Model VCP Compliance Statement For Employee Benefit Plans (Form 14568).pdf

## Form 14568 (Rev. 7-2023) - Model VCP Compliance Statement Summary

This document outlines a plan sponsor's (Applicant) correction to failures in their qualified retirement plan, as identified and described in detail across six sections:

I. Identifying Information:

Plan Name: [Plan name included by Applicant]
Applicant’s EIN: [EIN provided by Applicant, not Social Security Number]
Plan Number: [Plan number assigned to the retirement plan]

II. Applicant’s Description of Failures:

The Applicant identifies specific failures related to their plan's administration, focusing on:

Plan Loan Compliance (IRC §72(p)): Failure to properly track and report certain plan loans.
Excise Tax Waiver Requests: Request for IRS not to pursue excise taxes under IRC Sections 4972, 4973, 4974, and 4979 related to the identified failures.
Additional Tax Relief: Request for special relief regarding reporting of plan loan deemed distributions under IRC §72(t).

III. Applicant’s Description of the Proposed Method of Correction:

The Applicant outlines specific corrective actions for each failure, including:

Revised Administrative Procedures: Implementation of new procedures to ensure proper tracking and reporting of plan loans moving forward.
Correction of Deemed Distributions: Amortization and reporting corrections for affected participants to ensure tax treatment accuracy.

IV. Applicant’s Proposed Procedures to Locate and Notify Former Employees or Beneficiaries:

The Applicant will use [specific methods listed] to identify and notify former employees and beneficiaries impacted by the failures, ensuring they are informed about potential corrective actions.

V. Applicant’s Proposed Revision to Administrative Procedures:

Detailed explanation of how the failures occurred and measures taken (or to be implemented) to prevent recurrence, including:

Improved record keeping
Enhanced training for staff responsible for plan administration
Implementation of automated systems for tracking loan activity

VI. Requests Related to Taxes:

The Applicant requests IRS consideration regarding:

Waiver of excise taxes associated with the failures.
Alternative reporting of deemed distributions for affected loans.

VII. Enforcement Resolution (IRS Specific):

The IRS agrees not to pursue revocation of the plan's tax-favored status.
The Applicant and plan sponsor waive any claim for a refund or credit related to user fees associated with this submission.
Corrections must be completed within 150 days, with specific deadlines for governmental plans.