its proposed activities with
and as a part of its application for exemp-
tion (see § 1.501(a)-1(b)).

* * * * *

(6) Applicability of the organizational
test. A determination by the Commis-
sioner that an organization is described in
section 501(c)(3) and exempt under sec-
tion 501(a) will not be granted after July
26, 1959, regardless of when the applica-
tion is filed, unless such organization
meets the organizational test prescribed
by this paragraph (b). If, before July 27,
1959, an organization has been deter-
mined by the Commissioner or district
director to be exempt as an organization
described in section 501(c)(3) or in a cor-
responding provision of prior law and
such determination has not been revoked
before such date, the fact that such orga-
nization does not meet the organizational
test prescribed by this paragraph (b) shall
not be a basis for revoking such determi-
nation. Accordingly, an organization that
has been determined to be exempt before
July 27, 1959, and which does not seek a
new determination of exemption is not
required to amend its articles of organiza-
tion to conform to the rules of this para-
graph (b), but any organization that seeks
a determination of exemption after July
26, 1959, must have articles of organiza-
tion that meet the rules of this paragraph
(b). For the rules relating to whether an
organization determined to be exempt be-
fore July 27, 1959, is organized exclu-
sively for one or more exempt purposes,
see 26 CFR (1939) 39.101(6)-1 (Regula-

tions 118) as made applicable to the Code
by Treasury Decision 6091, approved Au-
gust 16, 1954 (19 FR 5167; 1954-2 CB
47).

* * * * *

(h) Effective/applicability date. Para-
graphs (b)(1)(v) and (b)(6) of this section
apply on and after July 1, 2014.

## Section 1.501(c)(3)-1T [Removed].

Par. 5. Section 1.501(c)(3)-1T is removed.

Par. 6. Section 1.508-1 is amended by
revising paragraphs (a)(2)(i), (a)(2)(ii),
(b)(2)(iv), (b)(2)(v), and (c) to read as
follows:

§ 1.508-1 Notices.

(a) * * *

(2) Filing of notice-(i) For purposes
of paragraph (a)(1) of this section, except
as provided in paragraph (a)(3) of this
section, an organization seeking exemp-
tion under section 501(c)(3) must file the
notice described in section 508(a) within
15 months from the end of the month in
which the organization was organized.
Such notice is filed by submitting a prop-
erly completed and executed Form 1023
(or, if applicable, Form 1023-EZ) exemp-
tion application. Notice should be filed
with the appropriate office as designated
by the Commissioner in guidance pub-
lished in the Internal Revenue Bulletin,
forms, or instructions to the applicable
forms. A request for extension of time for
the filing of such notice should be submit-
ted to such appropriate office. Such re-
quest may be granted if it demonstrates
that additional time is required.

(ii) Although the information required
by either Form 1023 or Form 1023-EZ
must be submitted to satisfy the notice
required by this section, the failure to sup-
ply, within the required time, all of the
information required to complete such
form is not alone sufficient to deny ex-
emption from the date of organization to
the date such complete information for
such form is submitted by the organiza-
tion. If the information that is submitted
within the required time is incomplete,
and the organization supplies the neces-
sary additional information requested by
the Commissioner within the additional

time period allowed, the original notice
will be considered timely.

* * * * *

(b) * * *

(2) * * *

(iv) Any organization filing notice un-
der this paragraph (b)(2)(iv) shall file its
notice by submitting a properly completed
and executed Form 1023 (or, if applicable,
Form 1023-EZ) and providing informa-
tion that it is not a private foundation. The
organization shall also submit all informa-
tion required by the regulations under sec-
tion 170 or 509 (whichever is applicable)
necessary to establish recognition of its clas-
sification as an organization described in
section 509(a)(1), (2), (3), or (4). The notice
required by this paragraph (b)(2)(iv) should

be filed with the appropriate office as des-
ignated by the Commissioner in guidance
published in the Internal Revenue Bulletin,
forms, or instructions to the applicable
forms.

(v) An extension of time for the filing
of a notice under this paragraph (b)(2)
may be granted by the office with which
the notice is filed upon timely request by
the organization, if the organization dem-
onstrates that additional time is required.

* * * * *

(c) Effective/applicability date. Para-
graphs (a)(2)(i), (a)(2)(ii), (b)(2)(iv), and
(b)(2)(v) of this section apply on and after
July 1, 2014.

Section 1.508-1T [Removed].

Par. 7. Section 1.508-1T is removed.

Kirsten B. Wielobob
Deputy Commissioner for Services and
Enforcement.
Approved: June 9, 2017

Thomas West
Tax Legislative Counsel

(Filed by the Office of the Federal Register on June 29,
2017, 8:45 a.m., and published in the issue of the Federal
Register for June 30, 2017, 82 F.R. 29733)

## Part III. Administrative, Procedural, and Miscellaneous

Cumulative List of Changes
in Plan Qualification
Requirements for
Pre-Approved Defined
Contribution Plans for 2017

Notice 2017-37

### I. PURPOSE

This notice contains the Cumulative
List of Changes in Plan Qualification Re-
quirements for Pre-Approved Defined
Contribution Plans for 2017 (2017 Cumu-
lative List). As described in section 17 of
Rev. Proc. 2016-37, 2016-29 I.R.B. 136,
146, Cumulative Lists identify changes in
the qualification requirements of the Inter-
nal Revenue Code that are required to be
taken into account in a pre-approved
plan document submitted under the pre-
approved plan program administered by
the Internal Revenue Service (IRS) and
that will be considered by the IRS for
purposes of issuing opinion letters.

The 2017 Cumulative List is to be used
to submit opinion letter applications for
pre-approved defined contribution plans
during the third six-year remedial amend-
ment cycle, which began February 1,
2017, and ends January 31, 2023 ("third-
cycle opinion letter applications"). De-
fined contribution plans may be submitted
for approval during the on-cycle submis-
sion period, which begins October 2,
2017, and ends October 1, 2018.

The list of changes in section IV of this
notice does not extend the deadline by which a
plan must be amended to comply with any
statutory, regulatory, or guidance changes.
The general deadline for timely adoption of an
interim or discretionary amendment is pro-
vided in section 15 of Rev. Proc. 2016-37.

## II. BACKGROUND

Rev. Proc. 2016-37 sets forth proce-
dures for issuing opinion letters and de-
scribes the six-year remedial amendment

cycle for pre-approved plans. Pre-approved
defined contribution plans and pre-approved
defined benefit plans each have separate six-
year cycles. In section 17 of Rev. Proc. 2016-
37, the IRS announced its intention to publish
Cumulative Lists to identify changes in the
qualification requirements that will be con-
sidered by the IRS in its review of pre-
approved plan documents for purposes of
issuing opinion letters. A change in the qual-
ification requirements includes a statutory
change or a change in the requirements pro-
vided in regulations or other guidance pub-
lished in the Internal Revenue Bulletin.

Rev. Proc. 2016-37 also modifies the
IRS determination letter program for quali-
fied plans by eliminating, as of January 1,
2017, the five-year remedial amendment cy-
cle system for individually designed plans
that was set forth in Rev. Proc. 2007-44,
2007-2 C.B. 54. Prior to Rev. Proc. 2016-
37, Cumulative Lists were used by the IRS
in reviewing both individually designed
plan documents and pre-approved plan doc-
uments. Pursuant to sections 12 and 17 of
Rev. Proc. 2016-37, beginning in 2017, the
IRS will use Cumulative Lists to review
pre-approved plan documents submitted
for opinion letters and will use Required
Amendments Lists, described in section 9 of
Rev. Proc. 2016-37, to review individually
designed plan documents submitted for deter-
mination letters. For the Required Amend-
ments List for 2016, see Notice 2016-80,
2016-52 I.R.B. 918.

To assist plan sponsors in achieving op-
erational compliance, the IRS intends to
provide an Operational Compliance List pe-
riodically to identify changes in qualifica-
tion requirements that are effective during a
calendar year. For the current Operational
Compliance List, see https://www.irs.gov/
retirement-plans/operational-compliance-list.

## III. APPLICATION OF THE 2017 CUMULATIVE LIST

This notice relates to the opinion letter
program for pre-approved defined contri-

bution plans. The third six-year remedial
amendment cycle for pre-approved de-
fined contribution plans began February 1,
2017, and ends January 31, 2023. Pursu-
ant to section 16.02 of Rev. Proc. 2016-
37, as modified by section 9.02 of Rev.
Proc. 2017-41, 2017-29 I.R.B. 92, 110
(July 17, 2017), the on-cycle submission
period for the third six-year remedial
amendment cycle begins October 2, 2017,
and ends October 1, 2018.

The 2017 Cumulative List set forth in
section IV of this notice lists specific matters
the IRS has identified for review in deter-
mining whether a defined contribution plan
document that has been filed for an opinion
letter has been properly updated.

Except as provided in section IV of this
notice, the IRS will not consider any of
the following items in its review of any
opinion letter application for the six-year
remedial amendment cycle that began
February 1, 2017:

1\. Guidance issued after February 1, 2017.

2\. Statutes enacted after February 1, 2017.

3\. Qualification requirements first effec-
tive in 2018 or later.

4\. Statutory provisions that are first ef-
fective in 2017 for which there is no
guidance identified in this notice.

In order to be qualified, a plan must
comply with all relevant qualification re-
quirements, not only those on the 2017
Cumulative List.

IV. CUMULATIVE LIST OF
CHANGES IN PLAN
QUALIFICATION REQUIREMENTS
FOR PRE-APPROVED DEFINED
CONTRIBUTION PLANS FOR 2017

The 2017 Cumulative List contains
items that relate to pre-approved defined
contribution plans that were included on
the 2011-2015 Cumulative Lists1 or were
issued after October 1, 2015.2 However, if
a plan has not been previously reviewed
for items on earlier Cumulative Lists that
relate to pre-approved defined contribu-

1For recent previous Cumulative Lists, see Notice 2015-84, 2015-52 I.R.B. 880; Notice 2014-77, 2014-52 I.R.B. 974; Notice 2013-84, 2013-52 I.R.B. 822; Notice 2012-76, 2012-52
I.R.B. 775; and Notice 2011-97, 2011-52 I.R.B. 923.

2Previous Cumulative Lists included certain items that the IRS does not intend to review in connection with third-cycle opinion letter applications, including items that affected only defined
benefit retirement plans or that affected the operations of a plan but did not require a change in the plan document. Those items have been removed from this 2017 Cumulative List. See
the Operational Compliance List, at https://www.irs.gov/retirement-plans/operational-compliance-list, for the current list of changes in qualification requirements that affect operational
compliance.

tion plans, those items must also be taken
into account. The items on earlier Cumu-
lative Lists that are referred to in the
preceding sentence can be found in the
2010 Cumulative List, Notice 2010-90,
2010-52 I.R.B. 909, and in the 2004 Cu-
mulative List, Notice 2004-84, 2004-2
C.B. 1030.

The 2017 Cumulative List sets forth
changes in the qualification requirements.
At the end of each item, a parenthetical
note indicates the year the item first ap-
peared on a Cumulative List or identifies
the item as new.

### 1. Section 401(a):

· Notice 2012-29, 2012-18 I.R.B. 872,
provides that the IRS and the Depart-
ment of the Treasury (Treasury De-
partment) intend to modify the normal
retirement age regulations to clarify
that governmental plans that do not
provide for in-service distributions be-
fore age 62 do not need to have a
definition of normal retirement age
and to modify the age-50 safe harbor
rule for qualified public safety em-
ployees. The notice also provides that
the IRS and Treasury Department in-
tend to amend the normal retirement
age regulations to extend the effective
date for governmental plans to annuity
starting dates that occur in plan years
beginning on or after the later of (1)
January 1, 2015, or (2) the close of the
first regular legislative session of the
legislative body with the authority to
amend the plan that begins on or after
the date that is 3 months after the final
regulations are published in the Fed-
eral Register. See also the description,
later in this 2017 Cumulative List, of
proposed regulations under § 401(a)
published on January 27, 2016, relat-
ing to normal retirement ages under
§ 414(d) governmental pension plans.
(2012 C. L.)

· United States v. Windsor, 570 U.S.
__ , 133 S. Ct. 2675 (2013). The Su-
preme Court found that Section 3 of
the Defense of Marriage Act
(DOMA), which provides that, in de-
termining the meaning of any Act of
Congress or of any ruling, regulation,
or interpretation of the various admin-
istrative bureaus and agencies of the
United States, the word "marriage"

means only a legal union between one
man and one woman as husband and
wife, and the word "spouse" refers
only to a person of the opposite sex
who is a husband or a wife, is uncon-
stitutional because it violates the prin-
ciples of equal protection. (2013 C. L.)

· Rev. Rul. 2013-17, 2013-38 I.R.B.
201, provides that for Federal tax pur-
poses, the terms "spouse," "husband
and wife," "husband," and "wife" in-
clude an individual married to a person
of the same sex if the individuals are
lawfully married under state law, and
the term "marriage" includes such a
marriage between individuals of the
same sex, and the IRS adopts a general
rule recognizing a marriage of same-
sex individuals that was validly en-
tered into in a state whose laws autho-
rize the marriage of two individuals of
the same sex even if the married cou-
ple is domiciled in a state that does not
recognize the validity of same-sex
marriages. (2013 C. L.)

· Notice 2014-19, 2014-17 I.R.B. 979,
provides guidance on the application
(including the retroactive application)
of the decision in United States v.
Windsor, and the holdings of Rev. Rul.
2013-17, to retirement plans qualified
under § 401(a). (2014 C. L.)

· Notice 2015-86, 2015-52 I.R.B. 887,
provides that qualified retirement
plans are not required to make addi-
tional changes as a result of the deci-
sion in Obergefell v. Hodges, 576
U.S .__ , 135 S. Ct. 2584 (2015).
However, a plan sponsor may decide
to amend its plan following Obergefell
to make certain discretionary amend-
ments (also described in Notice 2015-
86). (New)

· Proposed regulations under § 401(a)
were published on January 27, 2016
(81 Fed. Reg. 4599), and provide safe
harbors and other rules regarding nor-
mal retirement age under a § 414(d)
governmental pension plan. These reg-
ulations are proposed to be effective
for employees hired during plan years
beginning on or after the later of (1)
January 1, 2017, or (2) the close of the
first regular legislative session of the
legislative body with the authority to
amend the plan that begins on or after
the date that is three months after the

final regulations are published in the
Federal Register. However, employers
may choose to rely on these proposed
regulations currently and for prior pe-
riods. (New)

### 2. Section 401(a)(4):

· Notice 2014-66, 2014-46 I.R.B. 820,
provides a special nondiscrimination
rule for a qualified defined contribu-
tion plan that provides lifetime income
by offering, as investment options, a
series of target date funds (TDFs) that
include deferred annuities among their
assets, even if some of the TDFs
within the series are available only to
older participants. (2014 C. L.)

### 3. Section 401(a)(9):

· Final regulations that provide a limited
modification of the required minimum
distribution rules for tax-qualified
defined contribution plans holding
qualifying longevity annuity contracts
were published on July 2, 2014 (79
Fed. Reg. 37633). (2014 C. L.)

### 4. Section 401(a)(22):

· Notice 2011-19, 2011-11 I.R.B. 550,
provides that the terms "readily trad-
able on an established securities mar-
ket" and "readily tradable on an estab-
lished market" mean employer
securities that are readily tradable on
an established securities market within
the meaning of § 1.401(a)(35)-1(f)(5)
for purposes of § 401(a)(22). Notice
2011-19 is effective for plan years that
begin on or after January 1, 2012, ex-
cept for certain plans that have a de-
layed effective date. (2011 C. L.)

#### 5. Section 401(a)(28)(C):

· Notice 2011-19 provides that the
terms "readily tradable on an estab-
lished securities market" and "readily
tradable on an established market"
mean employer securities that are
readily tradable on an established se-
curities market within the meaning of
§ 1.401(a)(35)-1(f)(5) for purposes of
§ 401(a)(28)(C). Notice 2011-19 is ef-
fective for plan years that begin on or
after January 1, 2012, except for cer-
tain plans that have a delayed effective
date. (2011 C. L.)

6\. Section 401(a)(35):

· Notice 2013-17, 2013-20 I.R.B. 1082,
provides relief from anti-cutback rules
for an amendment to an employee

stock ownership plan (ESOP) that
becomes subject to the diversifica-
tion requirements of § 401(a)(35) to
eliminate all in-service distribution
options previously used to satisfy
the diversification requirements of
§ 401(a)(28)(B)(i). (2013 C. L.)

### 7. Section 401(k), 401(m):

· Final regulations that provide guid-
ance on permitted mid-year reductions
or suspensions of safe harbor nonelec-
tive contributions in certain circum-
stances for amendments adopted after
May 18, 2009, and revise the require-
ments for permitted mid-year reduc-
tions or suspensions of safe harbor
matching contributions for plan years
beginning on or after January 1, 2015,
were published on November 15, 2013
(78 Fed. Reg. 68735). (2013 C. L.)

· Notice 2016-16, 2016-7 I.R.B. 318,
permits mid-year changes to safe har-
bor 401(k) plans under certain circum-
stances. (New)

· Proposed regulations under §§ 401(k)
and 401(m) were published on January
18, 2017 (82 Fed. Reg. 5477), and
provide that qualified matching contri-
butions (QMACs) and qualified non-
elective contributions (QNECs) must
satisfy applicable nonforfeitability and
distribution requirements at the time
they are allocated to participants' ac-
counts, but need not meet these re-
quirements when they are contributed
to the plan. These proposed regula-
tions apply only to taxable years be-
ginning on or after the publication of
final regulations, but taxpayers may
choose to rely on these proposed reg-

ulations currently and for prior peri-
ods. (New)

### 8. Section 402(c):

· Protecting Americans from Tax Hikes
Act of 2015 § 306 amended
§ 408(p)(1)(B) to permit rollovers
from a qualified plan to a SIMPLE
IRA. (New)

### 9. Section 402A:

· American Taxpayer Relief Act of
2012 § 902 added § 402A(c)(4)(E),
which provides that rollovers from a
plan account to the plan's designated
Roth account can include a rollover of
an otherwise nondistributable amount.
(2013 C. L.)

· Notice 2013-74 provides guidance re-
garding § 402A(c)(4)(E) and also
provides guidance that applies to all
in-plan Roth rollovers under
§ 402A(c)(4). (2013 C. L.)

### 10. Section 409:

· Notice 2011-19 provides that the
terms "readily tradable on an estab-
lished securities market" and "readily
tradable on an established market"
mean employer securities that are
readily tradable on an established se-
curities market within the meaning of
§ 1.401(a)(35)-1(f)(5) for purposes of
§ 409(h)(1)(B) and § 409(l). Notice
2011-19 is effective for plan years that
begin on or after January 1, 2012, ex-
cept for certain plans that have a de-
layed effective date. (2011 C. L.)

11\. Section 411(d)(6):

· Notice 2013-17 provides relief from
anti-cutback rules for an amendment

to an ESOP to eliminate all in-service
distribution options previously used to
satisfy the diversification requirements
of § 401(a)(28)(B)(i). (2013 C. L.)

#### 12. Section 415:

· Proposed regulations under § 415
were published on November 15, 2013
(78 Fed. Reg. 68780), and provide that
amounts paid to an Indian tribe mem-
ber as remuneration for services per-
formed in a fishing rights-related ac-
tivity may be treated as compensation
for purposes of applying the limits on
qualified plan benefits and contribu-
tions. Taxpayers may rely on the pro-
posed regulations for periods preced-
ing the effective date of the final
regulations. (2014 C. L.)

### 13. Section 417:

· Rev. Rul. 2012-3, 2012-6 I.R.B.
383, describes how the qualified
joint and survivor annuity (QJSA)
and the qualified preretirement sur-
vivor annuity (QPSA) rules, de-
scribed in §§ 401(a)(11) and 417,
apply when a deferred annuity con-
tract is purchased under a profit
sharing plan. (2012 C. L.)

## DRAFTING INFORMATION

The principal author of this notice is
Patrick Gutierrez of the Office of Associ-
ate Chief Counsel (Tax Exempt and Gov-
ernment Entities). For further information
regarding this notice, contact Patrick Guti-
errez at (202) 317-4148 (not a toll-free
number).

26 CFR § 601.201: Rulings and determination letters.(Part I, §§ 401, 403, and 501; Reg. §§ 1.401(a)-1, 1.403(a)-1, and 1.501(a)-1.)

### Rev. Proc. 2017-41

#### TABLE OF CONTENTS

SECTION 1. PURPOSE

SECTION 2. BACKGROUND.

SECTION 3. SIGNIFICANT CHANGES TO REVENUE PROCEDURE 2015-36; FUTURE ENHANCEMENTS

SECTION 4. DEFINITIONS

SECTION 5. PROVISIONS REQUIRED IN PRE-APPROVED PLANS

SECTION 6. OPINION LETTERS - SCOPE

103

SECTION 7. EMPLOYER RELIANCE ON OPINION LETTER.

106

SECTION 8. APPROVED PLANS - PLAN AMENDMENTS.

108

SECTION 9. OPINION LETTER APPLICATIONS - INSTRUCTIONS TO PROVIDERS AND OTHER RULES FOR APPLICATIONS AND LETTERS.

110

SECTION 10. MASS SUBMITTERS

114

SECTION 11. OFF-CYCLE FILINGS

117

SECTION 12. REVIEW OF OPINION LETTER APPLICATIONS; ISSUANCE OF OPINION LETTERS

117

SECTION 13. WITHDRAWAL OF REQUESTS.

117

SECTION 14. NONTRANSFERABILITY OF OPINION LETTER

118

SECTION 15. NOTIFICATION OF ADOPTING EMPLOYER REGARDING LOSS OF QUALIFIED STATUS

118

SECTION 16. DISCONTINUED PLANS

118

SECTION 17. REVOCATION

118

SECTION 18. RECORD KEEPING REQUIREMENTS.

118

SECTION 19. WHERE TO FILE

119

SECTION 20. EFFECT ON OTHER DOCUMENTS.

