Form 5300, Application for Determination for Employee Benefit Plan

Forms and Documents

Document Name	Status
Form Schedul Q (Form 53 Form 5300 (Schedule Q) Form	Removed
Form 5300 Form 5300, Application for Determination for Employee Benefit Plan, Schedule Q (Form 5300), Elective Determination Requests Form	Modified
RP_2012-6.pdf Supplementary Document	2014-05-28
Ann. 2011-82.pdf Supplementary Document	2014-05-28
1545-0197_SS_REV_28MAY2014.doc Supporting Statement A	2014-05-28

IC Document Collections

IC ID	Document Title	Status
196429	Form 5300 (Schedule Q) Form	Removed
17106	Form 5300, Application for Determination for Employee Benefit Plan, Schedule Q (Form 5300), Elective Determination Requests Form	Modified

ICR Details

OMB Control No: 1545-0197	ICR Reference No: 201312-1545-025
Status: Historical Active	Previous ICR Reference No: 201102-1545-019
Agency/Subagency: TREAS/IRS	Agency Tracking No: GJS
Title: Form 5300, Application for Determination for Employee Benefit Plan
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/15/2014
	Date Received in OIRA: 05/29/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2017	36 Months From Approved	07/31/2014
Responses	85,000	0	185,000
Time Burden (Hours)	7,201,200	0	9,638,000
Cost Burden (Dollars)	0	0	0

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Abstract: IRS needs certain information on the financing and operating of employee benefit and employee contribution plans set up by employers. IRS uses Form 5300 to obtain the information needed to determine whether the plans qualify under Code sections 401(a) and 501(a).

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Authorizing Statute(s): US Code: 26 USC 501(a) Name of Law: Exemption from taxation.
   US Code: 26 USC 401(a) Name of Law: Requirements for qualification.
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 59098	09/25/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 30690	05/28/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Form 5300, Application for Determination for Employee Benefit Plan, Schedule Q (Form 5300), Elective Determination Requests	5300	Application for Determination for Employee Benefit Plan
Form 5300 (Schedule Q)	Schedul Q (Form 5300)	Elective Determination Requests

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	85,000	185,000	0	-100,000	0	0
Annual Time Burden (Hours)	7,201,200	9,638,000	0	-2,436,800	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The requirement to indicate whether certain qualifications relating to minimum participation, coverage, and nondiscrimination are to be considered in conjunction with an application for determination letter under Schedule Q has been eliminated by Announcement 2011-82 and reflected in Revenue Procedure 2012-6. The reduction of 100,000 responses and 4,232,000 burden hours is attributed to this program change. The increase of burden for Form 5300 is based on the increased number of attachments and other changes to Form 5300 in accordance with Revenue Procedure 2012-6. The increase in the time per respondent resulted in an increase of 1,795,200 burden hours associated with this program change. The program changes identified above resulted in a total reduction in burden of 2,436,800 hours; for 7,201,200 burden hours requested this submission.

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Annual Cost to Federal Government: $340,243

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/29/2014

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