Model Plan Amendme Model Plan Amendment, Compliance

Special Financial Assistance by PBGC

Model.Plan.Amendment September 2023

Application for Special Financial Assistance

OMB: 1212-0074

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AMENDMENT TO THE
[NAME OF PLAN DOCUMENT]
Background
1. The Board of Trustees of the [PLAN NAME] (the “Board”) has applied to the Pension Benefit
Guaranty Corporation (“PBGC”) under section 4262 of the Employment Retirement Income
Security Act of 1974, as amended (“ERISA”), and 29 C.F.R. § 4262 for special financial
assistance for the [PLAN NAME] (the “Plan”).
2. 29 C.F.R. § 4262.6(e)(1) requires that the plan sponsor of a plan applying for special
financial assistance amend the written instrument governing the plan to require that the plan
be administered in accordance with the restrictions and conditions specified in section 4262
of ERISA and 29 C.F.R. part 4262 and that the amendment be contingent upon approval by
PBGC of the plan’s application for special financial assistance.
3. Under [REFERENCE TO APPROPRIATE PROVISION] of the [NAME AND DATE OF
CURRENT PLAN DOCUMENT] (the “Plan Document”), the Board has the power to amend
the Plan Document.
4. [INCLUDE ONLY IF FEWER THAN ALL TRUSTEES HAVE EXECUTED THE
AMENDMENT] Section [REFERENCE TO APPROPRIATE PROVISION(S)] of the [NAME
AND DATE OF PLAN’S CURRENT TRUST DOCUMENT OR OTHER GOVERNING
DOCUMENT], as amended, authorizes [DESCRIBE HOW TRUST DOCUMENT OR OTHER
GOVERNING DOCUMENT AUTHORIZES THE SIGNERS TO AMEND THE PLAN
DOCUMENT ON BEHALF OF ENTIRE BOARD.]
[NOTE – If fewer than all trustees have executed the amendment, the board of
trustees must have delegated to those trustees the specific authority to amend the
plan document in accordance with § 4262.6(e)(1). A resolution authorizing a subset
of trustees to act on behalf of the board that does not delegate to those trustees the
specific authority to amend the plan document in accordance with § 4262.6(e)(1) will
be considered insufficient. For example, a resolution delegating the authority to
“sign any document required for the SFA application” will be considered
insufficient.]
Amendment
The Plan Document is amended by adding a new [ARTICLE/SECTION #] to read as follows:
“Beginning with the SFA measurement date selected by the Plan in the Plan’s application
for special financial assistance, notwithstanding anything to the contrary in this or any
other document governing the Plan, the plan shall be administered in accordance with the
restrictions and conditions specified in section 4262 of ERISA and 29 CFR part 4262.
This amendment is contingent upon approval by PBGC of the Plan’s application for
special financial assistance.”

- Amendment Required by 29 C.F.R. § 4262.6(e)(1), Page 1 of 2 -

[INSERT ONE SIGNATURE BLOCK FOR EACH TRUSTEE, EACH WITH A PRINTED NAME
AND TITLE:]
___________________________
[PRINTED NAME]
[TITLE]

___________________________
[PRINTED NAME]
[TITLE]

___________________________
[PRINTED NAME]
[TITLE]

___________________________
[PRINTED NAME]
[TITLE]

Date: [DATE OF EXECUTION]

- Amendment Required by 29 C.F.R. § 4262.6(e)(1), Page 2 of 2 -


File Typeapplication/pdf
AuthorAllender Emily
File Modified2023-09-28
File Created2023-09-28

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