Form 5316 Application for Group or Pooled Trust Ruling

Version A, Cycle 2

5316

Form
(April 2013)

Department of the Treasury
Internal Revenue Service

Application for Group or Pooled Trust Ruling
(Under section 401(a) and 501(a) of the Internal Revenue Code)
▶ Information about Form 5316 and its instructions is at
www.irs.gov/5316.

Review the Procedural Requirements Checklist before submitted this application.

OMB No. 1545-2166

For Internal Use Only

1a Name of the trust sponsor

1b Address of trust sponsor (if a P.O. Box, see instructions)

1c City

1d State

1e Zip Code

1f Country

1g Trust sponsor's employer identification number (EIN)

1h Telephone number

1i Fax number

INTERNAL USE ONLY
DRAFT AS OF
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2a Person to contact if more information is needed, see instructions
(If a Power of Attorney is attached, check box and do not complete this line.)
Contact person’s name

2b Contact person’s address

2c City

2f Telephone number

2g Fax number

2d State

2e Zip Code

If more space is needed for any item, attach additional sheets the same size as this form. Identify each additional sheet with the trust
sponsor’s name and EIN and identify each item.
3a Name of trust (If trust name exceeds 70 characters, including spaces, see instructions)

3b Enter date trust agreement was executed
Under penalties of perjury, I declare that I have examined this application, including accompanying statements and schedules, and to
the best of my knowledge and belief, it is true, correct, and complete.

SIGN HERE ▶
Type or print name

For Paperwork Reduction Act Notice, see instructions.

Date ▶
Type or print title

Cat. No. 49983G

Form 5316 (4-2013)

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Form 5316 (4-2013)

Yes

No

4

Is the group trust adopted as part of each adopting group trust retiree benefit plan? (See instructions.)

5

Does the group trust instrument expressly limit participation to: pension, profit-sharing, and stock bonus trusts
or custodial accounts qualifying under section 401(a) that are exempt under section 501(a); individual
retirement accounts that are exempt under section 408(e); eligible governmental plan trusts or custodial
accounts under section 457(b) that are exempt under section 457(g); custodial accounts under section
403(b)(7); retirement income accounts under section 403(b)(9); and section 401(a)(24) governmental plans?

6

Does the group trust instrument expressly prohibit any part of its corpus or income that equitably belongs to
any adopting group trust retiree benefit plan from being used for, or diverted to, any purpose other than for the
exclusive benefit of the participants and the beneficiaries of the group trust retiree benefit plan?

7

8

9

10

11

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Is each group trust retiree benefit plan entity which adopts the group trust itself a trust, a custodial account, or
a similar entity that is tax-exempt under section 408(e) or section 501(a) (or is treated as tax-exempt under
section 501(a))?
Does each group trust retiree benefit plan which adopts the group trust expressly provide in its governing
document that it is impossible for any part of the corpus or income of the group trust retiree benefit plan to be
used for, or diverted to, purposes other than for the exclusive benefit of the plan participants and their
beneficiaries?
Does the group trust instrument expressly limit the assets that may be held by the group trust to assets that
are contributed by, or transferred from, a group trust retiree benefit plan to the group trust (and the earnings on
such assets), and does the group trust instrument expressly provide for separate accounts (and appropriate
records) to reflect the interest which each adopting group trust retiree benefit plan has in the group trust?
Does the group trust instrument expressly prohibit an assignment by an adopting group trust retiree benefit
plan of any part of its equity or interest in the group trust?

Was the group trust created or organized in the United States and is the group trust maintained at all times as
a domestic trust in the United States?

Form 5316 (4-2013)

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Form 5316 (4-2013)

Procedural Requirements Checklist
Use this list to ensure that your submitted package is complete. Failure to supply the appropriate information may result in a delay in
the processing of the application.
1.

Is Form 8717, User Fee for Employee Plan Determination, Opinion, and Advisory Letter Request, attached to your
submission?

2.

Is the appropriate user fee for your submission attached to Form 8717?

3.

If appropriate, is Form 2848, Power of Attorney and Declaration of Representative, Form 8821, Tax Information
Authorization, or a privately designated authorization attached? (For more information, see the Disclosure Request by
Taxpayer in the instructions and Rev. Proc. 2012-4.)

4.