119

SECTION 21. EFFECTIVE DATE

119

SECTION 22. PUBLIC COMMENTS

119

SECTION 23. PAPERWORK REDUCTION ACT

119

## SECTION 1. PURPOSE

.01 This revenue procedure sets forth the procedures of the Internal Revenue Service (IRS) for
issuing Opinion Letters regarding the qualification in form of Pre-approved Plans under §§ 401,
403(a), and 4975(e)(7) of the Internal Revenue Code (Code). In addition, this revenue procedure
modifies the IRS pre-approved letter program by combining the master and prototype (M&P) and
volume submitter (VS) programs into a new Opinion Letter program. This revenue procedure
modifies and supersedes, in part, Rev. Proc. 2015-36, 2015-27 I.R.B. 20, and modifies Rev. Proc.
2017-4, 2017-1 I.R.B. 146, and Rev. Proc. 2016-37, 2016-29 I.R.B. 136.

.02 This revenue procedure also modifies the on-cycle submission period for the third six-year
remedial amendment cycle for Providers of pre-approved defined contribution plans so that it
begins on October 2, 2017 and ends on October 1, 2018.

.03 This revenue procedure modifies the IRS's historic approach to Pre-approved Plans in order
to expand the Provider market and encourage employers that currently maintain individually
designed plans to convert to the pre-approved format.

· The program is simplified by eliminating the distinction between M&P and VS plans.

· The program is liberalized by increasing the types of plans eligible for pre-approved status.

. The program is revised to afford greater flexibility in the design of Pre-approved Plans.

### SECTION 2. BACKGROUND

.01 The procedures for the issuance of opinion and advisory letters by the IRS regarding the
qualification in form of Pre-approved Plans are set forth in Rev. Proc. 2015-36 (as modified by
Rev. Proc. 2016-37).

.02 Rev. Proc. 2007-44, 2007-2 C.B. 54 (clarified, modified, and superseded by Rev. Proc.
2016-37), described a system of cyclical remedial amendment periods under which every
individually designed plan qualified under § 401(a) or 403(a) had a regular five-year remedial
amendment cycle and every Pre-approved Plan had a regular six-year remedial amendment cycle.

.03 Rev. Proc. 2016-37 modified the IRS determination letter program for qualified plans to
eliminate the five-year remedial amendment cycle for individually designed plans. It also
described and made modifying changes to the remedial amendment cycle system for pre-
approved qualified plans and modified the six-year cycle, as applicable, to reflect changes that had
been made to the determination letter program.

.04 Rev. Proc. 2016-37 provided that every Pre-approved Plan has a regular, six-year remedial
amendment cycle. As a result, M&P sponsors and VS practitioners, as defined in Rev. Proc.
2015-36, may apply for new opinion or advisory letters once every six years. M&P sponsors and
VS practitioners generally have until January 31st of the calendar year following the opening of
the six-year remedial amendment cycle to submit applications for opinion and advisory letters,
although the application period has been modified and extended periodically.

.05 From February 1, 2011, to April 2, 2012, M&P sponsors and VS practitioners maintaining
pre-approved defined contribution plans submitted their applications to the IRS for the second
six-year remedial amendment cycle. For employers that had adopted a pre-approved defined
contribution plan prior to January 1, 2016, the deadline to adopt a modification or restatement of
the Pre-approved Plan and apply for a determination letter, if eligible, was April 30, 2016.
Pursuant to section 18 of Rev. Proc. 2016-37, the deadline for an employer to adopt a newly
approved pre-approved defined contribution plan and apply for a determination letter, if eligible,

Sec. 1.

was extended by Notice 2016-3, 2016-3 IRB 278, from April 30, 2016, to April 30, 2017,1 for
any newly approved pre-approved defined contribution plan adopted on or after January 1, 2016.

.06 Under Rev. Proc. 2016-37, the third six-year remedial amendment cycle for pre-approved
defined contribution plans began on February 1, 2017, and ends on January 31, 2023. Also, under
Rev. Proc. 2016-37, the 12-month applicable on-cycle submission period for Pre-approved Plan
sponsors begins on August 1, 2017, and ends on July 31, 2018. The Cumulative List of Changes
in Plan Qualification Requirements for Pre-approved Defined Contribution Plans for 2017, Notice
2017-37, 2017-29 I.R.B. 89, will apply to plans submitted for review during the on-cycle
submission period. Once the review of a cycle for Pre-approved Plans has neared completion
(after approximately a two-year review process), the IRS will announce the date by which
Adopting Employers must adopt the newly approved plans.

.07 Rev. Proc. 2016-37 provided that the second six-year remedial amendment cycle for
pre-approved defined benefit plans began on February 1, 2013, and ends on January 31, 2019. The
third six-year remedial amendment cycle for pre-approved defined benefit plans is scheduled to
begin on February 1, 2019, and end on January 31, 2025.

.08 Rev. Proc. 2017-4 (as updated annually) sets forth the general procedures of the IRS on
the issuance of Employee Plans determination letters, including determination letters for Pre-
approved Plans.

SECTION 3.
SIGNIFICANT CHANGES
TO REVENUE
PROCEDURE 2015-36;
FUTURE
ENHANCEMENTS

.01 This revenue procedure significantly restructures the current approach for issuing Opinion
Letters regarding the qualification in form of Pre-approved Plans described in Rev. Proc.
2015-36. Section 3.02 through 3.122 describe the significant changes made by this revenue
procedure to Rev. Proc. 2015-36.

.02 The M&P and VS Programs are combined and replaced by a single Opinion Letter program
involving two types of plans: Standardized Plans and Nonstandardized Plans. See section 4.07.

.03 A Pre-approved Plan may utilize either of two formats: a basic plan document with an
adoption agreement or a single plan document. See section 4.07.

.04 An Adopting Employer of any Nonstandardized Plan may adopt minor modifications. See
section 8.04.

.05 The prohibition against combining a money purchase plan with a § 401(k) or profit-sharing
plan in the same Pre-approved Plan document is eliminated. See sections 9.06 and 9.07.

.06 A Nonstandardized Plan that contains an ESOP may include a § 401(k) feature. See
sections 9.06 and 9.07. (A Pre-Approved Plan that contains an ESOP cannot be a Standardized
Plan. See section 4.09.)

.07 A Nonstandardized Plan that contains a Cash Balance Formula may now permit the rate
used to determine an Interest Credit to be based on the actual return on plan assets. However, the
rate used to determine an Interest Credit cannot be based on a subset of plan assets. See section
6.03(7)(c). (A Pre-Approved Plan that contains a Cash Balance Formula cannot be a Standardized

1The deadline to apply for a determination letter was later extended to May 1, 2017.

2 All section references in this revenue procedure are to sections of this revenue procedure unless otherwise specified.

Plan. See section 4.09.) For limitations on the eligibility of certain types of Statutory Hybrid Plans
under the Pre-approved Plan program, see section 6.03(7).

.08 The prohibition against submitting an application for an Opinion Letter for a non-electing
church plan is eliminated. See section 6.03.

.09 Any Nonstandardized Plan may provide for either safe harbor or non-safe harbor hardship
distributions. See section 6.03.

.10 The beginning and ending dates for the defined contribution on-cycle submission period for
the third six-year remedial amendment cycle are modified to begin on October 2, 2017, and end
on October 1, 2018. See section 9.02.

.11 The IRS will no longer rule on the exempt status of a Pre-approved Plan's related trust or
custodial account under § 501(a). See section 9.03.

.12 References to specific requirements under Title I of the Employee Retirement Income
Security Act of 1974 (ERISA), Pub. L. 93-406, 1974-3 C.B. 1, have been removed and replaced
with a statement that Opinion Letters will not consider Title I issues. This is intended to clarify
the scope of reliance on Opinion Letters and is not a substantive change in IRS position. See
section 6.04.

.13 The procedures for a determination letter application by an Adopting Employer to obtain
reliance under §§ 415 and 416 have been modified to permit an application to be made on Form
5307, Application for Determination for Adopters of Modified Volume Submitter Plans. See
section 7.05.

.14 Future enhancements -

(1) Future updates - The IRS and the Department of the Treasury (Treasury Department)
expect to continue to update this Opinion Letter program revenue procedure, in whole or in part,
from time to time, including providing further improvements based on comments received.
Accordingly, the IRS and Treasury Department continue to invite further comments on how to
improve the Opinion Letter program. For information on how to submit comments, see section 22.

(2) Comments relating to the retention of legacy benefits - The Treasury Department and the
IRS have received comments relating to ways in which conversion from an individually designed
plan to a Pre-approved Plan could be facilitated. One area addressed in these comments relates
to enabling Adopting Employers to continue to maintain certain legacy benefit formulas, which
often arise in the context of mergers and acquisitions (either as frozen or as continuing benefit
formulas for a certain number of participants), when adopting a Pre-approved Plan. The Treasury
Department and IRS request comments on this issue, specifically with respect to the effect that
appending legacy benefit formulas to the plan document would have on reliance on a plan's
Opinion Letter.

SECTION 4.
DEFINITIONS

.01 Adopting Employer - An "Adopting Employer" is an employer that adopts a plan that is
offered by a Provider, including a plan that is word-for-word identical to, or a minor modification
of, a plan of a Mass Submitter.

.02 ESOP Definitions

(1) ESOP - An "ESOP" is an employee stock ownership plan within the meaning of
§ 4975(e)(7).

(2) Exempt Loan - An "Exempt Loan" is a loan described in § 4975(d)(3) that meets the
requirements for exemption from the excise tax imposed under § 4975(a) and (b) described in
§ 54.4975-7(b).

(3) Readily Tradable Employer Securities - "Readily Tradable Employer Securities" are
publicly traded securities as defined in § 1.401(a)(35)-1(f)(5).

#### .03 Hybrid Plan Definitions

(1) Cash Balance Formula - A "Cash Balance Formula" is a statutory hybrid benefit formula,
as defined in § 1.411(a)(13)-1(d)(4), that is used to determine all or any part of a participant's
accumulated benefit, and under which the accumulated benefit provided under the formula is
expressed as the current balance of a hypothetical account maintained for the participant. The
hypothetical account balance generally consists of Principal Credits and Interest Credits.

(2) Cash Balance Plan - A "Cash Balance Plan" is a defined benefit plan that includes a Cash
Balance Formula.

(3) Conversion Amendment - A "Conversion Amendment" is an amendment defined in
§ 1.411(b)(5)-1(c)(4). Under this regulation, a conversion amendment is an amendment (i) that
reduces or eliminates the benefits that, but for the amendment, a participant would have earned
after the effective date of the amendment under a benefit formula that is not a statutory hybrid
benefit formula within the meaning of § 1.411(a)(13)-1(d)(4), and (ii) with respect to which, after
the effective date of the amendment, all or a portion of the participant's benefit accruals under the
plan are determined under a statutory hybrid benefit formula.

(4) Interest Credit - An "Interest Credit" is an interest credit as defined in § 1.411(b)(5)-
1(d)(1)(ii)(A). Under this regulation, an interest credit is an adjustment to a participant's
hypothetical account balance for a period that is not conditioned on service and that is determined
by applying a rate of interest or rate of return to the participant's hypothetical account balance as
of the beginning of the period.

(5) Offset - An "Offset" is the reduction of benefits under an employer's defined benefit plan
by an amount attributable to the benefits payable under another plan of the employer.

(6) Principal Credit - A "Principal Credit" is a principal credit as defined in § 1.411(b)(5)-
1(d)(1)(ii)(D), which includes any increase in a participant's hypothetical account balance that is
not an Interest Credit.

(7) Statutory Hybrid Plan - A "Statutory Hybrid Plan" is a defined benefit plan that contains
a statutory hybrid benefit formula as defined in § 1.411(a)(13)-1(d)(4).

(8) Variable Annuity Plan - A "Variable Annuity Plan" is any defined benefit plan that
includes a variable annuity benefit formula as defined in § 1.411(a)(13)-1(d)(6).

.04 Mass Submitter - A "Mass Submitter" is any person that (1) has an established place of
business in the United States where it is accessible during every business day and (2) submits
Opinion Letter applications on behalf of at least 30 unaffiliated Providers, each of which is
offering, on a word-for-word identical basis, the same plan. A flexible plan (as defined in section

10\) that is offered by a Provider will be considered a word-for-word identical plan. For purposes
of determining whether 30 unaffiliated Providers offer, on a word-for-word basis, the same
Pre-approved Plan, a Mass Submitter that is also a Provider is treated as an unaffiliated Provider.
For purposes of this definition, affiliation is determined under § 414(b) and (c). Additionally, any
law firm, accounting firm, consulting firm, etc., will be considered to be affiliated with its
partners, members, associates, etc. A Mass Submitter is treated as a Mass Submitter with respect
to all of its plans, provided the 30 unaffiliated Provider requirement is met with respect to at least
one plan. See section 10 for rules relating to Mass Submitter plans.

.05 Nonstandardized Plan - A "Nonstandardized Plan" is a Pre-approved Plan that is not a
Standardized Plan and that satisfies section 5.15.

.06 Opinion Letter - An "Opinion Letter" is a written statement issued by the IRS to a Provider
or Mass Submitter as to the qualification in form of a plan under § 401, § 403(a), or both §§ 401
and 4975(e)(7).

.07 Pre-approved Plan -

(1) A "Pre-approved Plan" is a plan (including a plan covering self-employed individuals) that
is made available by a Provider for adoption by employers. The term Pre-approved Plan includes
both Standardized Plans and Nonstandardized Plans, as defined in sections 4.09 and 4.05,
respectively.

(2) A Pre-approved Plan may use a single funding medium (for example, a Trust or Custodial
Account Document) for the joint use of all Adopting Employers or separate funding mediums
established for each Adopting Employer.

(3) A Pre-approved Plan may be an "Adoption Agreement Plan" or a "Single Document
Plan." An Adoption Agreement Plan consists of a basic plan document and an adoption
agreement. The basic plan document contains all of the non-elective provisions applicable to all
Adopting Employers, and the adoption agreement contains the options that may be selected by
each Adopting Employer. No options (including blanks to be completed) may be provided in the
basic plan document portion of the Adoption Agreement Plan (except as provided in section 10
regarding flexible plans). A Single Document Plan consists of a single plan document offered by
a Provider without an adoption agreement. A Single Document Plan may contain alternate
paragraphs and options (including blanks to be completed by the Adopting Employer in accor-
dance with specified parameters) that may be selected by an Adopting Employer.

.08 Provider - A "Provider" is any person (including, if applicable, a Mass Submitter) that (1)
has an established place of business in the United States where it is accessible during every
business day, and (2) represents to the IRS in its application for an Opinion Letter that it has at
least 15 employer-clients, each of which is reasonably expected to adopt the same Pre-approved
Plan of the Provider.

A Provider (as described in the previous paragraph) may request an Opinion Letter for more
than one plan provided it represents to the IRS that it has at least 30 employer-clients in the
aggregate, each of which is reasonably expected to adopt at least one of the Provider's plans.

The IRS reserves the right at any time to request from the Provider a list of the employers that
have adopted or are expected to adopt the Provider's plans, including the employers' business
addresses and employer identification numbers.

Notwithstanding the preceding provisions of this section 4.08, any person that has an estab-
lished place of business in the United States where it is accessible during every business day may
offer a plan as a word-for-word identical adopter or minor modifier adopter of a plan of a Mass
Submitter regardless of the number of employers that are expected to adopt the plan. See section
10 for rules relating to Mass Submitter plans, including procedures for word-for-word identical
adopters and minor modifier adopters of Mass Submitter plans.

By submitting an application for an Opinion Letter for a Pre-approved Plan under this revenue
procedure (or by having an application filed on its behalf by a Mass Submitter), a person
represents to the IRS that it is a Provider, and that it agrees to comply with any requirements
imposed on Providers by this revenue procedure. Failure to comply with these requirements may
result in the loss of eligibility to offer Pre-approved Plans and the revocation of Opinion Letters
that have been issued to the Provider.

.09 Standardized Plan - A "Standardized Plan" is a Pre-approved Plan (other than an ESOP or
Statutory Hybrid Plan) that meets the requirements set forth in section 5.16.

.10 Trust or Custodial Account Document - A "Trust or Custodial Account Document" is the
separate portion of a plan that contains the trust agreement or custodial account agreement and
includes provisions covering such matters as the powers and duties of trustees, investment
authority, and the kinds of investments that may be made. All provisions of the Trust or Custodial
Account Document must be applicable to all Adopting Employers of that trust or custodial
account. The trust agreement or custodial account agreement must be in a document separate from
the rest of the plan.

SECTION 5.
PROVISIONS REQUIRED
IN PRE-APPROVED
PLANS

.01 Provisions required in all Pre-approved Plan - Each Pre-approved Plan must comply with
the requirements set forth in sections 5.03 through 5.14.

.02 Additional Provisions - Section 5.15 provides additional provisions that apply to Nonstan-
dardized Plans and section 5.16 contains additional provisions required for all Standardized Plans.
If a Pre-approved Plan contains an ESOP or a Cash Balance Formula, the plan also must include
the provisions set forth in section 5.17 or 5.18, as applicable.

.03 Provider Amendments - Each Pre-approved Plan must include a procedure for Provider
amendments, so that corrections of prior approved plans and changes in the Code, regulations, or
other guidance published in the Internal Revenue Bulletin may be applied to all employers who
have adopted the plan. The procedure for Provider amendments also must state that, for purposes
of reliance on the Opinion Letter, the Provider will no longer have the authority to amend the plan
on behalf of the Adopting Employer as of the date the plan is treated as an individually designed
plan pursuant to section 8.06.

.04 Anti-Cutback Provisions - Each Pre-approved Plan must specifically provide for the
protection required under § 411(a)(10) and (d)(6) in the event that the Adopting Employer amends
the plan (including by revising the options selected in the adoption agreement or adopting a new
plan). A Plan may not be amended in a manner that could result in the elimination of a benefit
to the extent the benefit is required to be protected under § 411(d)(6) with respect to the plan of
any Adopting Employer, unless the amendment is permitted under §§ 1.401(a)-4 and 1.411(d)-4.
See section 5.07 for anti-cutback provisions that are required in situations in which a plan
becomes top-heavy. See § 411(d)(6)(C) and § 1.411(d)-4, Q&A-2(d) for certain exceptions
applicable to ESOPs.

.05 Adopting Employer Modification to Satisfy §§ 415 and 416 - Each Pre-approved Plan must
provide that plan provisions may be amended by the Adopting Employer to the extent necessary

to satisfy § 415 or 416 because of the required aggregation of multiple plans under these sections.
Generally, a space should be provided in the plan with instructions for the Adopting Employer to add
such language as necessary to satisfy §§ 415 and 416. In addition, a space must be provided in the plan
for the Adopting Employer to specify the interest rate and mortality tables used for purposes of
establishing the present value of accrued benefits in order to compute the top-heavy ratio under § 416.
Such a space must be included in both defined contribution plans and defined benefit plans. These
provisions must be included in the adoption agreement of an Adoption Agreement Plan.

.06 Aggregation for § 415 compliance - Each Pre-approved Plan must provide for aggregation
of all of an employer's defined contribution plans and all of an employer's defined benefit plans
as necessary to satisfy § 415 (b), (c), and (f).

.07 Top-heavy Requirements - Each Pre-approved Plan must either provide that all of the
additional requirements applicable to top-heavy plans (described in § 416) apply at all times, or
provide that such requirements apply automatically if the plan is top-heavy, regardless of how the
options in the plan are completed. In the latter case, all of the requirements for determining
whether the plan is top-heavy must be included in the plan. (See Questions T-35 and T-36 of
§ 1.416-1.) In addition, a plan that is subject to the top-heavy requirements and that does not
contain vesting rules for all years that are at least as favorable to participants as those provided
in § 416(b) must specifically provide that any vesting that occurs while the plan is top-heavy will
not be reduced if the plan ceases to be top-heavy.

.08 Provisions Regarding Reliance - Each Pre-approved Plan must include, in close proximity
to the signature line, a statement that describes the limitations on employer reliance on an Opinion
Letter. See section 7.

.09 Provisions Regarding Conflicting Trust Provisions - Each Pre-approved Plan must contain
a statement that the provisions of the plan override any conflicting provision contained in Trust
or Custodial Account Documents used with the plan.

.10 Requirements Regarding Dated Signatures and Adoption Agreement Provisions - Each
Pre-approved Plan must contain an Adopting Employer signature and date line. The plan also
must contain a statement that the Provider will inform the Adopting Employer of any amendments
made to the plan or of the discontinuance of the plan. The employer must sign and date the
adoption agreement or signature page of the plan when it first adopts the plan and must complete,
sign, and date a new adoption agreement or signature page if the plan has been restated. In
addition, the employer must complete a new dated adoption agreement or signature page if it
modifies any prior elections or makes new elections. The signature requirement may be satisfied
by an electronic signature that reliably authenticates and verifies the adoption of the adoption
agreement, or restatement, amendment, or modification thereof, by the employer. In the case of
an Adoption Agreement Plan, the adoption agreement must state that it is to be used with only
one plan. In addition, the adoption agreement must contain a cautionary statement to the effect
that the failure to properly complete the adoption agreement may result in failure of the plan to
qualify under § 401, 403(a), or 4975(e)(7), as applicable.

.11 Provider Telephone Numbers - Each Pre-approved Plan must include the Provider's name,
address, and telephone number (or a space for the address and telephone number of the Provider's
authorized representative) for inquiries by Adopting Employers regarding the adoption of the
plan, the meaning of plan provisions, or the effect of the Opinion Letter.

.12 Definition of Employee - (1) In general. Each Pre-approved Plan must define an employee
as any employee of the employer maintaining the plan or any other employer aggregated with that

employer under § 414(b), (c), (m), or (o) and the regulations thereunder. The definition of
employee also must include any individual treated under § 414(n) or (o) as an employee of any
employer described in the preceding sentence.

(2) ESOPs. With respect to an ESOP, employees who meet the definition in section 5.12(1)
may not participate in the ESOP unless they are employed by the corporation that issues the stock
held by the ESOP or by any corporation that is a member of the same controlled group of
corporations (within the meaning of § 1563(a), as modified by § 409(l)(4)(B) and (C) and as
determined without regard to § 1563(a)(4) and (e)(3)(C)). For all other purposes under the ESOP,
including nondiscrimination and coverage, employees who meet the definition of employee in
section 5.12(1) are treated as employees.

