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Form 5500 EZ Samples and Instructions


On-line "Point-and-Click" Instructions 

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Form 5500-EZ: Annual Return of One-Participant (Owners and Their Spouses) Retirement Plan.

Click on the highlighted section of the below IRS Form or Schedule to access instructions on where to find the information within your 401k software and companion materials -- or click on the II. Detail section above, to view (or print) a text only page of 401k FedForms instructions for the IRS Form or Schedule.

Enter the appropriate plan year (month and day from your Adoption Agreement page 2, item B3, adding the appropriate year).
item A:
Check the appropriate box - most likely box (1) or (2).
item B:
Check if appropriate.
item 1a:
See Adoption Agreement page 2, item B1.
item 1b:
See Adoption Agreement page 3, item B5.
item 1c:
See Adoption Agreement page 2, item B2 - or 5500 Summary Worksheet.
Sign and date the form.
Type or print signee's name, as directed.

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Page 2 of 5

item 2a lines 1-8:
Complete as directed.
item 2b:
Same as Employer ID Number on your Adoption Agreement page 1, item A4.
item 2c:
Complete as directed.
item 2d:
Choose the appropriate business code from the IRS instructions.
item 3a:
Enter "same" (see Adoption Agreement page 4, item B7).
item 3b:
Leave blank (unless you happened to have established such a number for your plan administrator).
item 3c:
Complete as directed.
item 4:
Complete if appropriate, otherwise leave blank.

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item 5:
Complete as appropriate.
item 6:
Check response "(d) Profit-sharing plan".
item 6:
Check response "(d) Profit-sharing plan".
item 7a:
Enter "D7952246".
item 8a:
Complete as directed (most likely put "1").
item 8b:
Complete as appropriate.
items 9a thru 9c:
When the IRS says "Participants" it means "eligible employees" as far as your 401k administration software is concerned. Given the size of your plan, you likely know the answers to items 9a-c, but if you don't check your 401k software Under Reports, Administrative Reports, Employee Census for "Eligibles" in "All Divisions" to access a list of eligible employees that includes birth dates, from which you can quickly tally "Participants" in each age category as of the close of the year.

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Page 4 of 5

item 10a:
Check "No."
item 10b:
Add Employee Contributions for Year to any Employer Contributions for Year, as listed in your 5500 Summary Worksheet.

To the Employer Contributions listed in the Worksheet, add...

- any Qualified Nonelective Contributions made (see Yearly 401k Activity Reports, Year-to-Date Activity Log, Activity Type: Qualified Non-Elective Contrib.),

- any Discretionary Employer Contributions made (a.k.a., profit sharing contributions) (same location, Activity Type: Discretionary Employer Contributions)

- any ADP Test Correction contributions made (see Year-to-Date Activity Log, ADP Test Correction: If the report shows a positive total, include the amount here as part of item 10b but if the report shows a negative total, money was distributed from the plan to correct the ADP imbalance and the distribution amounts should be recorded as part of item 10d of this Form 5500-EZ.).
item 10c:
Enter "0".
item 10d:
Include all normal distributions, ADP test correction distributions and loans not to be paid back.

For normal distribution and ADP test correction figures, consult your Year-to-Date Activity Log for the appropriate Activity Type (ADP Test Correction or Distribution); see instructions for item 10b of this Form 5500-EZ regarding the ADP Test Correction report.

For loans not to be paid back, cross-reference your Current Loans report (Reports, Administrative Reports, Current Loans) with a listing of people who have quit the plan (Reports, Administrative Reports, Employee Census, Terminated). Contact any terminated employees who have outstanding loans to inquire if they intend to pay off the loan. If they DO intend to pay off the loan, record the amount as an asset on item 12e Participant Loans; if they DO NOT intend to pay off the loan, record the amount here as part of item 10d.
item 10e:
Enter the total amount of IRA Rollovers and rollovers to qualified plans for the year. This is a subset of the distributions recorded in the Year-to-Date Activity Log, Distributions.

To determine which distributions were nontaxable distributions, go to Employee Information in your 401k software, choose the relevant employee name, click on Activity and scroll to the relevant dated entry; the spreadsheet will list "Distribution" and under it the type of distribution, as typed in the Notes section of the New Activity window when the distribution was entered into the system. If your data entry person did not tag the distribution with a Note as to the type of distribution, you will need to consult your paper files on each distribution (and instruct your personnel to, in the future, define each Activity with a Note, as recommended in your 401k software's User's Guide).
item 10f:
If any trust transfers were made out of the plan during the year, record the amount as item 10f.