Is a copy of your group trust's determination letter, if any, attached?

5.
6.
7.
8.

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Have you included a copy of the group trust instrument and all amendments since your last determination letter?
Is the Employer Identification Number (EIN) of trust sponsor entered on line 1g?
Does line 3b provide the trust’s original effective date?

Is the application signed and dated? (Stamped signatures are not acceptable; see Rev. Proc. 2012-4.)

Form 5316 (4-2013)

Version A, Cycle 2

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Form 5316 (4-2013)

What’s New
This form was first issued in 2011. Prior to this form, a letter was
submitted in lieu of a form. Review the Procedural Requirements
Checklist and these instructions before completing the application.
Public inspection. The group trust application is open to public
inspection.
Disclosure request by taxpayer. The Tax Reform Act of 1976
permits a taxpayer to request the IRS to disclose and discuss the
taxpayer’s return and/or return information with any person(s) the
taxpayer designates in a written request. Use Form 2848, Power of
Attorney and Declaration of Representative, if the representative is
qualified to sign, or Form 8821, Tax Information Authorization, for
this purpose. See Pub. 947, Practice Before the IRS and Power of
Attorney, for more information.

Future Developments

• DHL Express (DHL): DHL Same Day Service.
• Federal Express (FedEx): FedEx Priority Overnight, FedEx
Standard Overnight, FedEx 2Day, FedEx International Priority, and
FedEx International First.
• United Parcel Service (UPS): UPS Next Day Air, UPS Next Day Air
Saver, UPS 2nd Day Air, UPS 2nd Day Air A.M., UPS Worldwide
Express Plus, and UPS Worldwide Express.
The private delivery service can tell you how to get written proof
of the mailing date.

How To Complete the Application
Applications are screened for completeness. The application must
be signed by the employer or plan administrator.
Stamped signatures are not acceptable; see Rev. Proc.
2012-4, 2012-1 I.R.B. 125, available at
www.irs.gov/irb/2012-01_IRB/ar09.html.

!
▲

INTERNAL USE ONLY
DRAFT AS OF
JULY 24, 2012

For the latest information about developments related to Form 5316
and its instructions, a such as legislation enacted after they were
published, go to www.irs.gov/form5316.

General Instructions

Section references are to the Internal Revenue Code unless
otherwise noted.

Purpose of Form

Group/pooled trust sponsors file this form to request a
determination letter from the IRS for a determination that the trust is
a group trust arrangement as described in Rev. Rul. 81-100, 1981-1
C.B. 326, as clarified and modified by Rev. Rul. 2004-67, 2004-2
C.B. 28, as modified by Rev. Rul. 2011-1, 2011-2 I.R.B. 251,
available at www.irs.gov/irb/2011-02_IRB/ar08.html, and as
modified by Notice 2012-6, 2012-3 I.R.B. 293, available at
www.irs.gov/irb/2012-03_IRB/ar12.html.

Type of Trust
A group/pooled trust is a trust that meets the qualification
requirements of Rev. Rul. 81-100 as modified and clarified by
Rev. Rul. 2004-67, as modified by Rev. Rul. 2011-1 and as modified
by Notice 2012-6.

Who May File
This form should be filed by the sponsor of a group/pooled trust.

Where To File
File Form 5316 at the address indicated below:
Internal Revenue Service
P.O. Box 12192
Covington, KY 41012-0192
Requests shipped by express mail or a delivery service should
be sent to:
Internal Revenue Service
201 West Rivercenter Blvd.
Attn: Extracting Stop 312
Covington, KY 41011
Private delivery services. In addition to the U.S. mail, you can use
certain private delivery services designated by the IRS to meet the
“timely mailing as timely filing/paying” rule for tax returns and
payments. The list of designated private delivery services includes
only the following:

