Form 8717 User Fee for Employee Plan Determination Letter Request

Form

8717

User Fee for Employee Plan Determination
Letter Request

For
IRS
Use
Only

(Rev. August 2014)
▶ Attach to determination letter application.
Department of the Treasury
▶ For the latest information about this form, go to www.irs.gov/form8717.
Internal Revenue Service
1 Name of plan sponsor (employer if single-employer plan)
2 Sponsor’s employer identification number

3 Plan number

OMB No. 1545–1772

Amount paid

4 Plan name

Caution. If you qualify for the exemption from user fees for small business employers, complete only the certification below (see the instructions
on page 2 for details). For all other applications, leave the certification blank and check the appropriate box in column B of line 5.

Certification
I certify that the application for a determination letter on the qualified status of the plan listed above meets the conditions for
exemption from user fees described in section 7528(b)(2)(B) of the Internal Revenue Code.
Date ▶

Sign Here ▶
Type or print name and title ▶

Fee Schedule
Form Submitted

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Cat. No. 64727O

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$
$
$
$

3,000
3,000
15,000
15,000

(1)
(2)
(3)
(4)

$
$
$
$

3,000
3,000
15,000
15,000

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(1)
(2)
(3)
(4)

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Multiple employer plans (Form 5300):
(1) 2 to 10 Forms 5300 submitted . . . .
(2) 11 to 99 Forms 5300 submitted . . .
(3) 100 to 499 Forms 5300 submitted . . .
(4) Over 499 Forms 5300 submitted . . .
f Multiple employer plans (Form 5310):
(1) 2 to 10 employers maintaining the plan .
(2) 11 to 99 employers maintaining the plan .
(3) 100 to 499 employers maintaining the plan
(4) Over 499 employers maintaining the plan
g Reserved
(1a) . . . . . . . . . . . . . .
(1b) . . . . . . . . . . . . . .
(2a) . . . . . . . . . . . . . .
(2b) . . . . . . . . . . . . . .
(3)
. . . . . . . . . . . . . .
(4)
. . . . . . . . . . . . . .
h Reserved
(1a) . . . . . . . . . . . . . .
(1b) . . . . . . . . . . . . . .
(2)
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(3)
. . . . . . . . . . . . . .
(4a) . . . . . . . . . . . . . .
(4b) . . . . . . . . . . . . . .
(5)
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(6)
. . . . . . . . . . . . . .
. . . . . . . . . . . . . .
(7)
i Form 5316 (Group trusts) . . . . . . .

$ 2,500
$
500
$ 2,000

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Form 5300:
Form 5307:
Form 5310:

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Attach Check or Money Order Here

5a
b
c
d
e

B
no Demo 5 and
no Demo 6:

A

$ 1,000
Form 8717 (Rev. 8-2014)

Page 2

Form 8717 (Rev. 8-2014)

What’s New
The user fees were updated by Rev. Proc.
2014-8, 2014-1 I.R.B. 242, and are effective
for applications filed on or after February 1,
2014.
Form 8717 has been renamed, User Fee for
Employee Plan Determination Letter Request.
Information previously on Form 8717 relating
to opinion or advisory letter requests for
Volume Submitter and Master or Prototype
plans has been deleted. This information may
now be found on new Form 8717-A, User Fee
for Employee Plan Opinion or Advisory Letter
Request.
Note. Please do not use any part of the form
that is shaded in grey. Those portions of the
form are no longer functional.

Instructions
(Section references are to the Internal
Revenue Code unless otherwise noted.)
Generally, a user fee is required with each
application for a determination letter. The
user fees are shown on page 1. For more
information, see Rev. Proc. 2014-6, 2014-1
I.R.B. 198.

Effective Date
The user fee schedule in Form 8717 is
effective for determination letter applications
postmarked after January 31, 2014. Use of
this revision of Form 8717 is mandatory
beginning July 1, 2014.