.13 Crediting of Service taking into account § 414(b), (c), (m), (n), and (o) - Each Pre-approved
Plan must credit all service with any employer aggregated under § 414(b), (c), (m), or (o) and the
regulations thereunder as service with the employer maintaining the plan. In addition, in the case
of an individual treated under § 414(n) or (o) as an employee of any employer described in the
previous sentence, service with such employer must be credited to such individual.

.14 Uniformed Services Employment and Reemployment Rights Act and § 414(u) - Each
Pre-approved Plan must contain a provision reflecting the requirements of § 414(u). (See Rev.
Proc. 96-49, 1996-2 C.B. 369.)

.15 Provisions Applicable to Nonstandardized Plans - In addition to the provisions set forth in
sections 5.03 through 5.14, the following provisions apply to Nonstandardized Plans:

(1) Compensation Provisions in Nonstandardized Plans - Each Nonstandardized Plan may
provide the Adopting Employer the option to select total compensation as the compensation to be
used in determining allocations or benefits. For this purpose, total compensation means a
definition that includes all compensation within the meaning of § 415(c)(3) and excludes all other
compensation, or a definition that otherwise satisfies § 414(s) under § 1.414(s)-1(c).

(2) Automatic or Optional Safe Harbor Provisions in Nonstandardized Plans - Each Nonstan-
dardized Plan, other than a Statutory Hybrid Plan as described in section 4.03(7), may automat-
ically or by option allow the Adopting Employer to satisfy the requirements of one of the
design-based safe harbors described in § 1.401(a)(4)-2(b)(2) or § 1.401(a)(4)-3(b)(3), (4), and
(5).

.16 Provisions Applicable to Standardized Plans - In addition to the requirements set forth in
sections 5.03 through 5.14, each Standardized Plan must meet the following requirements:

(1) Under the provisions governing eligibility and participation, the plan by its terms must
benefit all employees described in section 5.12(1) (regardless of whether any employer is treated
as operating separate lines of business under § 414(r)) except those employees that may be
excluded under § 410(a)(1) or (b)(3). The plan may provide options as to whether some or all of
the employees described in § 410(a)(1) or (b)(3) are excluded, provided that the criteria for
excluding employees described in § 410(a)(1) or (b)(3) apply uniformly to all employees. A
Standardized Plan generally may not deny an accrual or allocation to an employee eligible to
participate merely because the employee is not an active employee on the last day of the plan year
or has failed to complete a specified number of hours of service during the year. However, the
plan may deny an allocation or accrual to an employee who is eligible to participate if the
employee terminates service during the plan year with not more than 500 hours of service and is
not an active employee on the last day of the plan year.

A plan will not fail to satisfy the requirements of this paragraph (1) merely because the plan
provides, either as the result of an elective provision or by default in the absence of an election
to the contrary, that individuals who become employees, within the meaning of section 5.12(1),
as the result of a transaction described in § 410(b)(6)(C) will be excluded from eligibility to
participate in the plan during the period beginning on the date of the transaction and ending on
a date that is not later than the last day of the first plan year beginning after the date of the
transaction. A transaction described in § 410(b)(6)(C) is an asset or stock acquisition, merger, or
other similar transaction involving a change in the employer of the employees of a trade or
business.

(2) The eligibility requirements under the plan are not more favorable for highly compensated
employees (as defined in § 414(q)) than for other employees.

(3) Under the plan, allocations, in the case of a defined contribution plan (other than any cash
or deferred arrangement portion of the plan), or benefits, in the case of a defined benefit plan, are
determined on the basis of total compensation. For this purpose, total compensation means a
definition of compensation that includes all compensation within the meaning of § 415(c)(3) and
excludes all other compensation, or a definition that otherwise satisfies § 414(s) and § 1.414(s)-
1(c).

(4) Unless the plan is a target benefit plan or a § 401(k) and/or 401(m) plan, the plan satisfies,
by its terms, one of the design-based safe harbors described in § 1.401(a)(4)-2(b)(2) (taking
into account § 1.401(a)(4)-2(b)(4)) or § 1.401(a)(4)-3(b)(3), (4), or (5) (taking into account
§ 1.401(a)(4)-3(b)(6)).

(5) All benefits, rights, and features under the plan (other than those, if any, that have been
prospectively eliminated) are currently available to all employees benefiting under the plan.

(6) Any past service credit under the plan meets the safe harbor in § 1.401(a)(4)-5(a)(3).

(7) Any hardship distribution satisfies the safe harbor standards in the regulations under
§ 401(k).

.17 Additional Provisions Required in ESOPs - In addition to complying with sections 5.03
through 5.15, each Pre-approved Plan that includes an ESOP feature must include the following
provisions:

(1) A statement that the plan is an employee stock ownership plan within the meaning of
§ 4975(e)(7) and is designed to invest primarily in employer stock;

(2) A provision that defines employer stock in accordance with § 409(l)(1) or (2);

(3) Provisions that meet the diversification requirements of § 401(a)(28)(B) or, if applicable,
§ 401(a)(35);

(4) Provisions that meet the valuation, independent appraiser, and allocation of earnings
requirements set forth in § 401(a)(28)(C), § 54.4975-11(d)(5), and Rev. Rul. 80-155, 1980-1
C.B. 84;

(5) Provisions that meet the voting requirements of § 409(e);

(6) Provisions that meet the right-to-demand and put-option requirements of § 409(h), to the
extent applicable;

(7) Provisions that meet the distribution requirements of § 409(o);

(8) Provisions that set forth the requirements relating to exempt loans as described in
§ 4975(d)(3), § 54.4975-7, and § 54.4975-11(c);

(9) Provisions that meet the ESOP annual addition requirements described in § 1.415(c)-1(f)
and, if the ESOP is maintained by an employer that is a C corporation, the requirements described
in § 415(c)(6);

(10) If an ESOP provides for forfeitures, provisions that meet the forfeiture requirement of
§ 54.4975-11(d)(4);

(11) If an ESOP holds employer securities consisting of stock in an S corporation, provisions
that meet the requirements of § 409(p) and § 1.409(p)-1;

(12) If an ESOP is maintained by employers that are C corporations, provisions that meet the
requirements of § 409(n); and

(13) Provisions (in the plan document or adoption agreement) that identify the Adopting
Employer as either a C corporation or an S corporation.

.18 Additional Provisions Required in Cash Balance Plans - In addition to complying with
sections 5.03 through 5.15, each Pre-approved Plan that includes Cash Balance Formulas must
meet the following requirements:

(1) Prior benefit structures protected - All Cash Balance Plans must ensure compliance with the
anti-cutback provisions of § 411(d)(6). To receive an Opinion Letter under this revenue proce-
dure, a Cash Balance Plan must provide that, at all times, any benefits accrued prior to the
Adopting Employer's adoption of the Pre-approved Plan (and other benefits protected under
§ 411(d)(6)(B)) are protected. A Cash Balance Plan that was the subject of a Conversion
Amendment must comply with the provisions of § 411(b)(5)(B)(iii) and § 1.411(b)(5)-1(c).
However, an Opinion Letter will not be issued for a plan that uses an opening hypothetical
account balance as described in § 1.411(b)(5)-1(c)(3) to meet the requirements of § 1.411(b)(5)-
1(c).

(2) Step-rate structure of Principal Credits - Cash Balance Plans that contain any structure of
Principal Credits that increase with age, service, or any other measure during a participant's
employment must be definitely determinable, operationally nondiscriminatory, and at all times in
compliance with the "133 1/3 percent rule" of § 411(b)(1)(B) and the regulations thereunder.
Employers may not rely on the Opinion Letter with respect to the requirements of § 411(b)(1) for
increasing Principal Credit schedules that are created by Adopting Employers by completing
blanks in the plan formula, but may rely on the Opinion Letter with respect to the requirements
of § 411(b)(1) for increasing Principal Credit schedules specified in the Pre-approved Plan
document.

#### SECTION 6. OPINION LETTERS - SCOPE

.01 General Limits on Opinion Letters - Opinion Letters will be issued only to Providers or
Mass Submitters. Opinion Letters constitute determinations as to the qualification of the plans as
adopted by particular employers only under the circumstances, and to the extent, described in
section 7. Opinion Letters do not constitute rulings or determinations as to the exempt status of
related trusts or custodial accounts under § 501(a).

.02 Nonapplicability of this Revenue Procedure to IRAs (including traditional IRAs, Roth
IRAs, SEPS, and Simple IRAs) and to § 403(b) Plans - Opinion Letters will not be issued under
this revenue procedure for prototype plans intended to meet the requirements for individual
retirement arrangements under § 408. (See the Form 5305 series, which provides model IRA
documents that have been pre-approved by the IRS and for which an opinion letter is not needed.
See also Rev. Proc. 87-50, 1987-2 C.B. 647, as modified by Rev. Proc. 97-29, 1997-1 C.B. 698;
Rev. Proc. 98-59, 1998-2 C.B. 727; and Rev. Proc. 2010-48, 2010-50 I.R.B. 828, for
administrative procedures for seeking opinion letters for individual retirement arrangements
under § 408.) In addition, Opinion Letters will not be issued under this revenue procedure for
§ 403(b) plans (see Rev. Proc. 2013-22, 2013-18 I.R.B. 985, as modified by Rev. Proc. 2014-28,
2014-16 I.R.B. 944, and clarified by Rev. Proc. 2017-18, 2017-5 I.R.B. 743, and Rev. Proc.
2015-22, 2015-11 I.R.B. 754, for administrative procedures for seeking opinion and advisory
letters for § 403(b) arrangements).

.03 Areas Not Covered by Opinion Letters - Opinion Letters will not be issued for:

(1) Multiemployer plans;

(2) Single-employer collectively bargained plans (however, this rule does not preclude an
employer from covering employees of the employer that are included in a unit covered by a
collective bargaining agreement if it is adopting a Pre-approved Plan for its non-bargaining
employees or from adopting a Pre-approved Plan pursuant to such agreement as a single-
employer plan that covers only bargaining employees of the employer);

(3) Stock bonus plans other than ESOPs;

(4) ESOPs that are a combination of a stock bonus plan and a money purchase plan;

(5) ESOPs that provide for the holding of preferred employer stock, including ESOPs that hold
stock described in § 409(l)(3);

(6) Consistent with section 6.01, pooled fund arrangements contemplated by Rev. Rul. 81-100,
1981-1 C.B. 326 (as modified by Rev. Rul. 2004-67, 2004-2 C.B 28; Rev. Rul. 2011-1, 2011-2
I.R.B. 251; Notice 2012-6, 2012-3 I.R.B. 293; and Rev. Rul. 2014-24, 2014-37 I.R.B. 529);

(7) Statutory Hybrid Plans with any of the following features:

(a) A statutory hybrid benefit formula that is not a Cash Balance Formula, such as a formula
under which benefits are determined by reference to the current value of an accumulated
percentage of the participant's average compensation (a Pension Equity Plan or PEP);

(b) Provisions under which Interest Credits are based on rates of return that are subject to
participant choice, or any rate that does not meet the requirements of § 1.411(b)(5)-1(d);

(c) Provisions under which a rate used to determine Interest Credits is based on a subset of plan
assets (as described in § 1.411(b)(5)-1(d)(5)(ii)) or the rate of return on certain regulated
investment companies (RICs) (as described in § 1.411(b)(5)-1(d)(5)(iv));

(d) A Conversion Amendment, except for plans providing that, after the effective date of the
Conversion Amendment, a participant's accrued benefit is equal to the sum of accruals under the
prior formula plus the benefit based on the Cash Balance Formula ("A+B Conversion");

(e) Provisions that use the 3-percent accrual rule or the fractional accrual rule under
§ 411(b)(1)(A) or (C) to satisfy the accrued benefit requirements under § 411(b)(1);

(f) Provisions for funding exclusively through insurance contracts as described in § 412(e)(3);
or

(g) Provisions for Offsets of benefits accrued under another plan (the "offsetting plan"), unless:

(i) The Offset is applied on an accumulated basis at the participant's annuity starting date,
rather than offsetting each year's Principal Credit by that year's accruals or contributions under
the offsetting plan;

(ii) If plan provisions are consistent with treatment of the Cash Balance Formula as a lump
sum-based benefit formula under § 1.411(a)(13)-1(d)(3), then the offsetting plan is a defined
contribution plan and the Offset is applied by subtracting the account balance under the defined
contribution plan from the hypothetical account balance under the Cash Balance Formula prior to
converting the balance to an annuity benefit;

(iii) The Offset meets the safe-harbor requirements of § 1.401(a)(4)-8(d) (except that the
Offset can be computed by subtracting the account balance under the offsetting plan from the
hypothetical account balance under the Cash Balance Formula), including the requirement that
the offsetting plan may not be a § 401(k) plan or a § 401(m) plan;

(iv) For the purpose of determining the amount of the Offset against any defined benefit
formula, the Offset reflects the value of any distributions from the offsetting plan made prior to
the participant's annuity starting date under the Cash Balance Plan;

(v) The Offset is applied on a uniform basis for all participants;

(vi) The plan provides a minimum accrued benefit to participants (expressed as a lifetime
annuity commencing at normal retirement age) of no less than 0.5% of compensation for each
year of credited service, which is not reduced by the Offset applied to other formulas under the
plan;

(vii) Accrued benefits, considered in conjunction with defined contribution accounts subject to
any Offset, meet nondiscrimination requirements; and

(viii) The amount of the Offset, including any procedures and actuarial assumptions for
converting a defined contribution account balance (under a specifically-named defined contribu-
tion plan) to an annuity amount, is definitely determinable.

(8) Plans described in § 414(k) (relating to a defined benefit plan that provides a benefit derived
from employer contributions that is based partly on the balance of the separate account of a
participant);

(9) Target benefit plans, other than plans that, by their terms, satisfy each of the safe harbor
requirements described in § 1.401(a)(4)-8(b)(3)(i), as well as the additional rules in
§ 1.401(a)(4)-8(b)(3)(ii) through (vii);

(10) Governmental defined benefit plans that include "deferred retirement option plan" (DROP)
features, or similar provisions in which a participant earns additional benefits for continued
employment post-normal retirement age in the form of credits to a separate account (including a
cash balance account or other arrangement) under the same plan;

(11) Plans under which the § 415 limitations are incorporated by reference;

(12) Plans under which the ADP test under § 401(k)(3) or the ACP test under § 401(m)(2) are
incorporated by reference;

(13) Standardized § 401(k) plans that provide for hardship distributions under circumstances
other than those described in the safe harbor standards in the regulations under § 401(k);

(14) Nonstandardized § 401(k) plans that provide for hardship distributions under circum-
stances not described in the safe harbor standards in the regulations under § 401(k), unless these
distributions are subject to nondiscriminatory and objective criteria contained in the plan;

(15) Fully-insured § 412(e)(3) plans, other than non-statutory hybrid plans that by their terms
satisfy the safe harbor in § 1.401(a)(4)-3(b)(5);

(16) Plans that include purported fail-safe provisions for § 401(a)(4) or the average benefit test
under § 410(b);

(17) Plans that include blanks or fill-in provisions for the employer to complete, unless the
provisions have parameters that preclude the employer from completing the provisions in a
manner that could violate the qualification requirements;

(18) Plans designed to satisfy the provisions of § 105;

(19) Plans that include § 401(h) accounts;

(20) Eligible combined plans within the meaning of § 414(x)(2); or

(21) Variable Annuity Plans and plans that provide for accruals that are determined in whole
or in part based on the value of, or rate of return on, identified assets, including plan assets.

.04 Opinion Letters Will Not Consider Title I Issues - The IRS will not review for and an Opinion
Letter will not consider Title I issues, which are administered by the Department of Labor.

.05 The IRS may, in its discretion, decline to issue Opinion Letters for other types of plans or
issues not described in this section.

##### SECTION 7. EMPLOYER RELIANCE ON OPINION LETTER

.01 Standardized Plans - Except as provided in section 7.01(1) through (3), an employer
adopting a Standardized Plan may rely on that plan's Opinion Letter as to the qualification in form
of the plan under the Code provisions provided in section 4.06 if the plan has a currently valid
Opinion Letter, the employer's plan is identical to the Standardized Plan, the coverage and
contributions or benefits under the employer's plan are not more favorable for highly compen-
sated employees (as defined in § 414(q)) than for other employees, and the employer has not
amended the plan other than to choose options provided under the plan or to make amendments
as described in section 8.03. See also section 8.06, which provides that an employer that amends
a Standardized Plan other than as provided in section 8.03 will be treated as maintaining an
individually designed plan.

(1) An employer may not rely on an Opinion Letter for a Standardized Plan with respect to the
requirements of §§ 415 and 416 without obtaining a determination letter if the employer maintains
at any time, or has maintained at any time, another plan, including a Standardized Plan, that was
qualified or determined to be qualified and that covers or covered some of the same participants.
An employer that adopts a Standardized Plan that is a defined contribution plan will not be
considered to have maintained another plan merely because the employer has maintained another
defined contribution plan, provided such other plan has been terminated prior to the effective date
of the Standardized Plan and no annual additions have been credited to the account of any
participant under such other plan as of any date within a limitation year of the Standardized Plan.
For this purpose, a plan that has been properly replaced by the adoption of a Standardized Plan
is not considered another plan. To be considered a replacement plan and thus for the employer to
be able to rely on the Standardized Plan with respect to the requirements of §§ 415 and 416
without obtaining a determination letter, the plan that has been replaced and the Standardized Plan
must be of the same type (for example, both defined benefit plans).

(2) An employer that has adopted a Standardized Plan that is a defined benefit plan may rely
on an Opinion Letter with respect to the requirements of § 401(a)(26) only if the plan satisfies the
requirements of § 401(a)(26) with respect to its prior benefit structure (within the meaning of
§ 1.401(a)(26)-3) or is deemed to satisfy § 401(a)(26) pursuant to regulations thereunder.

(3) An employer that adopts a Standardized Plan may not rely on an Opinion Letter with
respect to: (a) whether the timing of any amendment to the plan (or series of amendments)
satisfies the nondiscrimination requirements of § 1.401(a)(4)-5(a), except with respect to plan
amendments granting past service that meet the safe harbor described in § 1.401(a)(4)-5(a)(3) and
are not part of a pattern of amendments that significantly discriminates in favor of highly
compensated employees; or (b) whether the plan satisfies the effective availability requirement of
§ 1.401(a)(4)-4(c) with respect to any benefit, right, or feature. An employer that adopts a
Standardized Plan as an amendment to a plan other than a Standardized Plan may not rely on an
Opinion Letter with respect to whether a benefit, right, or feature that is prospectively eliminated
satisfies the current availability requirements of § 1.401(a)(4)-4.

.02 Nonstandardized Plans - An employer adopting a Nonstandardized Plan may rely on that
plan's Opinion Letter as to the qualification in form of the plan under the Code provisions
provided in section 4.06 if the plan has a currently valid Opinion Letter, the employer's plan is
identical to the Nonstandardized Plan, and the employer has not amended the plan other than to
choose options provided under the plan or to make amendments as described in section 8.03.

(1) Except as otherwise provided in this section 7.02, Adopting Employers of Nonstandardized
Plans may not rely on an Opinion Letter with respect to the requirements of:

(a) § 401(a)(4), 401(a)(26), 401(l), 410(b), or 414(s); or

(b) if the employer maintains or has ever maintained another plan covering some of the same
participants, § 415 or 416 (for this purpose, whether an employer maintains or has ever
maintained another plan will be determined using principles consistent with section 7.01(1)).

(2) Adopting Employers of Nonstandardized Plans may rely on the Opinion Letter with respect
to the requirements of §§ 410(b) and 401(a)(26) (other than the § 401(a)(26) requirements that
apply to a prior benefit structure) if all nonexcludable employees benefit under the plan.

(3) Nonstandardized Plans may allow an Adopting Employer to select an allocation formula for
employer nonelective contributions that satisfies one of the design-based safe harbors in
§ 1.401(a)(4)-2(b)(2) or a benefit formula that satisfies one of the design-based safe harbors under
§ 1.401(a)(4)-3(b)(3), (4), or (5), and the ability to select a safe harbor compensation definition
for such formula that satisfies § 1.414(s)-1(c). If the plan of the Adopting Employer allocates
contributions or provides benefits using one of the design-based safe harbors in § 1.401(a)(4)-
2(b)(2) or § 1.401(a)(4)-3(b)(3), (4), or (5), and the plan defines compensation using a definition
that satisfies § 1.414(s)-1(c), then the Adopting Employer may rely on an Opinion Letter with
respect to the nondiscriminatory amounts requirement under § 401(a)(4). Adopting Employers of
Nonstandardized Plans that are § 401(k) and/or § 401(m) plans may rely on an Opinion Letter
with respect to whether the form of the plan satisfies the actual deferral percentage test of
§ 401(k)(3) or the actual contribution percentage test of § 401(m)(2) if the employer elects to use
a safe harbor definition of compensation in the test. Adopting Employers of Nonstandardized
Plans described in § 401(k)(11) and/or § 401(m)(12) may rely on an Opinion Letter with respect
to whether the form of the plan satisfies these requirements, unless the plan provides for the safe
harbor contribution to be made under another plan.

(4) Except as provided in section 5.18(2), Adopting Employers of plans that contain a Cash
Balance Formula with a structure of Principal Credits that increase with age, service, or any other
measure during a participant's employment may not rely on an Opinion Letter with respect to the
requirements of § 411(b)(1).

.03 Other Limitations and Conditions on Reliance - The following conditions and limitations
apply with respect to all Pre-approved Plans:

(1) An Adopting Employer may rely on an Opinion Letter for a plan that amends or restates
a plan of the employer only if the plan that is being amended or restated was qualified.

(2) An Adopting Employer will not have reliance if the employer's adoption of the plan
precedes the issuance of an Opinion Letter for the plan.

(3) An Adopting Employer will not have reliance on the Opinion Letter if the adoption agreement
or other elective provisions in the plan are not completed correctly when adopted by the employer.