CAUTION

Incomplete applications may be returned to the applicant. For this
reason, it is important that an appropriate response be entered for
each line item (unless instructed otherwise). In completing the
application, pay careful attention to the following:
• N/A (not applicable) is accepted as a response only if an N/A
block is provided.
• If a number is requested, a number must be entered.
• If an item provides a choice of boxes to check, check only one
box unless instructed otherwise.
• If an item provides a box to check, written responses are not
acceptable.
• The IRS may, at its discretion, require a plan restatement or
additional information any time it is deemed necessary.
• The application has formatted fields that will limit the number of
characters entered per field.
• All data input will need to be entered in Courier 10 point font.
• Alpha characters should be entered in all capital letters.
• Enter spaces between any words. Spaces do count as characters.
• All date fields are entered as an 8-digit field (MMDDYYYY).
The IRS annually updates the revenue procedure which sets forth
the procedures for issuing determination letters to qualified plans,
including determination letters for group trusts. The annual revenue
procedure may be found in the Internal Revenue Bulletin. For
example, the revenue procedure for 2012 is Rev. Proc. 2012-6,
2012-1 I.R.B. 197, available at www.irs.gov/irb/2012-01_IRB/
ar11.html.

What To File
1. A check for the appropriate user fee and Form 8717, User Fee for
Employee Plan Determination, Opinion, and Advisory Letter
Request. Attach a check or money order payable to the “United
States Treasury” for the full amount of the user fee.
2. A completed Form 5316.
3. A copy of the trust’s latest determination letter.
4. The trust instrument and related documents.

Form 5316 (4-2013)

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Form 5316 (4-2013)

Specific Instructions
Line 1a and 1b. Enter the name and address of the trust
sponsor/employer.
Address should include the suite, room, or other unit number after
the street address. If the post office does not deliver mail to the
street address and the plan has a P.O. box, show the box number
instead of the street address. The address should be the address of
the sponsor/employer.
Line 1g. Enter the 9-digit trust employer identification number (EIN)
assigned to the trust sponsor.
The trust sponsor/employer must have an EIN. To apply for an
EIN:
• Mail or fax Form SS-4, Application for Employer Identification
Number, obtained by calling 1-800-TAX-FORM (1-800-829-3676).
• Call 1-800-829-4933 to receive your EIN by telephone.
• Select the Online EIN Application link at IRS.gov. The EIN is
issued immediately once the application information is validated.
Note. This EIN must be used in all subsequent filings of the trust
determination letter requests.
Line 2a. Complete this line, or check the box and attach a power of
attorney or other written designation. The contact person will
receive copies of all correspondence as authorized. See instructions
for Form 2848 or Form 8821.
Line 3a. Due to space restrictions this field is limited to 70
characters, including spaces. Please complete this item with how
the trust name should read on the trust determination letter to the
extent permitted. Due to this restriction, please keep in mind that
“Employees” and “Trust” are not needed and will be left off if space
does not permit.
Line 3b. Enter the date the trust agreement was executed.
Line 4. Each group trust retiree benefit plan must adopt the group
trust as part of the plan. A group trust retiree benefit plan is defined
as a pension, profit-sharing, and stock bonus trust or custodial
account qualifying under section 401(a) that is exempt under
section 501(a); an individual retirement account that is exempt
under section 408(e); an eligible governmental plan trust or
custodial account under section 457(b) that is exempt under section
457(g); a custodial account under section 403(b)(7); a retirement
income account under section 403(b)(9); and a section 401(a)(24)
governmental plan.
Line 5. The group trust instrument must expressly limit participation
in the group trust to group trust retiree benefit plans. The group
trust instrument may also limit participation in the group trust to
certain types of group trust retiree benefit plans. For example, the
group trust instrument may limit participation in the group trust to
pension, profit-sharing, and stock bonus trusts qualifying under
section 401(a) that are exempt under section 501(a), and individual
retirement accounts exempt under section 408(e). See Rev. Rul.
2011-1, as modified by Notice 2012-6, for information on the assets
of commingled trust funds.
Line 6. The group trust instrument must expressly prohibit any part of its
corpus or income that equitably belongs to any adopting group trust
retiree benefit plan from being used for, or diverted to, any purpose
other than for the exclusive benefit of the participants and the
beneficiaries of the group trust retiree benefit plan. Plan assets are
treated as used for, or diverted to, a purpose other than for the exclusive
benefit of the plan participants or beneficiaries if the assets of one group