Exemption from User Fee
The exemption from the user fee applies to
all eligible employers (defined later) who
request a determination letter within the first 5
plan years or, if later, the end of any remedial
amendment period with respect to the plan
that begins within the first 5 plan years.
A determination letter application that is
filed by an eligible employer meets the
requirements for exemption if:
(1) the application is filed no later than the last
day of the submission period for the plan's
current remedial amendment cycle under Rev.
Proc. 2007-44, 2007-28 I.R.B. 54, and
(2) the plan was first in effect no earlier than
January 1 of the tenth calendar year
immediately before the year in which the
submission period for the plan's current
remedial amendment cycle begins. (If the plan
was first in effect before this date, but the
application is still filed within a remedial
amendment period that began within the first
5 plan years and you are an eligible employer,
complete only the Certification and attach an
explanation of how your application qualifies
for exemption under section 7528(b)(2)(B).)

Where To File (Include Form 8717 and user fee with your request or
application.)
IF you have this type of
request or application . . . .

THEN use this address if you send it by:
US mail

Determination letter
Internal Revenue Service
(Form 5307, 5300, 5310, 5310-A, P.O. Box 12192
and Form 5316, Group trust
Covington, KY 41012-0192
applications)
Example. An employer maintains an
individually designed plan first effective on
July 1, 2001. Assume that the plan's 5 year
remedial amendment cycle is Cycle A.
Therefore, a submission period for the plan's
cycle ended on January 31, 2012. Assume
that the employer filed a determination letter
application for the plan on January 31, 2012.
If the employer is an eligible employer, the
application was exempt from the user fee
requirement because the application was filed
by the last day of the submission period for
the plan's current remedial amendment cycle
and the date the plan was first in effect
(July 1, 2001) is not before January 1, 2001
(i.e., January 1 of the tenth calendar year
immediately before 2011, the year in which
the submission period for the plan's current
remedial amendment cycle began).
A determination letter application that was
filed by an eligible employer for a defined
benefit plan eligible for the 6-year remedial
amendment cycle ending on April 30, 2012,
also met the requirements for exemption if:
(1) the application was filed before May 1,
2012, and
(2) the plan was first in effect no earlier than
January 3, 1996.
See Notice 2002-1, 2002-1 C.B. 283 as
amplified by Notice 2003-49, 2003-2 C.B. 294
and Notice 2011-86, 2011-45 I.R.B. 698.
An eligible employer as defined in section
408(p)(2)(C)(i)(l) is an employer which had no
more than 100 employees who received at
least $5,000 of compensation from the
employer for the preceding year. In addition,
an eligible employer must have at least one
employee who is not a highly compensated
employee (as defined in section 414(q)) and is
participating in the plan.
The determination of whether an employer
is an eligible employer is made as of the date
of the request described above. If your
application meets these requirements,
complete only the Certification. Do not
complete any part of line 5.

Express Mail or
private delivery service
Internal Revenue Service
201 West Rivercenter Blvd.
Attn: Extracting Stop 312
Covington, KY 41011

Payment of User Fee
If you do not meet the conditions for
exemption discussed earlier, a user fee is due.
Check the appropriate box in Column B of
line 5 and attach to the left side of the form a
check or money order payable to the “United
States Treasury” for the full amount of the
user fee to Form 8717, if applicable. If you do
not include the full amount, your application
may be returned. Attach Form 8717 to your
determination letter application.
If you have multiple plans, submit a
separate determination letter application and
Form 8717 for each plan.
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 plan
approved by the IRS, you are required to give
us the information. We need it to determine
whether you meet the legal requirements for
plan approval. Section 7528 authorizes us to
charge a user fee.
You are not required to provide the
information requested on a form 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.
The time needed to complete and file this
form will vary depending on individual
circumstances. The estimated average time is:
Recordkeeping . . . . 8 hr., 07 min.
Learning about the law
or the form . . . . . . . . 57 min.
Preparing, copying, assembling 2 hr., 04 min.
Sending the form to the IRS
. . 16 min.
If you have comments about the accuracy
of this time estimate or suggestions for
making this form simpler, we would be happy
to hear from you. You can send your
comments to Internal Revenue Service, Tax
Forms and Publications Division, Room 6526,
1111 Constitution Ave. NW, Washington, DC
20224. Do not send this form to this address.
Instead, see Where To File.