(4) An Adopting Employer may rely on an Opinion Letter only if the requirements of this
section 7 are met and the employer's plan is identical (as described in section 8.03) to a
Pre-approved Plan with a currently valid Opinion Letter. Thus, the employer must not have added
any terms to the Pre-approved Plan and must not have modified or deleted any terms of the plan
other than by choosing options permitted under the plan or by amending the document as
permitted under section 8.03.

(5) An Adopting Employer of any pension plan in which the normal retirement age selected by
the employer is less than age 62 will not have reliance on the Opinion Letter that such age is

reasonably representative of the typical retirement age for the employer's industry, as required by
§ 1.401(a)-1(b)(2).

(6) The Trust or Custodial Account Document may not contain a provision that states that the
provisions of the trust override provisions of the plan. An Adopting Employer may not rely on
an Opinion Letter to the extent that provisions of a trust or custodial account that are a separate
portion of the plan override or conflict with the provisions of the plan document.

.04 Reliance Equivalent to Determination Letter - If an employer may rely on an Opinion Letter
pursuant to this section, the Opinion Letter will be equivalent to a determination letter. For
example, the Opinion Letter is treated as a determination letter for purposes of section 23 of Rev.
Proc. 2017-4 (as updated annually), regarding the effect of a determination letter. As provided
in this section, the extent of the employer's reliance may be limited.

.05 If an Adopting Employer may not rely on a plan's Opinion Letter, the employer, if eligible
as provided in section 12 of Rev. Proc. 2017-4 (as updated annually), may submit an application
for a determination letter to obtain reliance. In addition, if an employer adds language to a
Pre-approved Plan to satisfy the requirements of §§ 415 and 416 given the required aggregation
of plans, to obtain reliance with regard to §§ 415 and 416, the employer must submit an
application for a determination letter. In this case, section 12.01(5)(a) of Rev. Proc. 2017-4
provides that such submission must be made on Form 5300, Application for Determination for
Employee Benefit Plan. However, pursuant to this revenue procedure, a determination letter
application to obtain reliance for §§ 415 and 416 may be made on Form 5307, Application for
Determination for Adopters of Modified Volume Submitter Plans.

SECTION 8. APPROVED
PLANS - PLAN
AMENDMENTS

.01 Plan Amendments Generally - Providers are required to amend their Pre-approved Plans to
ensure that the form of their plans continues to satisfy the requirements of § 401. Providers must
make reasonable and diligent efforts, as soon as practicable following the adoption of plan
amendments, to ensure that Adopting Employers of the Provider's plan have actually received and
are aware of such plan amendments. The date on which each amendment is adopted by the
Provider must be included with the amendment. Failure to comply with this requirement may
result in the loss of eligibility to offer plans and the revocation of Opinion Letters that have been
issued to the Provider.

.02 Interim Amendment Requirement - A plan must be operated in accordance with the written
plan document. When there are changes with respect to plan qualification requirements that affect
the provisions of the written plan document, the adoption of interim amendments generally will
be required in accordance with the rules set forth in section 15 of Rev. Proc. 2016-37. See section
15.04 of Rev. Proc. 2016-37 regarding the time by which such amendments must be adopted.
Failure to so amend may result in the loss of a plan's qualified status. See section 9.04 for
additional application submission requirements for interim amendments.

.03 Effect of Amendments; Reliance - As provided in section 7.03, an Adopting Employer may
rely on an Opinion Letter issued with respect to a Pre-approved Plan only if the employer's plan
is identical to the Pre-approved Plan. An employer that amends any provision of a Pre-approved
Plan, including its adoption agreement, or an employer that chooses to discontinue participation
in a plan as amended by its Provider without substituting another Pre-approved Plan will lose
reliance on the Opinion Letter. Notwithstanding the preceding sentence, the following types of
amendments will not cause a plan to fail to be identical to a Pre-approved Plan and, thus, will not
result in the employer losing reliance on the Opinion Letter:

(1) Amendments to the plan to add or change a provision (including choosing among options
in the plan) and/or to specify or change the effective date of a provision, provided the employer

is permitted to make the modification or amendment under the terms of the Pre-approved Plan as
well as under § 401 or 403(a), and, except for the effective date, the provision is identical to a
provision in the Pre-approved Plan;

(2) Sample or model amendments published by the IRS that specifically provide that their
adoption will not cause such plan to fail to be identical to the Pre-approved Plan;

(3) Amendments that adjust the limitations under §§ 415, 402(g), 401(a)(17), and 414(q)(1)(B)
to reflect annual cost-of-living increases, other than amendments that add automatic cost-of-living
adjustment provisions to the plan;

(4) Plan language completed by the employer if such overriding language is necessary to satisfy
§ 415 or 416 because of the required aggregation of multiple plans under these sections, in
accordance with section 5.05;

(5) Interim amendments or discretionary amendments that are related to a change in qualifi-
cation requirements, in accordance with section 15 of Rev. Proc. 2016-37;

(6) Amendments that reflect a change of a Provider's name, in which case the Provider must
notify the IRS, in writing, of the change in name and certify that it still meets the conditions to
be a Provider described in section 4.08 (see also section 14 regarding changes in employer
identification numbers); and

(7) Amendments to the administrative provisions in the plan (such as provisions relating to
investments, plan claims procedures, and employer contact information), provided the amended
provisions are not in conflict with any other provision of the plan and do not cause the plan to fail
to qualify under § 401.

.04 Obtaining Reliance After Employer Amendment - An employer maintaining a Nonstan-
dardized Plan that may not rely on the plan's Opinion Letter pursuant to this revenue procedure
may obtain reliance for its plan by requesting a determination letter under certain circumstances.
See section 20.03(3) of Rev. Proc. 2016-37 and sections 12 and 13 of Rev. Proc. 2017-4 (as
updated annually) for application procedures and the conditions under which an employer that has
made modifications to a Pre-approved Plan may file for a determination letter to obtain reliance.
Section 12 of Rev. Proc. 2017-4 (as updated annually) provides guidance on (a) who is eligible
to file for a determination letter, (b) which form to use in applying for a determination letter (for
example, Form 5307 or Form 5300), and (c) whether the Cumulative List or the Required
Amendments List as described in section 17 or 9, respectively, of Rev. Proc. 2016-37 will be
used by the IRS in reviewing an employer's plan. Under section 20.03(3) of Rev. Proc. 2016-37,
an employer may submit a determination letter application on a Form 5300 only if the application
is made upon initial qualification, plan termination, or in other circumstances identified by the
IRS. For this purpose, an employer that previously filed an application on Form 5300 or Form
5307 with respect to the plan and was issued a favorable determination letter is not eligible to file
a Form 5300 for initial plan qualification.

###### .05 Effect of Employer Amendments on Remedial Amendment Cycle

(1) Employer amendments made to a Pre-approved Plan will not affect the plan's eligibility for
a six-year remedial amendment cycle. However, if an employer amends a Pre-approved Plan as
provided in section 8.06(2) within one year of the date the employer initially adopted the plan, the
plan will not be eligible for the six-year remedial amendment cycle. In cases in which an amended

plan remains eligible for the six-year cycle and the Adopting Employer wishes to and is otherwise
eligible to file for a determination letter for the plan as provided in section 12 of Rev. Proc.
2017-4 (as updated annually), the determination letter application must be filed during the
applicable two-year window for employer adoption described in section 12.03 of this revenue
procedure. Except for plans that are treated as individually designed, as described in section 8.06,
the plan submitted for a determination letter will be reviewed based on the Cumulative List
applicable to the underlying Pre-approved Plan. See also section 8.07.

(2) A plan will not lose eligibility for the six-year remedial amendment cycle if a closing
agreement under the Audit Closing Agreement Program or a compliance statement under the
Voluntary Correction Program of the Employee Plans Compliance Resolution System (EPCRS)
has been issued with respect to the employer's plan with regard to the amendment. See section
6.05(2)(b) of Rev. Proc. 2016-51, 2016-42 I.R.B. 465, regarding the ability of the employer to
rely on the Opinion Letter.

.06 Pre-approved Plans Treated as Individually Designed - A Pre-approved Plan will be treated
as individually designed under the following circumstances:

(1) Except as provided in section 8.03, an employer makes any amendment to a Standardized
Plan;

(2) An employer amends a Pre-approved Plan (including its adoption agreement if applicable)
to incorporate a type of plan not allowed in the Opinion Letter program, as described in section
6.03;

(3) The IRS, in its discretion, determines that a plan is an individually designed plan due to the
nature and extent of amendments made; or

(4) An employer chooses to discontinue participation in a Pre-approved Plan that has been
amended by the Provider, without substituting another Pre-approved Plan.

.07 Procedures for Pre-approved Plans Treated as Individually Designed - If a plan is treated
as individually designed, the employer may not file for a determination letter using a Form 5307.
However, if an employer is otherwise eligible to file a determination letter application pursuant
to section 4 of Rev. Proc. 2016-37, the employer may file for a determination letter on Form
5300. In this case, the IRS will review the plan using the Required Amendments List (as described
in section 12 of Rev. Proc. 2016-37) that was issued during the second calendar year preceding
the submission of the determination letter application. See section 8.05(1) with respect to a plan's
continued eligibility for the six-year remedial amendment cycle and the time period for filing a
determination letter (if applicable).

.01 Issuance of Opinion Letters -The IRS will, upon the request of a Provider, issue an Opinion
Letter as to the qualification in form of the Provider's plan under §§ 401, 403(a), and 4975(e)(7).

SECTION 9. OPINION
LETTER APPLICATIONS
\- INSTRUCTIONS TO
PROVIDERS AND
OTHER RULES FOR
APPLICATIONS AND
LETTERS

.02 Submission of Opinion Letter Applications - Rev. Proc. 2016-37 provides that every
Pre-approved Plan will continue to have a regular six-year remedial amendment cycle. Rev. Proc.
2016-37 also states that Providers of Pre-approved Plans must submit requests for Opinion
Letters during the on-cycle submission period that relates to an applicable six-year remedial
amendment cycle. The third six-year remedial amendment cycle for pre-approved defined
contribution plans began on February 1, 2017, and ends on January 31, 2023. Pursuant to this
revenue procedure, the on-cycle submission period for Pre-approved Plan Providers to submit
applications for Opinion Letters begins on October 2, 2017, and ends on October 1, 2018.

Providers may apply for Opinion Letters at other times, but these filings will be considered
"off-cycle." See section 11 regarding IRS review of off-cycle filings.

.03 Procedure for Requesting Opinion Letters - A request for an Opinion Letter relating to a
plan must be submitted on the version of Form 4461, Application for Approval of Master or
Prototype or Volume Submitter Defined Contribution Plans, Form 4461-A, Application for
Approval of Master or Prototype or Volume Submitter Defined Benefit Plan, or Form 4461-B,
Application for Approval of Master or Prototype or Volume Submitter Plans (Mass Submitter
Adopting Sponsor or Practitioner), as appropriate, that is applicable at the time of the request. The
IRS is updating these forms and will announce when the forms become available. Until such time
as the forms become available, an application for an Opinion Letter for a Pre-approved Plan must
be made by submitting to the IRS the plan along with a completed and signed Submission for
Pre-approved Defined Contribution Plan Opinion Letter provided in Appendix A of this revenue
procedure. The request must be accompanied by (1) the applicable required user fee as provided
in Appendix B of this revenue procedure, (2) a signed certification that all necessary amendments
required by the IRS to retain the qualified status of the Provider's plan have been made and
communicated to all Adopting Employers, and (3) either Attachment I to Form 4461 or
Attachment I-A to Form 4461-A, as applicable. These attachments may be downloaded from the
Internet at the following address: http://www.irs.gov/Retirement-Plans/Preapproved-Plan-
Submission-Procedures. All information on the Submission for Pre-approved Defined Contribu-
tion Plan Opinion Letter must be typed. The request must be sent to the address listed in section
19. The application must include a copy of the plan document and any adoption agreement, if
applicable. Copies of trusts or other funding mediums should not be submitted. The IRS will not
review for, and the Opinion Letter will not cover, any provisions included in trust documents.

.04 Additional Submission Requirements for Interim Amendments - In addition to the appli-
cation described in section 9.03, the Provider must submit a certification that all interim
amendments on the applicable Cumulative List have been made, and a cover letter summarizing
the changes to the plan that are affected by each such interim amendment. The IRS retains the
right to request and secure from the Provider in appropriate circumstances copies of all interim
amendments reflected on the applicable Cumulative List that the Provider has adopted on behalf
of its Adopting Employers.

.05 Expediting Review of Substantially Identical Plans - The IRS reserves the right to review
applications in any order that will expedite the processing of Opinion Letter applications, subject
to section 11 regarding off-cycle filing. To expedite the review of substantially identical plans that
are not Mass Submitter plans, the IRS encourages plan drafters and Providers to include with each
Opinion Letter application, if appropriate, a cover letter setting forth the following information:

(1) The name and file folder number (if available) of the plan that, for review purposes, the plan
drafter designates as the "lead plan" (including the name and EIN of the Provider);

(2) A list of all plans written by the plan drafter that are substantially identical to the lead plan
(including the information described in paragraph (1) above for each plan);

(3) A description of each location in the plan for which the application is being submitted that
is not word-for-word identical to the language of the lead plan, including an explanation of the
purpose and effect of each such difference; and

(4) A certification made under penalty of perjury by the plan drafter that the information
described in paragraph (3) above is true and complete. If the Provider or plan drafter is aware that

a lead plan or any substantially identical plan has been assigned for review to a specialist, the
cover letter also should indicate the name of the specialist, if possible.

To the extent feasible, lead plans and substantially identical plans should be submitted together.
The IRS will regard the information and certification described in paragraphs (3) and (4) above
as a representation of a material fact for purposes of issuing an Opinion Letter.

.06 Use of Same Basic Plan Document by Multiple Plans/Separate Applications Required for
Different Categories of Adoption Agreement Plans

(1) In general, provided that the provisions of a basic plan document are identical for all plans
using that document, separate defined contribution adoption agreements may be associated with
the same defined contribution basic plan document and separate defined benefit adoption agree-
ments may be associated with the same defined benefit basic plan document. Thus, for example,
a profit-sharing plan, a money purchase pension plan other than a target benefit plan, a target
benefit plan, and an ESOP may all use the same defined contribution basic plan document.
Defined benefit plans and defined contribution plans may not use the same basic plan document.

(2) A profit-sharing plan (with or without a § 401(k) arrangement) that does not include an
ESOP and a money purchase pension plan that is not a target benefit plan may use the same
adoption agreement; however, separate adoption agreements are required for ESOPs and target
benefit plans. In addition, although an ESOP is permitted to contain both profit-sharing and
§ 401(k) features in the same adoption agreement, an employer that adopts the plan may not adopt
such profit-sharing and § 401(k) features without also adopting the ESOP portion of the plan. The
adoption agreement submitted for a defined benefit plan may contain any combination of
integrated formulas (that is, formulas that provide for permitted disparity), non-integrated for-
mulas, and cash balance formulas. Standardized and Nonstandardized Plans may not be combined
in a single adoption agreement.

(3) Basic plan documents and associated adoption agreements used for governmental plans
(that is, plans described in § 414(d)) must be separate from the basic plan documents and
associated adoption agreements used for nongovernmental plans. Similarly, separate basic plan
documents and the associated adoption agreements must be used for non-electing church plans
(church plans described in § 414(e) that have not made the election provided in § 410(d)). Thus,
for example, a Provider that wishes to obtain Opinion Letters for a governmental plan and a
non-electing church plan must submit a separate basic plan document and associated adoption
agreement for the governmental plan and a separate basic plan document and associated adoption
agreement for the non-electing church plan.

(4) A separate application form must be submitted with respect to each adoption agreement for
which an Opinion Letter is requested. A basic plan document and all associated adoption
agreements should be submitted simultaneously. Only one copy of the basic plan document
should be provided. However, if additional adoption agreements are later submitted with respect
to a basic plan document, the Provider must submit a copy of the basic plan document with each
submission and include a cover letter identifying the original submission. The plan number given
to such basic plan document must remain the same as in the prior submission.

.07 Separate Categories and Applications Required for Single Document Plans

(1) A separate plan and application are required for each of the following categories of Single
Document Plans: a target benefit plan, an ESOP, and a defined benefit plan. A profit-sharing plan
(with or without a § 401(k) arrangement) that does not include an ESOP and a money purchase

pension plan that is not a target benefit plan may be combined in a single plan and application.
In addition, although an ESOP is permitted to contain both profit-sharing and § 401(k) features
in the same plan, an employer that adopts the plan may not select the profit-sharing and § 401(k)
features without also selecting the ESOP provisions in the plan. Standardized and Nonstandard-
ized Plans may not be combined in one Single Document Plan.

(2) With respect to a governmental plan or a non-electing church plan, a separate plan and
application must be submitted for each. Thus, for example, separate plans and application forms must
be submitted for a governmental plan, a nongovernmental plan, and a non-electing church plan.

.08 Sample Language - A Listing of Required Modifications (LRM) containing sample plan
language is available from the IRS. Although the sample language is designed for use in plans that
use an adoption agreement format, in order to expedite processing, Providers are encouraged to
refer to the sample language as a guide in drafting plans that do not use an adoption agreement
format. To expedite the review of their plans, Providers are encouraged to use LRM language if
appropriate and to identify the location of such language in their Pre-approved Plan. LRMs may
be downloaded from the Internet at http://www.irs.gov/Retirement-Plans/Listing-of-Required-
Modifications-LRMs.

.09 Material Furnished to Adopting Employers - A Provider must furnish each Adopting
Employer with a copy of the approved plan, copies of any subsequent amendments, and the most
recently issued Opinion Letter from the IRS.

.10 Effect of Failure to Disclose Material Fact or to Accurately Provide Information - A failure
to disclose a material fact or misrepresentation of a material fact in the application or the failure
to accurately provide any of the information called for on any form required by this revenue
procedure may result in the inability of Adopting Employers to rely on the Opinion Letter.

.11 Additional Information May Be Requested - When reviewing the application for an
Opinion Letter, the IRS may, in its discretion, require any additional information that it deems
necessary, including a demonstration of how the variables (options or alternatives) in the
Pre-approved Plan interrelate to satisfy the qualification requirements of the Code. If a letter
requesting changes to the Pre-approved Plan is sent to the Provider or an authorized represen-
tative, changes responsive to the letter must be received no later than 30 days from the date of the
letter, and the response must include either a copy of the plan with the changes highlighted or, if
the changes are not extensive, replacement pages. If the changes are not received within 30 days,
the application may be considered withdrawn. An extension of the 30-day time limit will only be
granted for good cause.

.12 Inadequate Submissions - The IRS will return, without further action, plans that are not in
substantial compliance with the qualification requirements of § 401, 403(a), or 4975(e)(7), or
plans that are so deficient that they cannot be reviewed in a reasonable period of time. A plan may
be considered not to be in substantial compliance if, for example, it omits language needed to
comply with a qualification requirement or merely incorporates qualification requirements by
reference to the applicable Code section. The IRS will not consider a plan with such an omission
or cross-reference until after the plan has been revised, and the modified plan will be treated as
a new request for approval as of the date it is resubmitted. No additional user fee will be charged
if an inadequate submission is amended to be in substantial compliance and is resubmitted to the
IRS within 30 days following the date the Provider is notified of such inadequacy.

.13 Nonidentification of Questionable Issues May Cause Delay - If the Pre-approved Plan
submitted as part of an Opinion Letter request contains a provision that gives rise to an issue for

##### SECTION 10. MASS SUBMITTERS

which contrary published authorities exist, failure to disclose and address significant contrary
authorities may result in requests for additional information, which will delay action on the
request. See section 9.11.

#### .01 Opinion Letters Issued to Mass Submitters

(1) The IRS will, upon request by a Mass Submitter, issue an Opinion Letter as to the
qualification in form of the Mass Submitter's plan under §§ 401, 403(a), and 4975(e)(7). With
respect to its plan, the Mass Submitter must submit the version of Form 4461 or Form 4461-A
that is applicable at the time of the request and include a completed Attachment I for a defined
contribution plan or Attachment I-A for a defined benefit plan. The IRS is updating these forms
and will announce when the forms will become available. Until such time as the forms are
available, an application for an Opinion Letter for a Pre-approved Plan may be made by
submitting the plan to the IRS along with a completed and signed Submission for Pre-approved
Defined Contribution Plan Opinion Letter provided in Appendix A of this revenue procedure. The
request must be sent to the address in section 19. In the case of an initial submission of a
Pre-approved Plan under this revenue procedure, the Mass Submitter's application also must be
accompanied by applications for Opinion Letters filed on behalf of the requisite number of
Providers that are offering the same plan on a word-for-word basis as provided in section 10.02,
unless the Mass Submitter has already satisfied this requirement in connection with a previous
application under this revenue procedure involving another Pre-approved Plan. Any plan sub-
mitted by a Mass Submitter must include language designating the Mass Submitter as agent for
the Provider for purposes of making plan amendments. The request must be accompanied by the
applicable required user fee as provided in Appendix B of this revenue procedure and a signed
certification that all necessary amendments required by the IRS to retain the qualified status of the
Mass Submitter's plan have been made and communicated to all adopting Providers. Attachments
I and I-A may be downloaded from the Internet at the following address: http://www.irs.gov/
Retirement-Plans/Preapproved-Plan-Submission-Procedures.

(2) After satisfying the requirement as to the number of adopting Providers, the Mass Submitter
may submit additional applications on behalf of other Providers that wish to adopt a word-for-
word identical plan or a plan that contains minor modifications to the Mass Submitter plan, as
provided in section 10.03(2). In addition, the Mass Submitter may then submit requests for
Opinion Letters under this section 10.01 for its other plans, regardless of the number of identical
adopters of such other plans.