trust retiree benefit plan are used to provide benefits under another
group trust retiree benefit plan even if the plan participant or beneficiary
receiving the benefits is a participant or beneficiary under both plans.
Line 7. A group trust retiree benefit plan that is a governmental plan
for purposes of section 401(a)(24) is treated as meeting the
requirement to be tax exempt if it is not subject to federal income
taxation.
Line 8. Each group trust retiree benefit plan which adopts the group
trust must expressly provide in its governing document that it is
impossible for any part of the corpus or income of the group trust
retiree benefit plan to be used for, or diverted to, purposes other
than for the exclusive benefit of the plan participants and their
beneficiaries. For more information see Rev. Rul. 2011-1 as
modified by Notice 2012-6.
Line 9. The group trust instrument must expressly limit the assets
that may be held by the group trust to assets that are contributed
by, or transferred from, a group trust retiree benefit plan to the
group trust (and the earnings on the assets), and the group trust
instrument must expressly provide for the separate accounts (and
appropriate records) to reflect the interest which each adopting
group trust retiree benefit plan has in the group trust. This includes
separate accounting for contributions to the group trust from the
adopting plan, disbursements made from the adopting plan's
account in the group trust, and investment experience of the group
trust allocable to that account. A transaction or accounting method
which has the effect of directly or indirectly transferring value from
the account of one adopting plan into the account of another
adopting plan violates this separate accounting requirement.
However, a transaction that merely exchanges investments at fair
market value between the accounts of one adopting plan to another
account of that adopting plan does not violate this separate
accounting requirement.

INTERNAL USE ONLY
DRAFT AS OF
JULY 24, 2012
How To Get Forms, Publications, and
Assistance

Internet. You can access the IRS website 24 hours a day, 7 days a
week at IRS.gov to:
• Download forms, instructions, and publications;
• Order IRS products on-line;
• Research your tax questions on-line;
• Search publications on-line by topic or keyword; and
• Sign up to receive local and national tax news by email.
DVD of tax products. You can order Publication 1796, IRS Tax
Products DVD, and obtain:
• Current-year forms, instructions, and publications.
• Prior-year forms, instructions, and publications.
• Tax Map: an electronic research tool and finding aid.
• Tax Law frequently asked questions.
• Tax Topics from the IRS telephone response system.
• Internal Revenue Code — Title 26.
• Fill-in, print, and save features for most tax forms.
• Internal Revenue Bulletins.
• Toll-free and email technical support.
• The DVD is released twice during the year.
— The first release will ship the beginning of January.
— The final release will ship the beginning of March.
Form 5316 (4-2013)

Version A, Cycle 2

Form 5316 (4-2013)

Purchase the DVD from the National Technical Information
Service (NTIS) at www.irs.gov/cdorders for $30 (no handling fee), or
call 1-877-233-6767 toll-free to purchase the DVD for $30 (plus a $6
handling fee) (price subject to change).
By phone and in person. You can order forms and publications 24
hours a day, 7 days a week, by calling 1-800-TAX-FORM
(1-800-829-3676). You can also get most forms and publications at
your local IRS office.
For questions regarding this form, call the Employee Plans
Customer Service, toll-free, at 1-877-829-5500.
Paperwork Reduction Act Notice. We ask for the information on
this form to carry out the Internal Revenue laws of the United
States. If you want to have your group trust approved by the IRS,
you are required to give us the information. We need it to determine
whether you meet the legal requirements for the group trust
approval.
You are not required to provide the information requested on a
form that is subject to the Paperwork Reduction Act unless the form
displays a valid OMB control number. Books or records relating to a
form or its instructions must be retained as long as their contents
may become material in the administration of any Internal Revenue
law. Generally, tax returns and return information are confidential,
as required by section 6103.

Page 6

The time needed to complete and file this form will vary
depending on individual circumstances. The estimated average time
is:
Recordkeeping . . . . . . . . . . . . 6 hr., 42 min.
Learning about the law or the form . . . . . 3 hr., 2 min.
Preparing, copying, assembling, and sending
the form to the IRS . . . . . . . . . . . 9 hr., 15 min.
If you have comments concerning the accuracy of these time
estimates or suggestions for making this form simpler, we would be
happy to hear from you. You can write to the Internal Revenue
Service, Tax Products Coordinating Committee,
SE:W:CAR:MP:T:M:S, 1111 Constitution Ave. NW, IR-6526,
Washington, DC 20224.
Do not send any of these forms or schedules to this address.
Instead, see Where To File.

INTERNAL USE ONLY
DRAFT AS OF
JULY 24, 2012

Form 5316 (4-2013)