Any trust transfers out of the plan could have be recorded in your 401k software in either of two ways, depending on where you entered them into your system: (1) as part of the Trust Transfers Into Plan on your 5500 Summary Worksheet if you processed the transfers as a negative transfer-in amount, or (2) as Distributions.

If you processed any trust transfers as distributions and do not have a clear record of the total trust transfer out, you can reconstruct the total by looking at each affected employee's Employee Information--Activity, scrolling to the relevant distribution(s) for the amount transferred for that employee, then totalling the amounts transferred for all affected employees.

If you recorded them as negative trust transfers in, you will similarly need to reconstruct which transfers were going out and which were coming in, and enter the total that went out as item 10f, the total that came in as part of item 10g.
item 10g:
Enter the total of (1) rollovers into the plan, (2) trust transfers into the plan, and (3) earning from investments.

Items (1) and (2) are on the year's Yearly 5500 Summary Worksheet (under Reports, Yearly 401k Activity Reports); please see the instructions for item 10f if you chose to record any trust transfers out of the plan as negative trust transfers.

Earnings from investments can be calculated as follows: take your End of Year plan assets total (item 11a(b)), subtract your Beginning of Year plan assets total (item 11a(a)), subtract cash contributions received (a.k.a., Employee + Employer contributions) (item 10b), any rollovers into the plan (5500 Summary Worksheet) and any trust transfers into the plan (5500 Summary Worksheet). Then to that subtotal, ADD your total plan distributions (items 10d and 10e), any trust transfers out of the plan (item 10f) and, finally, any other plan expenses (item 10h). This will yield any earning from investments; add the amount to items (1) and (2), above, and enter the total as item 10g. (Click here to access our 401k FedForms Earnings From Investments Calculation Worksheet.)
item 10h:
This would include travel expenses, etc. incurred in the business of your 401k. This amount should be "0".
item 11a column (a):
Enter your Beginning of Year Total Plan Assets:

- "0" for new plans

- for other plans, the amount listed on last year's Form 5500-EZ item 11a column (b) End of Year Total Plan Assets).
item 11a column (b):
To calculate your End of Year Total Plan Assets, use our 401k FedForms End of Year Assets Calculation Worksheet, or on your own total the following three items:

(1) Ending Value of each plan investment (Year End Auditor's Worksheet, last column, last item for each investment),

(2) any December contributions that didn't appear on the December investment statements from which the Ending Values were derived (check your December Monthly Investments Purchase Order - Reports, Monthly 401k Activity Reports - against the relevant December mutual fund/brokerage account statements), and

(3) outstanding loans as of the end of December; see your December Current Loans report (Reports, Administrative Reports, Current Loans); if you did not save a copy of this December report, print the current Current Loans report, discard any loans made subsequent to the close of the year, and add in any loan amounts paid off during the new year that were active as of 12/31 of the filing year (consult your files for these records).

Finally, subtract any loans not to be paid off, as determined for item 10d, above. The end-of-year outstanding loan balance you derive is the same as the figure you will enter for item 12e, below.
item 11b columns (a) and (b):
Enter "0" unless otherwise instructed.
items 12a thru 12c:
Check "No".
items 12a thru 12c:
Check "No".
items 12a thru 12c:
Check "No".

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item 12d:
Check "No".
item 12e:
Outstanding loan balance as of the close of the year. See the instructions for item 11a column (b) on page 4 of this Form 5500-EZ.
items 12f:
Check "No".
items 12g:
Check "No".
items 13a thru 13d:
Check "No".
items 13a thru 13d:
Check "No".
items 13a thru 13d:
Check "No".
items 13a thru 13d:
Check "No".
items 13a thru 13d:
Check "No".
item 14a:
Check the relevant box.
item 14b:
Complete as appropriate.
item 14c:
Check "Yes".
item 15a:
Check "No".
items 15b and 15c:
Check the relevant boxes.
That's it for Form 5500-EZ! Remember to keep a copy for your records, and send the original to the IRS on or before July 31 (non January-December plans: file by the last day of the seventh month after the close of your plan year).
items 15b and 15c:
Check the relevant boxes.
That's it for Form 5500-EZ! Remember to keep a copy for your records, and send the original to the IRS on or before July 31 (non January-December plans: file by the last day of the seventh month after the close of your plan year).

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Printable Fedform Instructions 

Page 1 of 5

Sign and date.

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Page 5 of 5

That's it for Form 5500-EZ! Remember to keep a copy for your records, and send the original to the IRS on or before July 31 (non January-December plans: file by the last day of the seventh month after the close of your plan year).

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Printable IRS Instructions

PDF Form 5500 EZ

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