.02 Reduced Procedural Requirements for Providers That Use Mass Submitter Plans - A
Provider of a plan of a Mass Submitter must obtain an Opinion Letter. The Mass Submitter must
submit on behalf of each Provider a completed Submission for Pre-approved Defined Contribu-
tion Plan Opinion Letter which contains a declaration by the Mass Submitter under penalty of
perjury that the Provider will offer a plan that is word-for-word identical to a plan of the Mass
Submitter, or a plan that is a minor modification of the Mass Submitter's plan. The Submission
for Pre-approved Defined Contribution Plan Opinion Letter must be typed. If the Provider is
offering a word-for-word identical plan (including a flexible plan) a copy of the plan need not be
submitted. If the Mass Submitter submits a plan with minor modifications, it must comply with
the requirements of section 10.03(2). The request must be accompanied by the required user fee
as provided in Appendix B and a signed certification that all necessary amendments required by
the IRS to retain the qualified status of the Provider's plan have been made and communicated
to all Adopting Employers. Upon receipt of the request for an Opinion Letter, the IRS will, as
soon as administratively feasible, issue an Opinion Letter with respect to the Provider's plan
(provided that an Opinion Letter has been issued with respect to the Mass Submitter's plan).

.03 Definitions for Mass Submitter Plans -

##### (1) Flexible Plan

(a) In general - A "flexible plan" is a plan submitted by a Mass Submitter that contains
optional provisions (as defined in paragraph (b) immediately below). Providers that adopt the
flexible plan may include or delete any optional provision that is designated as such in the Mass
Submitter's plan, provided the inclusion or deletion of specific optional provisions conforms to
the Mass Submitter's written representation to the IRS concerning the choices available to
Providers and the coordination of optional provisions. A Mass Submitter must bracket and
identify the optional provisions when submitting such plan, and also must provide the IRS a
written representation describing the choices available to Providers and the coordination of
optional provisions. Thus, such a representation must indicate whether a Provider's plan may
contain only one of a certain group of optional provisions, may contain only a specific combi-
nation of provisions, or may exclude the provisions entirely. Similarly, if the inclusion (or
deletion) of a specific optional provision in a Provider's plan will automatically result in the
inclusion (or deletion) of any other optional provision, this must be set forth in the Mass
Submitter's representation. A flexible plan may contain only optional provisions that meet the
requirements of section 10.03(1)(b), and must be drafted so that the qualification of any
Provider's plan will not be affected by the inclusion or deletion of optional provisions. For
example, if a Provider's defined contribution plan contains an optional provision that allows a
portion of a participant's account to be invested in life insurance, then under the terms of the
Provider's plan, the application of the proceeds of the life insurance must meet the requirements
of §§ 401(a)(11) and 417. A flexible plan adopted by a Provider that differs from the Mass
Submitter plan only because the Provider has deleted certain optional provisions from its plan in
conformance with the Mass Submitter's representation described in this paragraph will be treated
as a word-for-word identical plan to the Mass Submitter plan. The IRS encourages Mass
Submitters to limit the number of optional provisions described in section 10.03(1)(b)(i) and (ii)
that they provide under a flexible plan to six investment provisions and six administrative
provisions.

(b) Optional Provisions - A flexible plan may contain optional provisions that comply with the
requirements set forth in this paragraph. The optional provisions may be arranged as separate
optional articles or sections within a Pre-approved Plan or as separate optional provisions within
a single article or section. A flexible plan also may contain related optional provisions in the
adoption agreement. For example, if a plan document for a Mass Submitter flexible plan contains
an optional provision that would allow for loans under a Provider's plan, the adoption agreement
may also include an optional provision that would enable an Adopting Employer to elect whether
loans will be available under the plan it adopts. If the Provider does not wish to enable Adopting
Employers to make loans available under their plans, the Provider would delete from the
Provider's plan both the plan document optional provision and the adoption agreement optional
provision. A Provider may include or delete optional provisions of a Mass Submitter plan, but
once the Provider has decided to include an optional provision, it must offer that provision to all
Adopting Employers. Any optional provision that the IRS determines does not meet the require-
ments of this section must be changed to a non-optional provision or deleted from the Mass
Submitter's plan. The following is an exclusive list of the allowable optional provisions that a
flexible plan may contain:

(i) Investment Provisions - A Mass Submitter may offer a variety of investment provisions in
its plan for Providers to include or delete from their version of the plan. However, the plan as
adopted by the Provider must provide some method for investing trust assets. Investment
provisions are those provisions that describe the plan's methods of investing the trust or custodial
funds, including provisions such as the availability of loans and investments in insurance
contracts or other funding media, and self-directed investments.

(ii) Administrative Provisions - A Mass Submitter may offer a variety of administrative

provisions in its plan for Providers to include or delete from their version of the plan. However,
the plan as adopted by the Provider must describe how the plan will be administered. Adminis-
trative provisions are those provisions that describe the administration of the plan, including the
powers, duties, and responsibilities of a plan's custodian, trustee, administrator, employer, and
other fiduciaries. Administrative provisions include the allocation of responsibilities among
fiduciaries, the resignation or replacement of fiduciaries, the claims procedures under the plan,
and the record-keeping requirements. However, procedural provisions that are required for plan
qualification are not administrative provisions under this section. For example, provisions that
provide for the notice to participants required by § 417 and record-keeping required by regula-
tions under §§ 401(k) and/or 401(m) are not administrative provisions for purposes of this
revenue procedure, and may not be optional provisions.

(iii) Cash or Deferred Arrangement - A Mass Submitter of a defined contribution plan may
include a self-contained cash or deferred arrangement (as defined in § 401(k)) for Providers to
include or delete.

(2) Minor Modifications

(a) A "minor modification" is a minor change to an otherwise word-for-word identical
Pre-approved Plan of the Mass Submitter that the IRS determines does not require an in-depth
IRS technical review. For example, a change from five-year 100% vesting to three-year 100%
vesting is a minor modification. On the other hand, a change in the method of accrual of benefits
in a defined benefit plan would not be considered a minor modification. A minor modification
must be submitted by the Mass Submitter on behalf of the Provider that will adopt the modified
plan. Subject to sections 10.05 and 11 and the provisions of this section, submissions with respect
to minor modifications will be reviewed on an expedited basis, and Opinion Letters will be issued
to the Provider as soon as possible.

(b) The IRS reserves the right to determine if changes described in the previous paragraph are
minor. If it is determined that the changes are extensive or require an in-depth technical review,
the plan submitted under paragraph (c) immediately below will not be entitled to expedited review
and will otherwise be treated as a non-mass submitter plan. In the event the plan is treated as a
non-mass submitter plan, the IRS will notify the Mass Submitter in writing of its determination.
Within 30 days following the date of such communication, either the Mass Submitter may revise
the plan so that the modifications are minor and resubmit the revised plan, or the Provider may
submit Form 4461 or 4461-A, whichever is applicable, and an additional user fee in an amount
equal to the difference between a non-mass submitter plan application user fee and a minor
modifier application user fee. If, after such 30 day period, neither action has been taken, the IRS
may treat the application as having been withdrawn.

(c) The Mass Submitter must initially submit the first page of the applicable Form 4461-B as
a placeholder with respect to each Provider that will offer a plan that is a minor modification of
the Mass Submitter's plan. The form must be typed. When the IRS sends a notification to the
applicable Mass Submitter with respect to the lead plan indicating that the IRS has determined
that the plan appears to be in full compliance with the applicable qualification requirements, the
Mass Submitter must submit a copy of the Mass Submitter's plan with the modifications
highlighted, as well as a statement indicating the location and effect of each change. The Mass
Submitter must certify under penalty of perjury that the plan of the Provider, except for the
delineated changes, is word-for-word identical to the plan for which the Mass Submitter received
an Opinion Letter. If a Mass Submitter fails to identify each modification, such failure will be
considered a material misrepresentation, and an Adopting Employer may not rely on any Opinion
Letter that may be issued with respect to the plan. If a Mass Submitter repeatedly fails to identify
such modifications, the IRS may deny permission to that Mass Submitter to submit additional
modifications.

.04 Amendments of Mass Submitter Plans - If a Mass Submitter amends the plan, the Mass
Submitter must provide copies of the amendment to Providers who have adopted the plan. Any
Provider that does not wish to make the amendments made by a Mass Submitter may switch to
another Mass Submitter or may submit an application for an Opinion Letter on its own behalf
during the next applicable on-cycle submission period for Pre-approved Plans. A Mass Submitter
should not submit an application for an Opinion Letter with respect to plan amendments. The IRS
will not issue an Opinion Letter with respect to amendments made between the applicable
on-cycle submission periods, and the Mass Submitter should submit a restated plan, including the
amendments, during the next six-year cycle.

.05 Expeditious Processing Accorded Mass Submitter Plans - Subject to section 11, all Mass
Submitter plans, including the adoption of approved Mass Submitter plans by Providers, will be
accorded more expeditious processing than plans submitted by non-mass submitters, to the extent
administratively feasible.

SECTION 11. OFF-
CYCLE FILINGS

An application for an Opinion Letter for a plan that is word-for-word identical to a Mass
Submitter plan will not be treated as off-cycle merely because it is submitted after the end of the
applicable on-cycle submission period for the six-year cycle. Any other application for an
Opinion Letter that is submitted after the applicable on-cycle submission period for the six-year
remedial amendment cycle is treated as an off-cycle application. If such an off-cycle application
is submitted before the beginning of the two-year window for employer adoption announced by
the IRS for an applicable six-year cycle (as described in section 12.03), the IRS generally will not
review the application until it has reviewed and processed all on-cycle plans. However, the IRS
may, in its discretion, determine whether the processing of off-cycle filings may be prioritized and
accelerated. Off-cycle applications that are submitted during or after the two-year window will
not be accepted.

# SECTION 12. REVIEW OF OPINION LETTER APPLICATIONS; ISSUANCE OF OPINION LETTERS

.01 The IRS will review the plans that have been submitted during the applicable on-cycle
submission period for a six-year cycle (as well as off-cycle plans that the IRS will review in
accordance with section 11) taking into account the applicable Cumulative List that identifies
changes in the qualification requirements of the Code as well as items of published guidance
relating to the plan qualification requirements, such as regulations and revenue rulings. However,
in order to be qualified, a plan must comply with all relevant qualification requirements, not just
those on the applicable Cumulative List.

.02 Timing of Issuance of Opinion Letters - The IRS intends to issue Opinion Letters to Mass
Submitters and Providers at approximately the same time within the applicable six-year cycle. In
the interim, the IRS will send a notification to the applicable Mass Submitter or Provider, if the
IRS determines that the plan appears to be in full compliance with the applicable qualification
requirements, based on the submissions and the review as of the date of notification. However,
this notification only indicates that the plan appears to meet the applicable qualification require-
ments under review as of the date of the notification. This notification is for the convenience of
the applicable Provider or Mass Submitter concerning the status of its application and does not
constitute an official Opinion Letter on which the Mass Submitter or Provider may rely. In
addition, the IRS reserves the right to require changes after the notification is sent.

.03 When the review of Pre-approved Plan documents for a specific six-year remedial
amendment cycle is close to being completed, the IRS will announce the date by which Adopting
Employers must adopt newly approved Pre-approved Plans. Depending upon the length of the
review process employers will have approximately a two-year period to adopt the updated plan
("two-year window").

SECTION 13.
WITHDRAWAL OF
REQUESTS

.01 Notification and Effect - A Provider may withdraw its request for an Opinion Letter at any
time prior to the issuance of such letter by notifying the IRS in writing of such withdrawal at the
address provided in section 19.01. The Provider also must notify each employer that adopted the

plan that the request has been withdrawn. The plan of such an employer will become an
individually designed plan unless the employer adopts another Pre-approved Plan.

.02 IRS Retains Information - Even though a request is withdrawn, the IRS will retain all
correspondence and documents associated with that request and will not return them to the
Provider. If a request is withdrawn, the case may be referred to IRS Employee Plans Examina-
tions, which has audit jurisdiction over the returns of any employers that have adopted the plan.

## SECTION 14. NONTRANSFERABILITY OF OPINION LETTER

An Opinion Letter issued to a Provider is not transferable to any other entity. In the case of a
change in entity with respect to a Provider, an Opinion Letter issued to such Provider may not be
utilized by the changed entity. In addition, if a different entity assumes sponsorship of a
Pre-approved Plan, it must submit an application for a new letter. Such an application may be filed
at the time of the assumption of plan sponsorship by the new Provider, and the filing is not limited
to the applicable on-cycle submission period. The application will be subject to a reduced user fee
as provided in Appendix A of Rev. Proc. 2017-4 (as updated annually). The new letter will
recognize the change in sponsorship and will not modify the scope of or change the reliance on
the original letter. The IRS may, in appropriate circumstances, request documentation of the
assumption of sponsorship prior to issuing a letter to the new entity. Examples of a change in
entity include, but are not limited to, the acquisition of a Provider by another entity, the sale or
transfer of the stock or assets of the Provider to another entity, and any other circumstance that
results in a change in an employer's employer identification number.

SECTION 15.
NOTIFICATION OF
ADOPTING EMPLOYER
REGARDING LOSS OF
QUALIFIED STATUS

If a Provider reasonably concludes that an Adopting Employer's plan may no longer be a
qualified plan and the Provider does not submit a request to correct the qualification failure under
EPCRS, it is incumbent on the Provider to notify the Adopting Employer that the plan may no
longer be qualified, advise the Adopting Employer that adverse tax consequences may result from
loss of the plan's qualified status, and inform the Adopting Employer about the availability of
EPCRS. See Rev. Proc. 2016-51.

SECTION 16.
DISCONTINUED PLANS

.01 Notification to the IRS - A Provider must notify the IRS in writing if an approved plan is
no longer in use by any Adopting Employers or the Provider no longer intends to offer the plan
for adoption. The written notification must be sent to the address in section 19 and must refer to
the file folder number appearing on the latest Opinion Letter issued.

.02 Notification to Employers - A Provider that intends to discontinue an approved plan that has
one or more Adopting Employers must inform each Adopting Employer that the plan has ceased
to be a Pre-approved Plan, and that the employer's plan will convert to an individually designed
plan (unless the employer adopts another Pre-approved Plan). After so informing the Adopting
Employers, the Provider must notify the IRS in accordance with section 16.01.

SECTION 17.
REVOCATION

Revocation of Opinion Letter by the IRS - An Opinion Letter found to be in error or not in
accord with the current procedures of the IRS or the IRS's current interpretation of applicable law
may be revoked. See also sections 4.08, 8.01, and 18.01 for other circumstances under which an
Opinion Letter may be revoked. Except in rare or unusual circumstances, such revocation will not
be applied retroactively. For this purpose, Opinion Letters will be given the same effect as rulings.
See section 23 of Rev. Proc. 2017-4 (as updated annually). Revocation may be effected by a
notice to the Provider to which the letter was originally issued. The Provider should then notify
each Adopting Employer of the revocation as soon as possible. The content of the notification to
each Adopting Employer must explain how the revocation affects any reliance an Adopting
Employer has on the applicable Opinion Letter and on any determination letter issued.

# SECTION 18. RECORD KEEPING REQUIREMENTS

.01 Filing of Opinion Letter Application Constitutes Agreement to Comply with Record
Keeping Requirements - By submitting an application for an Opinion Letter under this revenue
procedure (or by having an application filed on its behalf by a Mass Submitter), a Provider agrees,
as provided in section 4.08, to comply with the requirements imposed on the Provider by this
revenue procedure, including the record keeping requirements of this section. Failure to comply
with the requirements imposed on the Provider by this revenue procedure may result in the loss

of eligibility to be a Provider and the revocation of Opinion Letters that have been issued to the
Provider.

.02 Maintenance and Availability of Records of Adopting Employers - A Provider must
maintain, or have maintained on its behalf, for each of its plans, a record of the names, business
addresses, and taxpayer identification numbers of all Adopting Employers. However, a Provider
need not maintain such records with respect to employers that, to the best of the Provider's
knowledge, ceased to maintain its Pre-approved Plan more than three years earlier. Upon written
request, a Provider must provide to the IRS a list of Adopting Employers that indicates, to the best
of the Provider's knowledge, which of such employers continue to maintain the plan as a
Pre-approved Plan and which of such employers have ceased to maintain its Pre-approved Plan
within the preceding three years.

SECTION 19. WHERE
TO FILE

.01 Opinion Letters - Applications for Opinion Letters, including applications filed by Mass
Submitters, should be sent to:

Internal Revenue Service
Attn: Pre-Approved Plans Coordinator
Room 5106, Group 7521
P.O. Box 2508
Cincinnati, OH 45201-2508

.02 A request shipped by Express Mail or a delivery service should be sent to the attention of
the Pre-Approved Plans Coordinator, to:

Internal Revenue Service
550 Main Street
Room 5106, Group 7521
Cincinnati, OH 45202

SECTION 20. EFFECT ON OTHER DOCUMENTS

Rev. Proc. 2015-36 is modified and superseded regarding defined contribution plan and defined benefit plan Opinion Letter applications submitted with respect to a plan's third (and subsequent) six-year remedial amendment cycles. The provisions of Rev. Proc. 2015-36 continue to apply to opinion and advisory letter applications for defined contribution plans and defined benefit plans submitted with respect to a plan's previous six-year remedial amendment cycles. Rev. Proc. 2016-37 and Rev. Proc. 2017-4 are modified.

SECTION 21. EFFECTIVE DATE

This revenue procedure is effective on October 2, 2017, and will apply solely to applications for Opinion Letters submitted with respect to a plan's third (and subsequent) six-year remedial amendment cycles.

SECTION 22. PUBLIC COMMENTS

The Treasury Department and the IRS invite comments on this revenue procedure. Send submissions to CC:PA:LPD:PR, (Rev. Proc. 2017-41), Room 5203, Internal Revenue Service, PO Box 7604, Ben Franklin Station, Washington, D.C. 20044. Comments also may be hand delivered Monday through Friday between the hours of 8 a.m. and 4:00 p.m. to: Internal Revenue Service, CC:PA:LPD:PR, (Rev. Proc. 2017-41), Courier's Desk, Internal Revenue Service, 1111 Constitution Avenue, N.W., Washington DC. Alternatively, comments may be submitted via the Internet at notice.comments@irscounsel.treas.gov. Please include "Rev. Proc. 2017-41" in the subject line of any electronic communication. All comments will be available for public inspec- tion.

SECTION 23. PAPERWORK REDUCTION ACT

The collection of information contained 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. 3507) under control number 1545-1674.

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 5.10, 8.01, 8.02, 9.03, 10,
and 18. This information is required to enable the Commissioner, Tax Exempt and Government
Entities Division of the Internal Revenue Service, to make determinations in connection with plan
qualification. This information will be used to determine whether a plan is entitled to favorable
tax treatment. The likely respondents are banks, insurance companies, other financial institutions,
law, actuarial, and consulting firms, employee benefit practitioners and employers.

The estimated total annual reporting and/or recordkeeping burden is 1,108,225 hours.

The estimated annual burden per respondent/recordkeeper varies from 1/2 to 2,000 hours,
depending on individual circumstances, with an estimated average of 3.45 hours. The estimated
number of respondents and/or recordkeepers is 321,500.

The estimated frequency of responses is occasional.

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. § 6103.

## DRAFTING INFORMATION

The principal author of this revenue procedure is Kathleen Herrmann of the Office of Associate
Chief Counsel (Tax Exempt and Government Entities). For further information regarding this
revenue procedure, contact Employee Plans at (513) 975-6319 (not a toll-free number).

## APPENDIX A

Submission for Pre-approved Defined Contribution Plan Opinion Letter

1\. Enter amount of user fee submitted: $

2\. Name of applicant:

a. EIN:

b. Address:

c. Phone:

3\. Person to contact:

a. Phone:

b. Fax:

c. Email address:

d. Power of attorney attached?

4\. Type of applicant (check one):

a. Provider

b. Mass Submitter

c. Identical Provider of Mass Submitter plan

d. Minor modifier of Mass Submitter plan

5\. Form of plan (check either a. or b.);

a. Standardized Plan

i. Adoption Agreement Plan

ii. Single Document Plan

b. Nonstandardized Plan

i. Adoption Agreement Plan

ii. Single Document Plan

6\. Approval requested:

a. Initial application

b. Amendment

i. File folder number on last letter:

ii. Date of last letter issued:

7\. Type of Plan (check all that apply):

See sections 9.06 and 9.07 of this revenue procedure for how a Provider may structure an Adoption Agreement Plan or a Single
Document Plan. Under certain circumstances, more than one type of plan may be included in one adoption agreement or in one
Single Document Plan (for example, a money purchase, profit-sharing, and § 401(k)).

a. Money purchase

b. Profit-sharing

c. Profit-sharing/§ 401(k)

d. Target benefit

e. ESOP

f. Governmental

g. Non-electing church plan

7.a. Plan document number:

7.b. Adoption agreement number, if applicable:

8\. If 4.a. is checked, do you expect at least 15 employer-clients to adopt this plan's basic plan document or Single Document Plan?

a. If you will provide more than one basic plan document (for an Adoption Agreement Plan) or Single Document Plan, do
you have at least 30 employer-clients in the aggregate that are reasonably expected to adopt one of the plans?

9\. If 4.b. is checked, are applications on behalf of at least 30 unaffiliated Providers who are offering the same basic plan document
(for an Adoption Agreement Plan) or Single Document Plan on a word-for-word identical basis included with this application?
a. If no, enter the file folder number (or plan number, if file folder number not available) of the basic plan document or
Single Document Plan for which the requisite number of Providers requirement is met:

10\. If 4.a. or 4.b. is checked, are the following documents included with the application:

a. Basic plan document or Single Document Plan?

b. Adoption Agreement (if applicable)?

11\. If 4.c. or 4.d. 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 Single Document Plan number (if b, c, and d not available):

f. Adoption agreement number, if applicable (if b, c, and d not available)

12\. Applicant's signature under penalties of perjury (required if 4.a. or 4.b. 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:

13\. Provider's and Mass Submitter's signatures under penalties of perjury (required if 4.c. or 4.d. checked):

Under penalties of perjury, I declare that the Provider identified in line 2 of this application will offer an Adoption Agreement
Plan or Single Document Plan that is identical to the Mass Submitter plan identified in line 11, or is a minor modifier of the Mass
Submitter plan identified in line 11.

Provider's signature:

Title:

Date:

Mass Submitter's signature:

Title:

Date:

# APPENDIX B User Fees For Pre-approved Plans

1\) Opinion letters for Mass Submitter and non-Mass Submitter plans with adoption agreements

a) Per basic plan document, new or amended,
with one adoption agreement
$16,000

b) Per each additional adoption agreement

$11,000

a) Per each Single Document Plan

2\) Opinion letters for Mass Submitter and non-Mass Submitter Single Document Plans (NO ADOPTION AGREEMENTS)
$28,000

3\) Provider's word-for-word identical adoption of Mass Submitter's basic plan document per adoption agreement or Single
Document Plan
$300

4\) Provider's minor modification of Mass Submitter's basic plan document per adoption agreement or Single Document
Plan
$700

See Revenue Procedure 2017-4 (as updated annually) for additional fees regarding Pre-approved Plans that remain unchanged.

NOTE. This revenue procedure will be reproduced as the next revision of IRS Publication 1141, General Rules and Specifications
for Substitute Forms W-2 and W-3.

26 CFR 601.602: Tax forms and instructions.(Also Part I, Sections 6041, 6051, 6071, 6081, 6091; 1.6041-1, 1.6041-2, 31.6051-1, 31.6051-2, 31.6071(a)-1,
31.6081(a)-1, 31.6091-1.)

## Rev. Proc. 2017-42

### TABLE OF CONTENTS

#### Part 1 - GENERAL

Section 1.1 - Purpose
124

Section 1.2 - What's New
126

Section 1.3 - General Rules for Paper Forms W-2 and W-3
126

Section 1.4 - General Rules for Filing Forms W-2 (Copy A) Electronically
128

#### Part 2 - SPECIFICATIONS FOR SUBSTITUTE FORMS W-2 AND W-3

Section 2.1 - Specifications for Red-Ink Substitute Form W-2 (Copy A) and Form W-3 Filed with the SSA
129

Section 2.2 - Specifications for Substitute Black-and-White Copy A and W-3 Forms Filed with the SSA
131

Section 2.3 - Requirements for Substitute Forms Furnished to Employees (Copies B, C, and 2 of Form W-2)
134

Section 2.4 - Electronic Delivery of Form W-2 and W-2c Recipient Statements
137

#### Part 3 - ADDITIONAL INSTRUCTIONS

Section 3.1 - Additional Instructions for Form Printers
138

Section 3.2 - Instructions for Employers
139

Section 3.3 - OMB Requirements for Both Red-Ink and Black-and-White Copy A and W-3 Substitute Forms
139

Section 3.4 - Order Forms and Instructions
140

Section 3.5 - Effect on Other Documents
140

Section 3.6 - Exhibits.
140

## Part 1 General

Section 1.1 - Purpose

.01 The purpose of this revenue procedure is to state the requirements of the Internal Revenue
Service (IRS) and the Social Security Administration (SSA) regarding the preparation and use of
substitute forms for Form W-2, Wage and Tax Statement, and Form W-3, Transmittal of Wage
and Tax Statements, for wages paid during the 2017 calendar year.

.02 For purposes of this revenue procedure, substitute Form W-2 (Copy A) and substitute Form
W-3 are forms that are not printed by the IRS. Copy A or any other copies of a substitute Form
W-2 or a substitute Form W-3 must conform to the specifications in this revenue procedure to
be acceptable to the IRS and the SSA. No IRS office is authorized to allow deviations from this
revenue procedure. Preparers also should refer to the 2017 General Instructions for Forms W-2
and W-3 for details on how to complete these forms. See Section 3.4 for information on obtaining
the official IRS forms and instructions. See Sections 2.3 and 2.4 for requirements for the copies
of substitute forms furnished to employees and for electronic delivery of recipient statements.

.03 For purposes of this revenue procedure, the official IRS-printed red dropout ink Forms W-2
(Copy A) and W-3, and their exact substitutes, are referred to as "red-ink." The SSA-approved
black-and-white Forms W-2 (Copy A) and W-3 are referred to as "substitute black-and-white
Copy A" and "substitute black-and-white W-3" forms.

Any questions about the red-ink Form W-2 (Copy A) and Form W-3 and the substitute employee
statements should be emailed to Substituteforms@irs.gov. Please enter "Substitute Forms" on the
subject line. Or send your questions to:

Internal Revenue Service
Attn: Substitute Forms Program
SE:W:CAR:MP:P:TP
5000 Ellin Rd., C6-440
Lanham, MD 20706

Any questions about the black-and-white Copy A and W-3 forms should be emailed to
copy.a.forms@ssa.gov or sent to:

Social Security Administration
Direct Operations Center
Attn: Substitute Black-and-White Copy A Forms, Room 341
1150 E. Mountain Drive
Wilkes-Barre, PA 18702-7997

Note. You should receive a response from either the IRS or the SSA within 30 days.

.04 Some Forms W-2 that include logos, slogans, and advertisements (including advertisements
for tax preparation software) may be considered as suspicious or altered Forms W-2 (also known
as "questionable Forms W-2"). An employee may not recognize the importance of the employee
copy for tax reporting purposes due to the use of logos, slogans, and advertisements. Thus, the
IRS has determined that logos, slogans, and advertising will not be allowed on Copy A of Forms
W-2, Forms W-3, or any employee copies reporting wages, with the following exceptions for the
employee copies.

· Forms may include the exact name of the employer or agent, primary trade name, trademark,
service mark, or symbol of the employer or agent.

· Forms may include an embossment or watermark on the information return (and copies) that
is a representation of the name, a primary trade name, trademark, service mark, or symbol of
the employer or agent.

· Presentation may be in any typeface, font, stylized fashion, or print color normally used by the
employer or agent, and used in a non-intrusive manner.

. These items must not materially interfere with the ability of the recipient to recognize,
understand, and use the tax information on the employee copies.

The IRS e-file logo on the IRS official employee copies may be included, but it is not required,
on any of the substitute form copies.

The information return and employee copies must clearly identify the employer's name associated
with its employer identification number.

Logos and slogans, may be used on permissible enclosures, such as a check or account statement,
but not on information returns and employee copies.

Forms W-2 and W-3 are subject to annual review and possible change. This revenue procedure
may be revised to state other requirements of the IRS and the SSA regarding the preparation and

use of substitute forms for Form W-2 and Form W-3 for wages paid during the 2017 calendar
year, at a future date. If you have comments about the restrictions on including logos, slogans, and
advertising on information returns and employee copies, send or email your comments to: Internal
Revenue Service, Attn: Substitute Forms Program, SE:W:CAR:MP:P:TP, 5000 Ellin Road,
C6-440, Lanham, MD 20706, or Substituteforms@irs.gov.

.05 The Internal Revenue Service/Information Returns Branch (IRS/IRB) maintains a centralized
customer service call site to answer questions related to information returns (Forms W-2, W-3,
W-2c, W-3c, 1099 series, 1096, etc.). You can reach the call site at 866-455-7438 (toll-free) or
304-263-8700 (not a toll-free number). Persons with a hearing or speech disability with access to
Telecommunication Device for the Deaf (TDD) can call 304-579-4827 (not a toll-free number).
You also may email questions to mccirp@irs.gov. Do not submit employee information via email,
because electronic mail is not secure and the information may be compromised.

File paper or electronic Forms W-2 (Copy A) with the SSA. IRS/IRB does not process Forms
W-2 (Copy A). IRS/IRB does not process any information returns filed on paper forms. However,
IRS/IRB does process Form 8508, Request for Waiver From Filing Information Returns Elec-
tronically, and Form 8809, Application for Extension of Time to File Information Returns, for
Forms W-2 (Copy A) and requests for an extension of time to furnish the employee copies of
Form W-2. See Publication 1220, Specifications for Electronic Filing of Forms 1097, 1098, 1099,
3921, 3922, 5498, and W-2G, for information on waivers and extensions of time.

.06 The following form instructions and publications provide more detailed filing procedures for
certain information returns.

· General Instructions for Forms W-2 and W-3 (Including Forms W-2AS, W-2CM, W-2GU,
W-2VI, W-3SS, W-2c, and W-3c).

· Publication 1223, General Rules and Specifications for Substitute Forms W-2c and W-3c.

Section 1.2 - What's New

.01 New Box 9 Verification code. Box 9 is used by participants in the W-2 Verification Code
initiative. For more information, go to www.irs.gov/ individuals/W-2-verification-code.

.02 New Box 12 Code FF. A new box 12 Code FF has been added to report the total amount of
permitted benefits under a qualified small employer health reimbursement arrangement
(QSEHRA). For more information, see the 21st Century Cures Act, Public Law 114-255,
Division C, Section 18001.

.03 Editorial changes. We made editorial changes. Redundancies were eliminated as much as
possible.

### Section 1.3 - General Rules for Paper Forms W-2 and W-3

.01 Employers not filing electronically must file paper Forms W-2 (Copy A) along with Form
W-3 with the SSA by using either the official IRS form or a substitute form that exactly meets
the specifications shown in Parts 2 and 3 of this revenue procedure.

Note. Substitute territorial forms (W-2AS, W-2GU, W-2VI, W-3SS) also must conform to the
specifications as outlined in this revenue procedure. These forms require the form designation
("W-2AS," "W-2GU," "W-2VI") on Copy A to be in black ink. If you are an employer in the
Commonwealth of the Northern Mariana Islands, you must contact Department of Finance,
Division of Revenue and Taxation, Commonwealth of the Northern Mariana Islands, P.O. Box
5234 CHRB, Saipan, MP 96950 or www.cnmidof.net to get Form W-2CM and instructions for
completing and filing the form. For information on Forms 499R-2/W-2PR, use this website:
www.hacienda.gobierno.pr.

Employers may design their own statements to furnish to employees. Employee statements
designed by employers must comply with the requirements shown in Parts 2 and 3.

.02 Red-ink substitute forms that completely conform to the specifications contained in this
revenue procedure may be privately printed without prior approval from the IRS or the SSA. Only
the substitute black-and-white Copy A and W-3 forms need to be submitted to the SSA for
approval, prior to their use (see Section 2.2).

.03 As in the past, SSA-approved black-and-white Copy A and Form W-3 may be generated
using a printer by following all guidelines and specifications (also see Section 2.2). In general,
regardless of the method of entering data, use black ink on Forms W-2 and W-3 which provides
better readability for processing by scanning equipment. Colors other than black are not easily
read by the scanner and may result in delays or errors in the processing of Forms W-2 (Copy A)
and W-3. The printing of the data should be centered within the boxes. The size of the variable
data must be printed in a font no smaller than 10-point.

Note. With the exception of the identifying number, the year, the form number for Form W-3,
and the corner register marks, the preprinted form layout for the red-ink Forms W-2 (Copy A)
and W-3 must be in Flint J-6983 red OCR dropout ink or an exact match.

.04 Substitute forms filed with the SSA and substitute copies furnished to employees that do not
conform to these specifications are unacceptable. Penalties may be assessed for not complying
with the form specifications. Forms W-2 (Copy A) and W-3 filed with the SSA that do not
conform may be returned.

.05 Substitute red-ink forms should not be submitted to either the IRS or the SSA for specific
approval. If you are uncertain of any specification and want clarification, do the following.

· Submit a letter or email to the appropriate address in Section 1.1 citing the specification.

· State your understanding of the specification.

· Enclose an example (if appropriate) of how the form would appear if produced using your
understanding. Do not use actual employee information in the example.

· Be sure to include your name, complete address, and phone number with your correspondence.
If you want the IRS to contact you via email, also provide your email address.

.06 Any questions about the specifications, especially those for the red-ink Form W-2 (Copy A)
and Form W-3, should be emailed to: Substituteforms@irs.gov. Please enter "Substitute Forms"
on the subject line. Or send your questions to:

Internal Revenue Service
Attn: Substitute Forms Program
SE:W:CAR:MP:P:TP
5000 Ellin Rd., C6-440
Lanham, MD 20706

Any questions about the substitute black-and-white Copy A and W-3 should be emailed to
copy.a.forms@ssa.gov or sent to:

Social Security Administration
Direct Operations Center
Attn: Substitute Black-and-White Copy A Forms, Room 341
1150 E. Mountain Drive
Wilkes-Barre, PA 18702-7997

Note. You should receive a response within 30 days from either the IRS or the SSA.

.07 Forms W-2 and W-3 are subject to annual review and possible change. Therefore, employers
are cautioned against overstocking supplies of privately printed substitutes.

.08 Separate instructions for Forms W-2 and W-3 are provided in the 2017 General Instructions
for Forms W-2 and W-3. Form W-3 should be used only to transmit paper Forms W-2 (Copy
A). Form W-3 is a single sheet including only essential filing information. Be sure to make a copy
of your completed Form W-3 for your records. You can order current year official IRS Forms
W-2, W-2AS, W-2GU, W-2VI, W-3, and W-3SS, and the 2017 General Instructions for Forms
W-2 and W-3, online at www.irs.gov/businesses. Click on the Online Ordering for Information
Returns and Employer Returns link. The IRS provides only cutsheet sets of Forms W-2 and
cutsheets of Form W-3.

.09 Because substitute Forms W-2 (Copy A) and W-3 are machine-imaged and scanned by the
SSA, the forms must meet the same specifications as the official IRS Forms W-2 and W-3 (as
shown in the exhibits).

### Section 1.4 - General Rules for Filing Forms W-2 (Copy A) Electronically

.01 Employers must file Forms W-2 (Copy A) with the SSA electronically if they are required
to file 250 or more for a calendar year unless the IRS grants a waiver. For details, see the 2017
General Instructions for Forms W-2 and W-3. The SSA publication EFW2, Specifications for
Filing Forms W-2 Electronically, contains specifications and procedures for electronic filing of
Form W-2 information with the SSA. Employers are cautioned to obtain the most recent revision
of EFW2 (and supplements) due to any subsequent changes in specifications and procedures.

.02 You may obtain a copy of the EFW2 by:

· Accessing the SSA website at: www.ssa.gov/employer/EFW2&EFW2C.htm.

.03 Electronic filers do not file a paper Form W-3. See the SSA publication EFW2 for guidance
on transmitting Form W-2 (Copy A) information to SSA electronically.

.04 Employers filing fewer than 250 Forms W-2 are encouraged to electronically file Forms W-2
(Copy A) with the SSA. Doing so will enhance the timeliness and accuracy of forms processing.
You may visit the SSA's employer website at www.ssa.gov/employer. This helpful site has links
to Business Services Online (BSO) and tutorials on registering and using BSO to file your Forms
W-2.

.05 Employers who do not comply with the electronic filing requirements for Form W-2 (Copy
A) and who are not granted a waiver by the IRS may be subject to penalties. Employers who file
Form W-2 information with the SSA electronically must not send the same data to the SSA on
paper Forms W-2 (Copy A). Any duplicate reporting may subject filers to unnecessary contacts
by the SSA or the IRS.

## Part 2 Specifications for Substitute Forms W-2 and W-3

### Section 2.1 - Specifications for Red-Ink Substitute Form W-2 (Copy A) and Form W-3 Filed with the SSA

.01 The official IRS-printed red dropout ink Form W-2 (Copy A) and W-3 and their exact
substitutes are referred to as red-ink in this revenue procedure. Employers may file substitute
Forms W-2 (Copy A) and W-3 with the SSA. The substitute forms must be exact replicas of the
official IRS forms with respect to layout and content because they will be read by scanner
equipment.

Note. Even the slightest deviation can result in incorrect scanning, and may affect money amounts
reported for employees.

.02 Paper used for cutsheets and continuous-pinfed forms for substitute Form W-2 (Copy A) and
Form W-3 that are to be filed with the SSA must be white 100% bleached chemical wood, 18-20
pound paper only, optical character recognition (OCR) bond produced in accordance with the
following specifications:

· Acidity: Ph value, average, not less than
4.5

· Basis weight: 17 x 22 inch 500 cut sheets, pound
18-20

. Metric equivalent-gm./sq. meter (a tolerance of +5 pct. is allowed)
68-75

· Stiffness: Average, each direction, not less than-milligrams
Cross direction
Machine direction

· Tearing strength: Average, each direction, not less than-grams

. Opacity: Average, not less than-percent

· Reflectivity: Average, not less than-percent
68

· Thickness: Average-inch
0.0038

Metric equivalent-mm

0.097

(a tolerance of +0.0005 inch (0.0127 mm) is allowed) Paper cannot vary more
than 0.0004 inch (0.0102 mm) from one edge to the other.

. Porosity: Average, not less than-seconds
10

· Finish (smoothness): Average, each side-seconds
20-55

(for information only) the Sheffield equivalent-units
170-d200

· Dirt: Average, each side, not to exceed-parts per million

Note. Reclaimed fiber in any percentage is permitted, provided the requirements of this standard
are met.

.03 All printing of red-ink substitute Forms W-2 (Copy A) and W-3 must be in Flint red OCR
dropout ink except as specified below. The following must be printed in nonreflective black ink.

· Identifying number "22222" or "33333" at the top of the forms.

· Tax year at the bottom of the forms.

· The four (4) corner register marks on the forms.

· The form identification number ("W-3") at the bottom of Form W-3.

. All the instructions below Form W-3 beginning with "Send this entire page .... " line to the
bottom of Form W-3.

.04 The vertical and horizontal spacing for all federal payment and data boxes on Forms W-2 and
W-3 must meet specifications. On Form W-3 and Form W-2 (Copy A), all the perimeter rules
must be 1-point (0.014-inch), while all other rules must be one-half point (0.007-inch). Vertical
rules must be parallel to the left edge of the form; horizontal rules parallel to the top edge.

.05 The official red-ink Form W-3 and Form W-2 (Copy A) are 7.50 inches wide. Employers
filing Forms W-2 (Copy A) with the SSA on paper also must file a Form W-3. Form W-3 must
be the same width (7.50 inches) as the Form W-2. One Form W-3 is printed on a standard-size,
8.5 x 11-inch page. Two official Forms W-2 (Copy A) are contained on a single 8.5 x 11-inch
page (exclusive of any snap-stubs).

.06 The top, left, and right margins for the Form W-2 (Copy A) and Form W-3 are 0.50 inches
(1/2 inch). All margins must be free of printing except for the words "DO NOT STAPLE" on
red-ink Form W-3. The space between the two Forms W-2 (Copy A) is 1.33 inches.

.07 The identifying numbers are "22222" for Form W-2 (Copies A (and 1)) and "33333" for Form
W-3. No printing should appear anywhere near the identifying numbers.

Note. The identifying number must be printed in nonreflective black ink in OCR-A font of 10
characters per inch.

.08 The depth of the individual scannable image on a page must be the same as that on the official
IRS forms. The depth from the top line to the bottom line of an individual Form W-2 (Copy A)
must be 4.17 inches and the depth from the top line to the bottom line of Form W-3 must be 4.67
inches.

.09 Continuous-pinfed Forms W-2 (Copy A) must be separated into 11-inch deep pages. The
pinfed strips must be removed when Forms W-2 (Copy A) are filed with the SSA. The two Forms
W-2 (Copy A) on the 11-inch page must not be separated (only the pages are to be separated
(burst)). The words "Do Not Cut, Fold, or Staple Forms on This Page" must be printed twice
between the two Forms W-2 (Copy A) in Flint red OCR dropout ink. All other copies (Copies
1, B, C, 2, and D) must be able to be distinguished and separated into individual forms.

.10 Box 12 of Form W-2 (Copy A) contains four entry boxes - 12a, 12b, 12c, and 12d. Do not
make more than one entry per box. Enter your first code in box 12a (for example, enter Code D
in box 12a, not 12d, if it is your first entry). If more than four items need to be reported in box
12, use a second Form W-2 to report the additional items (see "Multiple forms" in the 2017
General Instructions for Forms W-2 and W-3). Do not report the same federal tax data to the SSA
on more than one Form W-2 (Copy A). However, repeat the identifying information (employee's
name, address, and SSN; employer's name, address, and EIN) on each additional form.

.11 The checkboxes in box 13 of Form W-2 (Copy A) and in box b of Form W-3 must be 0.14
inches each. The space before the first checkbox is 0.24 inches; the space between the first and

second checkbox and between the second and third checkbox must be 0.36 inches; the space
between the third checkbox to the right border of box 13 should be 0.32 inches (see Exhibit A).

Note. More than 50% of an applicable checkbox must be covered by an "X."

.12 All substitute Forms W-2 (Copy A) and W-3 in the red-ink format must have the tax year,
form number, and form title printed on the bottom face of each form using type identical to that
of the official IRS form. The red-ink substitute Form W-2 (Copy A) and Form W-3 must have
the form producer's EIN entered directly to the left of "Department of the Treasury," in red.

.13 The words "For Privacy Act and Paperwork Reduction Act Notice, see the separate instruc-
tions." must be printed in Flint red OCR dropout ink in the same location as on the official Form
W-2 (Copy A). The words "For Privacy Act and Paperwork Reduction Act Notice, see the
separate instructions." must be printed at the bottom of the page of Form W-3 in black ink.

.14 The Office of Management and Budget (OMB) Number must be printed on substitute Forms
W-3 and W-2 (on each ply) in the same location as on the official IRS forms.

.15 All substitute Forms W-3 must include the instructions that are printed on the same sheet
below the official IRS form.

.16 The back of substitute Form W-2 (Copy A) and Form W-3 must be free of all printing.

.17 All copies must be clearly legible. Fading must be minimized to assure legibility.

.18 Chemical transfer paper is permitted for Form W-2 (Copy A) only if the following standards
are met.

· Only chemically backed paper is acceptable for Form W-2 (Copy A). Front and back
chemically treated paper cannot be processed properly by scanning equipment.

· Chemically transferred images must be black.

· Carbon-coated forms are not permitted.

.19 The Government Printing Office (GPO) symbol and the Catalog Number (Cat. No.) must be
deleted from substitute Form W-2 (Copy A) and Form W-3.

### Section 2.2 - Specifications for Substitute Black-and-White Copy A and W-3 Forms Filed with the SSA

.01 The SSA-approved substitute black-and-white Forms W-2 (Copy A) and W-3 are referred to
as substitute black-and-white Copy A and W-3. Specifications for the substitute black-and-white
Copy A and W-3 are similar to the red-ink forms (Section 2.1) except for the items that follow
(see Exhibits D and E). Exhibits are samples only and must not be downloaded to meet tax
obligations.

1\. Forms must be printed on 8.5 x 11-inch single-sheet paper only. There must be two Forms
W-2 (Copy A) printed on a page. There must be no horizontal perforations between the two
Forms W-2 (Copy A) on each page.

2\. All forms and data must be printed in nonreflective black ink only.

3\. The data and forms must be programmed to print simultaneously. Forms cannot be produced
separately from wage data entries.

4\. The forms must not contain corner register marks.

5\. The forms must not contain any shaded areas, including those boxes that are entirely shaded
on the red-ink forms.

6\. Identifying numbers on both Form W-2 ("22222") and Form W-3 ("33333") must be
preprinted in 14-point Arial bold font or a close approximation.

7\. The form numbers ("W-2" and "W-3") must be in 18-point Arial font or a close approxi-
mation. The tax year (for example, "2017") on Forms W-2 (Copy A) and W-3 must be in
20-point Arial font or a close approximation.

8\. No part of the box titles or the data printed on the forms may touch any of the vertical or
horizontal lines, nor should any of the data intermingle with the box titles. The data should
be centered in the boxes.

9\. Do not print any information in the margins of the substitute black-and-white Copy A and
W-3 forms (for example, do not print "DO NOT STAPLE" in the top margin of Form W-3).

10\. The word "Code" must not appear in box 12 on Form W-2 (Copy A).

11\. A 4-digit vendor code preceded by four zeros and a slash (for example, 0000/9876) must
appear in 12-point Arial font, or a close approximation, under the tax year in place of the Cat.
No. on Form W-2 (Copy A) and in the bottom right corner of the "For Official Use Only"
box at the bottom of Form W-3. Do not display the form producer's EIN to the left of
"Department of the Treasury." The vendor code will be used to identify the form producer.

12\. Do not print Catalog Numbers (Cat. No.) on either Form W-2 (Copy A) or Form W-3.

13\. Do not print the checkboxes in:

· Box 13 of Form W-2 (Copy A). The "X" should be programmed to be printed and centered
directly below the applicable box title.

14\. Do not print dollar signs. If there are no money amounts being reported, the entire field should
be left blank.

15\. The space between the two Forms W-2 (Copy A) is 1.33 inches.

.02 You must submit samples of your substitute black-and-white Copy A and W-3 forms to the
SSA. Only black-and-white substitute Forms W-2 (Copy A) and W-3 for tax year 2017 will be
accepted for approval by the SSA. Questions regarding other red-ink forms (that is, red-ink Forms
W-2c, W-3c, 1099 series, 1096, etc.) must be directed to the IRS only.

.03 You will be required to send one set of blank and one set of dummy-data substitute
black-and-white Copy A and W-3 forms for approval. Sample data entries should be filled in to
the maximum length for each box entry, preferably using numeric data or alpha data, depending
upon the type required to be entered. Include in your submission the name, telephone number, fax
number, and email address of a contact person who can answer questions regarding your sample
forms.

.04 To receive approval, you may first contact the SSA at copy.a.forms@ssa.gov to obtain a
template and further instructions in PDF or Excel format. You may also send your 2017 sample
substitute black-and-white Copy A and W-3 forms to:

Social Security Administration
Direct Operations Center
Attn: Substitute Black-and-White Copy A Forms, Room 341
1150 E. Mountain Drive
Wilkes-Barre, PA 18702-7997

Send your sample forms via private mail carrier or certified mail in order to verify their receipt.
You can expect approval (or disapproval) by the SSA within 30 days of receipt of your sample
forms.

.05 The 4-digit vendor code preceded by four zeros and a slash (0000/9876) must be preprinted
on the sample substitute black-and-white Copy A and W-3 forms. Forms not containing a vendor
code will be rejected and will not be submitted for testing or approval. If you have a valid vendor
code provided to you through the National Association of Computerized Tax Processors, you
should use that code. If you do not have a valid vendor code, contact the Social Security
Administration at copy.a.forms@ssa.gov to obtain an SSA-issued code. (Additional information
on vendor codes may be obtained from the SSA or the National Association of Computerized Tax
Processors (NACTP) via email at president@nactp.org.)

Note. Vendor codes from the NACTP are required by those companies producing the W-2
family of forms as part of a product for resale to be used by multiple employers and payroll
professionals. Employers developing Forms W-2 or W-3 to be used only for their individual
company require a vendor code issued by Social Security Administration.

.06 If you use forms produced by a vendor and have questions concerning approval, do not
send the forms to the SSA for approval. Instead, you may contact the software vendor to obtain
a copy of SSA's dated approval notice supplied to that vendor.

.07 In response to feedback from the user community, the SSA (and the IRS) have added a 2-D
barcoded version for the substitute Form W-2 and Form W-2 to the list of acceptable submission
formats. This version is an optional alternative to the non-barcoded substitute Forms W-2 and
W-3. Both versions are fully supported by the SSA. At this time, neither the IRS nor the SSA
mandates the use of 2-D barcoded substitute forms.

Note. The data contained in the barcode must not differ from the data displayed on the form. If
they differ, the data in the barcode will be ignored and the data displayed on the form will be
considered the submission. This also occurs when the barcode is not read correctly. The
information on the form needs to be manually keyed into the database.
To get the barcode information:

· See the SSA's BSO website at www.ssa.gov/bso,

· Get the PDF version of the specifications at copy.a.forms@ssa.gov, and

· Download the substitute W3/W2 2-D barcoding standards from www.ssa.gov/employer/
subBarCodeStd.pdf.

If you are using a form produced by another vendor that contains a 2-D barcode, you must submit
the form for approval using your own NACTP code. Prior to sending your first submission for
approval, contact the SSA at copy.a.forms@ssa.gov to register your NACTP code and explain
what forms you want to submit.

### Section 2.3 - Requirements for Substitute Forms Furnished to Employees (Copies B, C, and 2 of Form W-2)

Note. Rules in Section 2.3 apply only to employee copies of Form W-2 (Copies B, C, and 2).
Printers are cautioned that the paper filers who send Forms W-2 (Copy A) to the SSA must follow
the requirements in Sections 2.1 and/or 2.2 above.

.01 All employers (including those who file electronically) must furnish employees with at least
two copies of Form W-2 (three or more for employees required to file a state, city, or local income
tax return). The following rules are guidelines for preparing employee copies.

The dimensions of these copies (Copies B, C, and 2), but not Copy A, may differ from the
dimensions of the official IRS form to allow space for reporting additional information, including
additional entries such as withholding for health insurance, union dues, bonds, or charity in box
14. The limitation of a maximum of four items in box 12 of Form W-2 applies only to Copy A,
which is filed with the SSA.

Note. Payee statements (Copies B, C, and 2 of Form W-2) may be furnished electronically if
employees give their consent (as described in Treasury Regulations Section 31.6051-1(j)). See
also Publication 15-A, Employer's Supplemental Tax Guide.

.02 The minimum dimensions for employee copies only (not Copy A) of Form W-2 should be
2.67 inches deep by 4.25 inches wide. The maximum dimensions should be no more than 6.50
inches deep by no more than 8.50 inches wide.

Note. The maximum and minimum size specifications in this document are for tax year 2017 only
and may change in future years.

.03 Either horizontal or vertical format is permitted (see Exhibit D).

.04 The paper for all copies must be white and printed in black ink. The substitute Copy B, which
employees are instructed to attach to their federal income tax returns, should be at least 9-pound
paper (basis 17 x 22-500). Other copies furnished to employees also should be at least 9-pound
paper (basis 17 x 22-500) unless a state, city, or local government provides other specifications.

.05 Employee copies of Form W-2 (Copies B, C, and 2), including those that are printed on a
single sheet of paper, must be easily separated. The best method of separation is to provide
perforations between the individual copies. Whatever method of separation is used, each copy
should be easily distinguished.

Note. Perforation does not apply to printouts of copies of Forms W-2 that are furnished
electronically to employees (as described in Treasury Regulations Section 31.6051-1(j)). How-
ever, these employees should be cautioned to carefully separate the copies of Form W-2. See
Publication 15-A, for information on electronically furnishing Forms W-2 to employees.

.06 Interleaved carbon and chemical transfer paper employee copies must be clearly legible.
Fading must be minimized to assure legibility.

.07 The electronic tax logo on the IRS official employee copies is not required on any of the
substitute form copies. To avoid confusion and questions by employees, employers are encour-
aged to delete the identifying number ("22222") from the employee copies of Form W-2.

.08 All substitute employee copies must contain boxes, box numbers, and box titles that match the
official IRS Form W-2. Boxes that do not apply can be deleted. However, certain core boxes must
be included. The placement, numbering, and size of this information is specified as follows.

. The core boxes must be printed in the exact order shown on the official IRS form. The items
and box numbers that constitute the core data are:

Box 1 - Wages, tips, other compensation,

Box 2 - Federal income tax withheld,

Box 3 - Social security wages,

Box 4 - Social security tax withheld,

Box 5 - Medicare wages and tips, and

Box 6 - Medicare tax withheld.

· The core data boxes (1 through 6) must be placed in the upper right of the form. Substitute
vertical-format copies may have the core data across the top of the form. Boxes or other
information definitely will not be permitted to the right of the core data.

· The form title, number, or copy designation (B, C, or 2) may be at the top of the form. Also,
a reversed or blocked-out area to accommodate a postal permit number or other postal
considerations is allowed in the upper right.

· Boxes 1 through 6 must each be a minimum of 11/8 inches wide x 1/4 inch deep.

· Other required boxes are:

a) Employee's social security number,

b) Employer identification number (EIN),

c) Employer's name, address, and ZIP code,

e) Employee's name, and

f) Employee's address and ZIP code.

Identifying items must be present on the form and be in boxes similar to those on the official IRS
form. However, they may be placed in any location other than the top or upper right. You do not
need to use the lettering system (a-c, e-f) used on the official IRS form. The employer
identification number (EIN) may be included with the employer's name and address and not in
a separate box.

Note. Box d ("Control number") is not required.

.09 All copies of Form W-2 furnished to employees must clearly show the form number, the form
title, and the tax year prominently displayed together in one area of the form. The title of Form
W-2 is "Wage and Tax Statement." It is recommended (but not required) that this be located on
the bottom left of substitute Forms W-2. The reference to the "Department of the Treasury -
Internal Revenue Service" must be on all copies of substitute Forms W-2 furnished to employees.
It is recommended (but not required) that this be located on the bottom right of Form W-2.

.10 If the substitute employee copies are labeled, the forms must contain the applicable description.

· "Copy B, To Be Filed With Employee's FEDERAL Tax Return."

. "Copy C, For EMPLOYEE'S RECORDS."

. "Copy 2, To Be Filed With Employee's State, City, or Local Income Tax Return."

It is recommended (but not required) that these be located on the lower left of Form W-2. If the
substitute employee copies are not labeled as to the disposition of the copies, then written
notification using similar wording must be provided to each employee.

.11 The tax year (for example, 2017) must be clearly printed on all copies of substitute Form W-2.
It is recommended (but not required) that this information be in the middle at the bottom of the
Form W-2. The use of 24-pt. OCR-A font is recommended (but not required).

.12 Boxes 1 and 2 (if applicable) on Copy B must be outlined in bold 2-point rule or highlighted
in some manner to distinguish them. If "Allocated tips" are being reported, it is recommended
(but not required) that box 8 also be outlined. If reported, "Social security tips" (box 7) must be
shown separately from "Social security wages" (box 3).

Note. Boxes 8 and 9 may be omitted if not applicable.

.13 If employers are required to withhold and report state or local income tax, the applicable
boxes are also considered core information and must be placed at the bottom of the form. State
information is included in:

· Box 15 (State, Employer's state ID number)

· Box 16 (State wages, tips, etc.)

· Box 17 (State income tax)

Local information is included in:

· Box 18 (Local wages, tips, etc.)

· Box 19 (Local income tax)

· Box 20 (Locality name)

.14 Boxes 7 through 14 may be omitted from substitute employee copies unless the employer
must report any of that information to the employee. For example, if an employee did not have
"Social security tips" (box 7), the form could be printed without that box. But if an employer
provided dependent care benefits, the amount must be reported separately, shown in box 10, and
labeled "Dependent care benefits."

.15 Employers may enter more than four codes in box 12 of substitute Copies B, C, and 2 (and
1 and D) of Form W-2, but each entry must use Codes A-FF (see the 2017 General Instructions
for Forms W-2 and W-3).

.16 If an employer has employees in any of the three categories in box 13, all checkbox headings
must be shown and the proper checkmark made, when applicable.

.17 Employers may use box 14 for any other information that they wish to give to their
employees. Each item must be labeled. (See the instructions for box 14 in the 2017 General
Instructions for Forms W-2 and W-3.)

.18 The front of Copy C of a substitute Form W-2 must contain the note "This information is
being furnished to the Internal Revenue Service. If you are required to file a tax return, a

negligence penalty or other sanction may be imposed on you if this income is taxable and you fail
to report it."

.19 Instructions similar to those contained on the back of Copies B, C, and 2 of the official IRS
Form W-2 must be provided to each employee. An employer may modify or delete instructions
that do not apply to its employees. (For example, remove Railroad Retirement Tier 1 and Tier 2
compensation information for nonrailroad employees or information about dependent care ben-
efits that the employer does not provide.)

.20 Employers must notify their employees who have no income tax withheld that they may be
able to claim a tax refund because of the earned income credit (EIC). They will meet this
notification requirement if they furnish a substitute Form W-2 with the EIC notice on the back
of Copy B, IRS Notice 797, Possible Federal Tax Refund Due to the Earned Income Credit (EIC),
or on their own statement containing the same wording. They also may change the font on Copies
B, C, and 2 so that the EIC notification and Form W-2 instructions fit differently. For more
information about notification requirements, see Notice 1015, "Have You Told Your Employees
About the Earned Income Credit (EIC)?"

Note. An employer does not have to notify any employee who claimed exemption from
withholding on Form W-4, Employee's Withholding Allowance Certificate, for the calendar
year.

### Section 2.4 - Electronic Delivery of Form W-2 and W-2c Recipient Statements

.01 If you are required to furnish a written statement (Copy B or an acceptable substitute) to a
recipient, then you may furnish the statement electronically instead of on paper. This includes
furnishing the statement to recipients of Forms W-2 and W-2c.

If you meet the requirements listed below, you are treated as furnishing the statement timely.

.02 The recipient must consent in the affirmative and not have withdrawn the consent before the
statement is furnished. The consent by the recipient must be made electronically in a way that
shows that he or she can access the statement in the electronic format in which it will be furnished.

You must notify the recipient of any hardware or software changes prior to furnishing the
statement. A new consent to receive the statement electronically is required after any new
hardware or software is put into service.

To furnish Forms W-2 electronically, you must meet the following disclosure requirements as
described in Treasury Regulations Section 31.6051-1(j) or Publication 15-A and provide a clear
and conspicuous statement of each requirement to your employees.

· The employee must be informed that he or she will receive a paper Form W-2 if consent isn't
given to receive it electronically.

· The employee must be informed of the scope and duration of the consent.

· The employee must be informed of any procedure for obtaining a paper copy of his or her Form
W-2 and whether or not the request for a paper statement is treated as a withdrawal of his or
her consent to receiving his or her Form W-2 electronically.

. The employee must be notified about how to withdraw a consent and the effective date and
manner by which the employer will confirm the withdrawn consent.

. The employee also must be notified that the withdrawn consent doesn't apply to the previously
issued Forms W-2.

. The employee must be informed about any conditions under which electronic Forms W-2 will
no longer be furnished (for example, termination of employment).

· The employee must be informed of any procedures for updating his or her contact information
that enables the employer to provide electronic Forms W-2.

· The employer must notify the employee of any changes to the employer's contact information.

.03 Additionally, you must:

· Ensure the electronic format complies with the guidelines in this document and contains all the
required information described in the 2017 General Instructions for Forms W-2 and W-3.

· If posting the statement on a website, post it for the recipient to access on or before the January
31 due date through October 15 of that year.

· Inform the recipient in person, electronically, or by mail, of the posting and how to access and
print the statement.

## Part 3 Additional Instructions

Section 3.1 - Additional Instructions for Form Printers

.01 If paper copies are used for filing with the SSA, the substitute copies of Forms W-2 (either red-ink
or substitute black-and-white forms) must be assembled in the same order as the official IRS Forms
W-2. Copy A must be first, followed sequentially by perforated sets (Copies 1, B, C, 2, and D).

.02 The substitute form to be filed by the employer with the SSA must carry the designation
"Copy A."

Note. Electronic filers do not submit either red-ink or substitute black-and-white paper Form W-2
(Copy A) or Form W-3 to the SSA.

.03 Employers must retain a copy of Forms W-2 and W-3 (or be able to reconstruct the
information) for at least 4 years. Employers also must be able to generate Forms W-2 (Copy A)
that meet the requirements of this revenue procedure in case of loss.

.04 Except for copies in the official assembly, described in Section 3.1.01 above, no additional
copies that may be prepared by employers should be placed ahead of Form W-2 (Copy C) "For
EMPLOYEE'S RECORDS."

.05 You must provide instructions similar to those contained on the back of Copies B, C, and 2
of the official IRS Form W-2 to each employee. You may print them on the back of the substitute
Copies B, C, and 2 or provide them to employees on a separate statement. You do not need to use the
back of Copy 2. If you do not use Copy 2, you may include all the information that appears on the back
of the official Copies B, C, and 2 on the back of your substitute Copies B and C only. As an example,
you may use the "Note" on the back of the official Copy C as the dividing point between the text for
your substitute Copies B and C. Do not print these instructions on the back of Copy 1. Any Forms

### Section 3.2 - Instructions for Employers

.01 Only originals of Form W-2 (Copy A) and Form W-3 may be filed with the SSA. Carbon
copies and photocopies are unacceptable.

.02 Employers should type or machine-print data entries on plain paper forms whenever possible.
Ensure good quality by using a high-quality type face, inserting data in the middle of blocks that
are well separated from other printing and guidelines, and taking any other measures that will
guarantee clear, sharp images. Black ink must be used with no script type, inverted font, italics,
or dual-case alpha characters.

Note. 12-point Courier font is preferred by the SSA.

.03 Form W-2 (Copy A) requires decimal entries for wage data. Do not print dollar signs with
money amounts on Forms W-2 (Copy A) and W-3.

.04 The employer must provide a machine-scannable Form W-2 (Copy A). The employer also
must provide employee copies (Copies B, C, and 2) that are legible and able to be photocopied
(by the employee). Do not print any data in the top margin of the payee copies of the forms.

.05 Any printing in box d (Control number) on Form W-2 or box a on Form W-3 may not touch
any vertical or horizontal lines and should be centered in the box.

.06 The filer's employer identification number (EIN) must be entered in box b of Form W-2 and
box e of Form W-3. The EIN entered on Form(s) W-2 (box b) and Form W-3 (box e) must be
the same as on Forms 941, 941-SS, 943, 944, CT-1, Schedule H (Form 1040), or any other
corresponding forms filed with the IRS. Be sure to use EIN format (00-0000000) rather than SSN
format (000-00-0000).

.07 The employer's name, address, and EIN may be preprinted.

### Section 3.3 - OMB Requirements for Both Red-Ink and Black-and-White Copy A and W-3 Substitute Forms

.01 The Paperwork Reduction Act (the Act) of 1995 (Public Law 104-13) requires the following.

· The Office of Management and Budget (OMB) approves all IRS tax forms that are subject to
the Act.

· Each IRS form contains (in or near the upper right corner) the OMB approval number, if
assigned. (The official OMB numbers may be found on the official IRS printed forms and also
are shown on the forms in Exhibits A, B, C, E, and F.)

· Each IRS form (or its instructions) states:

1\. Why the IRS needs the information,

2\. How it will be used, and

3\. Whether or not the information is required to be furnished to the IRS.

.02 This information must be provided to any users of official or substitute IRS forms or instructions.

.03 The OMB requirements for substitute IRS Form W-2 (Copy A) and Form W-3 are the
following.

· Any substitute form or substitute statement to a recipient must show the OMB number as it
appears on the official IRS form.

. The OMB number for both Form W-2 and Form W-3 is 1545-0008 and must appear exactly
as shown on the official IRS form.

. For any copy of Form W-2 other than Copy A, the OMB number must use one of the following
formats.

1\. OMB No. 1545-0008 (preferred) or

2\. OMB # 1545-0008 (acceptable).

.04 Any substitute Form W-2 (Copy A only) and Form W-3 must state "For Privacy Act and
Paperwork Reduction Act Notice, see the separate instructions." If no instructions are provided
to users of your forms, you must furnish them with the exact text of the Privacy Act and
Paperwork Reduction Act Notice.

### Section 3.4 - Order Forms and Instructions

.01 You can order IRS Forms W-2, Forms W-3, the General Instructions for Forms W-2 and
W-3, and other tax material online at IRS.gov. Click on the Forms and Pubs link and then the
Order Forms and Pubs link or by clicking on www.irs.gov/businesses and then the Online
Ordering for Information Returns and Employer Returns link.

.02 Copies of Form W-2 (Copy A) and Form W-3 downloaded from IRS.gov cannot be used for
filing with the SSA. These copies of Forms W-2 and W-3 are for information purposes only.

### Section 3.5 - Effect on Other Documents

.01 Revenue Procedure 2016-54, 2016-45 I.R.B. 685, dated November 7, 2016 (reprinted as
Publication 1141, Revised 11-2016), is superseded.

### Section 3.6 - Exhibits

Exhibits A through F provide the general measurements for Forms W-2 and W-3 as discussed
in this revenue procedure. Certain exhibits show a 0000/ in the location designated for your
vendor code. See Section 2.2.01, item 11, and Section 2.2.05 for more information.

Exhibit A - Form W-2 (Copy A) (Red-Ink) 2017

Exhibit B - Form W-2 (Copy B) 2017

Exhibit C - Form W-3 (Red-Ink) 2017

Exhibit D - Form W-2 (Copy A) (Substitute Black-and-White) 2017

Exhibit E - Form W-3 (Substitute Black-and-White) 2017

Exhibit F - Form W-2 Alternative Employee Copies (Illustrating Horizontal and Vertical
Formats)

.10 in

22222

14 in ++ Void a Employee's social security 44 in

number For Official Use Only OMB No. 1545-0008

33 in

b Employer identification number (EIN)

1 Wages

tips, other compensation

2 Federal income tax withheld

.50 in

c Employer's name, address, and ZIP code

5.50 in

3 Social

security wages

4 Social security tax withheld

5 Medicare

wages and tips

6 Medicare tax withheld

7 Social

security tips

8 Allocated tips

d Control number

9 Verification

code 4.17 in

10 Dependent care benefits

e Employee's first name and initial

Last name

Suff.

11 Nonqualified

plans

12a See instructions for box 12

f Employee's address and ZIP code

13 Statutory employe ☐

Retirement plan Third-party giOK Day ☒ ☐

12b . .50 in

14 Other

.14 in

12c

12d

33 in

15 State Employer's state ID number

16 State wages.

ps, etc. 17

State income

tax 18

Local wages, tips, etc.

19 Local insme tax

20 Locality name

.67 in

## Exhibit A

Form W-2 (Copy A) (Red Ink)

7.50 in

50 in

.50 in

Form
W-2
Wage and Tax Statement

2017

Department of the Treasury-Internal Revenue Service
For Privacy Act and Paperwork Reduction
Act Notice, see the separate instructions.

Copy A For Social Security Administration - Send this entire page with
Form W-3 to the Social Security Administration; photocopies are not acceptable.

Do Not Cut, Fold, or Staple Forms on This Page

Cat. No. 10134D
1.33 in

.90 in

.70 in

1.80 in

22222

Void

☐

a Employee's social security number

For Official Use Only
UMB No. 1645-0008

4.10 in

b Employer identification number (EIN)

Wages, tips, other compensation
1

2 Federal income tax withheld

c Employer's name, address, and ZIP code

3 Social security wages

4 Social security tax withheld

4.10 in

5
Medicare wages and tips
1.70 in

6
Medicare tax withheld
1.70 in

7
Social security tips

8 Allocated tips

d Control number

.30 in

9 Verification code

10
Dependent care benefits

e Employee's first name and initial

Last name

Suff.

1.90 in

1.90in

11 Nonqualified plans
.24 in .36 in

.36 in

.32 in

12a See instructions for box 12

2.20in

1
Statutory
employee
☐

Retiremer
plan
☐

Third-par
sick pay

12b

☐

14 Other

12c

.50 in

12d

f Employee's address and ZIP code

15 State

Employer's state ID number
2.20 in

16 State wages, tips, etc.
1.20 in

State income tax

3 Local wages, tips, etc.

19
Local income tax
1.10 in

Locality name

1.10 in

1.20 in

70 in

40 in

W-2
Wage and Tax Statement

2017

Department of the Treasury-Internal Revenue Service
For Privacy Act and Paperwork Reduction
Act Notice, see the separate instructions.
Cat. No. 10134D

Form

Copy A For Social Security Administration - Send this entire page with
Form W-3 to the Social Security Administration; photocopies are not acceptable.

## Exhibit B

a Employee's social security number Safe, accurate, FAST! Use Rse + file Visit the IRS website at OMB No. 1545-0008 www.irs.gov/efilo

b Employer identification number (EIN)

1 Wages, tips, other compensation

2 Federal income tax withheld

c Employer's name, address, and ZIP code

3 Social security wages

4 Social security tax withheld

5 Medicare wages and tips

6 Medicare tax withheld

7 Social security tips

8 Allocated tips

d Control number

9 Verification code

10 Dependent care benefits

e Employee's first name and initial Last name Suff f Employee's address and ZIP code

1 Nonqualified plans

12a See instructions for box 12

13 Statutory employée Retirement Third-party plan sick pay ☐ ☐ ☐

4 12b .

14 Other

12c

. 12d .

15 State

Employer's state ID number

16 State wages, tips, etc.

17 State income tax

18 Local wages, tips, etc.

19 Local income tax

20 Locality name

W-2 Wage and Tax Form Statement Copy B-To Be Filed With Employee's FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service.

2017

Department

of the Treasury-Internal

Revenue Service

0000/

### Exhibit C

Form W-3 (Red Ink)

33333

a Control number

For Official

Use Only- 5.00 in

.85 in

1.65 in

SMB N

1545-0008

b 941 Military 943 944 Kind ☐ ☐ ☐ .36 in ☐ of Payer CT-1 Hshld. 36 in emp Medicare govt. emp. (Check one) ☐ ☐ ☐

None apply Kind ☐ of Employer State/local non-501c (Check one) ☐

501c non-govt.

Third-party sick pay (Check if applicable)

☐ State/local 501c Federal govt. ☐ ☐

c Total number of Forms W-2 1.60 in

d Establishment number 1.60 in

1 Wages, tips, other compensation

2 Federal income tax withheld .14 in

e Employer identification number (EIN)

3 Social security wages

4 Social security tax withheld

f Employer's name 4.67 in

5 Medicare wages and tips

6 Medicare tax withheld

3.20 in

7 Social security tips 2.15 in

8 Allocated tips 2.15 in

g Employer's address and ZIP code

10 Dependent care benefits

11 Nonqualified plans

12a Deferred compensation

h Other EIN used this year

13 For third-party sick pay use only

12b

15 State Employer's state ID number

14 Income tax withheld by payer of third-party sick pay

60 in 2.60 in

16 State wages, tips, etc.

17 State income tax

18 Local wages, tips, etc.

19 Local income tax 1 33

Employer's contact person

Employer's telephone number

For Official Use Only

Employer's fax number

Employer's email address

7.50 in

50 in

DO NOT STAPLE

1.20 in

50 in

Under penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowledge and belief, they are true, correct, and
complete.

50 in

Signature

Tite

Date

#### W-3 Transmittal of Wage and Tax Statements

2017

Form

Department of the Treasury
Internal Revenue Service

Send this entire page with the entire Copy A page of Form(s) W-2 to the Social Security Administration (SSA).
Photocopies are not acceptable. Do not send Form W-3 if you filed electronically with the SSA.
Do not send any payment (cash, checks, money orders, etc.) with Forms W-2 and W-3.

##### Reminder

Separate instructions. See the 2017 General Instructions for Forms
W-2 and W-3 for information on completing this form. Do not file Form
W-3 for Form(s) W-2 that were submitted electronically to the SSA.

##### Purpose of Form

Complete a Form W-3 Transmittal only when filing paper Copy A of
Form(s) W-2, Wage and Tax Statement. Don't file Form W-3 alone. All
paper forms must comply with IRS standards and be machine readable.
Photocopies are not acceptable. Use a Form W-3 even if only one
paper Form W-2 is being filed. Make sure both the Form W-3 and
Form(s) W-2 show the correct tax year and Employer Identification
Number (EIN). Make a copy of this form and keep it with Copy D (For
Employer) of Form(s) W-2 for your records. The IRS recommends
retaining copies of these forms for four years.

5.33in

When To File Paper Forms
Mail Form W-3 with Copy A of Forth(s) W-2 by January 31, 2018.
Where To File Paper Forms
Send this entire page with the entire Copy A page of Form(s) W-2 to:
Social Security Administration
Direct Operations Center
Wilkes-Barre, PA 18769-0001

E-Filing

The SSA strongly suggests employers report Form W-3 and Forms W-2
Copy A electronically instead of on paper. The SSA provides two free
e-filing options on its Business Services Online (BSO) website:

. W-2 Online. Use fill-in forms to create, save, print, and submit up to
50 Forms W-2 at a time to the SSA.

. File Upload. Upload wage files to the SSA you have created using
payroll or tax software that formats the files according to the SSA's
Specifications for Filing Forms W-2 Electronically (EFW2).

W-2 Online fill-in forms or file uploads will be on time if submitted by
January 31, 2018. For more information, go to www.socialsecurity.gov/
employer. First time filers, select "Register"; returning filers select "Log
in."

Note: If you use "Certified Mail" to file, change the ZIP code to
"18769-0002." If you use an IRS-approved private delivery service, add
"ATTN: W-2 Process, 1150 E. Mountain Dr." to the address and change
the ZIP code to "18702-7997." See Publication 15 (Circular E),
Employer's Tax Guide, for a list of RS-approved private delivery
services.

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

### Exhibit D

.90 in

.70 in

1.80 in

.50 in

22222 Void ☐

Employee's guclar sacuimy number For Official Use Only OMB No. 1545-0008

b Employer identification number (EIN)

1 Wages, tips, other con

sensation

2 Federal income tax withheld

c Employer's name, address, and ZIP code

3 Social security wage

4 Social security tax withheld

5 Medicare wages and

tips

6 Medicare tax withheld

7 Social security tips

8 Allocated tips

d Control number

9 Verification code

4.17 in

10 Dependent care benefits

. Employee's first name and initial Last name

Suff.

11 Nonqualified plans

12a See instructions for box 12 0 4

13 Statutory employee Retirement plan ☐ ☐

Third-party sick pay ☐

12b ·

14 Other

12c

2 12d

f Employee's address and ZIP code

.50 in

15 State

Employer's state ID number

16 State wages, tips, etc.

17 State income tax

18
Local wages,

tips, etc.

19 Local income tax

20 Locality name

.40 in

1.80 in

1.20 in

1.10 in

1.20 ir

1.10 in

.70 in

Form
W-2
Wage and Tax Statement

2017

Copy A For Social Security Administration - Send this entire page with 0000/
Form W-3 to the Social Security Administration; photocopies are not acceptable.

Do Not Cut, Fold, or Staple Forms on This Page

Departnight 1.33 in

of the Treasury-Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

.83 in

Cat. No. 10134D

50 in

22222

Void ☐ a

Employee's social security number For OMB

Official Use Only No. 1545-0008

b Employer identification number (EIN)

1 Wages, tips, other compensation

2 Federal income tax withheld

G Employer's name, address, and ZIP code

3 Social security wages

4 Social security tax withheld

5 Medicare wages and tips

6 Medicare tax withheld

7 Social security tips

8 Allocated tips

d Control number

9 Verification code

10 Dependent care benefits

e Employee's first name and initial

Last name Suff.

11 Nonqualified plans

12a a See instructions for box 12 G 3

13 Statutory employee Retirement plan Third-party sick pay ☐ ☐ ☐

12b

14 Other

12c

12d .

f Employee's address and ZIP code

15 State

Employer's state ID number

16 State wages, tips, etc.

17 State income tax

18 Local wages, tips, etc.

19 Local income tax

20 Locality name

Form
W-2
Wage and Tax Statement

2017

Copy A For Social Security Administration - Send this entire page with 0000/
Form W-3 to the Social Security Administration; photocopies are not acceptable.

Department of the Treasury-Internal Revenue Service
For Privacy Act and Paperwork Reduction
Act Notice, see the separate instructions.
Cat. No. 10134D

#### Exhibit E

DO NOT STAPLE

33333

a Control number

For Official Use Only
OMB No. 1545-0008

.67 in

b
Kind

Military

941
☐
.36 in
☐
.36 in

943
☐
Medicare
govt. emp.
☐

501c non-govt.
☐
Employer
(Check one)
55 in

944

None apply

1.20 in

36 in
☐
.36 in

Kind
1.40 in

1.25 in
State/local 501c
Federal govt.
☐ ☐
66 in
☐
Third-party
sick pay
(Check if
applicable)

Hshld.

Payer
(Check one)

CT-1
☐

emp

☐

☐
State/local
non-501c
☐

e Total number of Forms W-2

d Establishment number

1 Wages, tips, other compensation

2 Federal income tax withheld

· Employer identification number (EIN)

3 Social security wages

4 Social security tax withheld

f Employer's name

5 Medicare wages and tips

6 Medicare tax withheld

7 Social security tips

8 Allocated tips

1.00 in

10 Dependent care benefits

11 Nonqualified plans

12a Deferred compensation

g Employer's address and ZIP code

h Other EIN used this year

13 For third-party sick pay use only

12b

15 State

Employer's state ID number

14 Income tax withheld by payer of third-party sick pay

16 State wages, tips, etc.

17 State income tax

18 Local wages, tips, etc.

19 Local income tax

Employer's contact person

3.20 in

Employer's telephone number
2.15 in

For Official Use Only

33 in

Employer's fax number

Employer's email address

4.30 in

Under penalties of perjury, I declare that I haveexamined this return and accompanying documents and, to the best of my knowledge and belief, they are true, correct, and
complete.

.50 in

Signature

Title

Date

Form
W-3 Transmittal of Wage and Tax Statements

2017

Department of the Treasury
Internal Revenue Service

##### Reminder

##### Purpose of Form

When To File Paper Forms
Mail Form W-3 with Copy A of Form(s) W-2 by January 31, 2018.
Where To File Paper Forms

E-Filing

The SSA strongly suggests employers report Form W-3 and Forms W-2
Copy A electronically instead of on paper. The SSA provides two free
e-filing options on its Business Services Online (BSO) website:

· W-2 Online. Use fill-in forms to create, save, print, and submit up to
50 Forms W-2 at a time to the SSA.

Send this entire page with the entire Copy A page of Form(s) W-2 to:
Social Security Administration
Direct Operations Center
Wilkes-Barre, PA 18769-0001

. File Upload. Upload wage files to the SSA you have created using
payroll or tax software that formats the files according to the SSA's
Specifications for Filing Forms W-2 Electronically (EFW2).

W-2 Online fill-in forms or file uploads will be on time if submitted by
January 31. 2018. For more information, go to www.socialsecurity.gov/
employer. First time filers, select "Register"; returning filers select "Log
In."

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

a Employee's social security number

OMB No,

1545-0008 Safe, accurate, IRse + file Visit the IRS website at FAST! Use www.irs.gov/efile

b Employer identification number (EIN)

1 Wages, tips, other compensation

2 Federal income tax withheld

c Employer's name, address, and ZIP code

3 Social security wages

4 Social security taxx withheld

5 Medicare wages and tips

6 Medicare tax withheld

7 Social security tips

8 Allocated tips

d Control number

9 Verification code

10 Dependent care benefits

e Employee's first name and initial Last name Suff.

11 Nonqualified plans

12a See instructions for box: 12

13 Statutory employee Retirement Third party plan sick pay ☐ ☐ ☐

12b

14 Other

12G

12d

f Employee's address and ZIP code

15 State

Employer's state ID number

16 State wages, tips, eto.

17 State income tax

18 Local wages, tips, etc.

19 Local income tax

20 Locality name

Form
W-2
Wage and Tax
Statement

2017
0000/

Department of the Treasury-Internal Revenue Service

Copy B-To Be Filed With Employee's FEDERAL Tax Return.
This information is being furnished to the Internal Revenue Service,

Wages, tips, other compensation
1

2
Federal income tax withheld

3 Social security wages

4 Social security tax withheld

5 Medicare wages and tips

6 Medicare tax withheld

Employee's social security number

Employer identification number (EIN)

Employer's name, address, and ZIP code

Employee's name

Employee's address and ZIP code

15 State Employer's state ID number

18 Local wages, tips, etc.

16 State wages, tips, etc.

19 Local income tax:

17 State income tax

20 Locality name

Copy B To Be Filed With Employee's FEDERAL Tax Return.

Form W-2
Wage and Tax
Statement

2017
0000/

Department of the Treasury-
Internal Revenue Service

Note: Exhibit F displays examples of how Form W-2
Copy B can be furnished to employees. Copy B can
be furnished in horizontal or vertical format.
Specifications and requirements for employee
copies can be found in Section 2.3 - Requirements
for Substitute Forms Furnished to Employees
(Copies B, C, and 2 of Form W-2).

Although employee copies can be manipulated,
Section 2.3 has specific requirements for core data
boxes that must be present on substitute employee
copies.

# Definition of Terms

Revenue rulings and revenue procedures
(hereinafter referred to as "rulings") that
have an effect on previous rulings use the
following defined terms to describe the
effect:

Amplified describes a situation where
no change is being made in a prior pub-
lished position, but the prior position is
being extended to apply to a variation of
the fact situation set forth therein. Thus, if
an earlier ruling held that a principle ap-
plied to A, and the new ruling holds that
the same principle also applies to B, the
earlier ruling is amplified. (Compare with
modified, below).

Clarified is used in those instances
where the language in a prior ruling is
being made clear because the language
has caused, or may cause, some confu-
sion. It is not used where a position in a
prior ruling is being changed.

Distinguished describes a situation
where a ruling mentions a previously pub-
lished ruling and points out an essential
difference between them.

Modified is used where the substance
of a previously published position is being
changed. Thus, if a prior ruling held that a
principle applied to A but not to B, and the
new ruling holds that it applies to both A

and B, the prior ruling is modified because
it corrects a published position. (Compare
with amplified and clarified, above).

Obsoleted describes a previously pub-
lished ruling that is not considered deter-
minative with respect to future transac-
tions. This term is most commonly used in
a ruling that lists previously published rul-
ings that are obsoleted because of changes
in laws or regulations. A ruling may also
be obsoleted because the substance has
been included in regulations subsequently
adopted.

Revoked describes situations where the
position in the previously published ruling
is not correct and the correct position is
being stated in a new ruling.

Superseded describes a situation where
the new ruling does nothing more than
restate the substance and situation of a
previously published ruling (or rulings).
Thus, the term is used to republish under
the 1986 Code and regulations the same
position published under the 1939 Code
and regulations. The term is also used
when it is desired to republish in a single
ruling a series of situations, names, etc.,
that were previously published over a pe-
riod of time in separate rulings. If the new

ruling does more than restate the sub-
stance of a prior ruling, a combination of
terms is used. For example, modified and
superseded describes a situation where the
substance of a previously published ruling
is being changed in part and is continued
without change in part and it is desired to
restate the valid portion of the previously
published ruling in a new ruling that is
self contained. In this case, the previously
published ruling is first modified and then,
as modified, is superseded.

Supplemented is used in situations in
which a list, such as a list of the names of
countries, is published in a ruling and that
list is expanded by adding further names
in subsequent rulings. After the original
ruling has been supplemented several
times, a new ruling may be published that
includes the list in the original ruling and
the additions, and supersedes all prior rul-
ings in the series.

Suspended is used in rare situations to
show that the previous published rulings
will not be applied pending some future
action such as the issuance of new or
amended regulations, the outcome of
cases in litigation, or the outcome of a
Service study.

# Abbreviations

The following abbreviations in current
use and formerly used will appear in ma-
terial published in the Bulletin.

A-Individual.

Acq .- Acquiescence.

B-Individual.

BE-Beneficiary.

BK-Bank.

B.T.A .- Board of Tax Appeals.

C-Individual.

C.B .- Cumulative Bulletin.

CFR-Code of Federal Regulations.

CI-City.

COOP-Cooperative.

Ct.D .- Court Decision.

CY-County.

D-Decedent.

DC-Dummy Corporation.

DE-Donee.

Del. Order-Delegation Order.

DISC-Domestic International Sales Corporation.
DR-Donor.

E-Estate.

EE-Employee.

E.O .- Executive Order.

ER-Employer.

ERISA-Employee Retirement Income Security Act.
EX-Executor.

F-Fiduciary.

FC-Foreign Country.

FICA-Federal Insurance Contributions Act.

FISC-Foreign International Sales Company.

FPH-Foreign Personal Holding Company.

F.R .- Federal Register.

FUTA-Federal Unemployment Tax Act.

FX-Foreign corporation.

G.C.M .- Chief Counsel's Memorandum.

GE-Grantee.

GP-General Partner.

GR-Grantor.

IC-Insurance Company.

I.R.B .- Internal Revenue Bulletin.

LE-Lessee.

LP-Limited Partner.

LR-Lessor.

M-Minor.

Nonacq .- Nonacquiescence.

O-Organization.

P-Parent Corporation.

PHC-Personal Holding Company.

PO-Possession of the U.S.

PR-Partner.

PRS-Partnership.

PTE-Prohibited Transaction Exemption.
Pub. L .- Public Law.

REIT-Real Estate Investment Trust.

Rev. Proc .- Revenue Procedure.

Rev. Rul .- Revenue Ruling.

S-Subsidiary.

S.P.R .- Statement of Procedural Rules.

Stat .- Statutes at Large.

T-Target Corporation.

T.C .- Tax Court.

T.D .- Treasury Decision.

TFE-Transferee.

TFR-Transferor.

T.I.R .- Technical Information Release.

TP-Taxpayer.
TR-Trust.

TT-Trustee.

U.S.C .- United States Code.

X-Corporation.

Y-Corporation.

Z-Corporation.

## Numerical Finding List1

Bulletin 2017-27 through 2017-29

Action on Decision:

2017-5, 2017-27 I.R.B. 1

Announcements:

2017-05, 2017-27 I.R.B. 5
2017-08, 2017-28 I.R.B. 9

Notices:

2017-37, 2017-29 I.R.B. 89

Proposed Regulations:

REG-136118-15, 2017-28 I.R.B. 9

Revenue Procedures:

2017-41, 2017-29 I.R.B. 92
2017-42, 2017-29 I.R.B. 124

Revenue Rulings:

2017-14, 2017-27 I.R.B. 2

Treasury Decisions:

9819, 2017-29 I.R.B. 85

1A cumulative list of all revenue rulings, revenue procedures, Treasury decisions, etc., published in Internal Revenue Bulletins 2017-01 through 2017-26 is in Internal Revenue Bulletin
2017-26, dated June 27, 2017.

# Finding List of Current Actions on Previously Published Items1

Bulletin 2017-27 through 2017-29

1 A cumulative list of all revenue rulings, revenue procedures, Treasury decisions, etc., published in Internal Revenue Bulletins 2017-01 through 2017-26 is in Internal Revenue Bulletin
2017-26, dated June 27, 2017.

# Internal Revenue Service Washington, DC 20224

Official Business
Penalty for Private Use, $300

# INTERNAL REVENUE BULLETIN

The Introduction at the beginning of this issue describes the purpose and content of this publication. The weekly Internal Revenue
Bulletins are available at www.irs.gov/irb/.

## We Welcome Comments About the Internal Revenue Bulletin

If you have comments concerning the format or production of the Internal Revenue Bulletin or suggestions for improving it, we
would be pleased to hear from you. You can email us your suggestions or comments through the IRS Internet Home Page
(www.irs.gov) or write to the Internal Revenue Service, Publishing Division, IRB Publishing Program Desk, 1111 Constitution Ave.
NW, IR-6230 Washington, DC 20224.

Internal Revenue Bulletin 2017-29 (PDF rendition): IRS Notices

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