Federal Register - December 29, 2021
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Source: Federal Register
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Federal Register / Vol. 86, No. 247 / Wednesday, December 29, 2021 / Rules and Regulations
Multiple-Employer Plan Participating Employer Information Insert Name of Plan and EIN/PN as shown on the Insert Form 5500 or Form 5500-SF as applicable 1. Name of participating employer
2. EIN
3. Percent of Total Contributions for Plan Year
4. Aggregate Account Balances at End of Year Attributable to Participating Employer
1. Name of participating employer
2. EIN
3. Percent of Total Contributions for Plan Year
4. Aggregate Account Balances at End of Year Attributable to Participating Employer
1. Name of participating employer
2. EIN
3. Percent of Total Contributions for Plan Year
4. Aggregate Account Balances at End of Year Attributable to Participating Employer
1. Name of participating employer
2. EIN
3. Percent of Total Contributions for the Plan Year
4. Aggregate Account Balances at End of Year Attributable to Participating Employer
1. Name of participating employer
2. EIN
3. Percent of Total Contributions for the Plan Year
4. Aggregate Account Balances at End of Year Attributable to Participating Employer
Complete as many rows as needed to report the required information for all participating employers in the plan.
For Form 5500 Instructions only Pooled Employer Plan/Pooled Plan Provider Information Insert Name of Plan and EIN/PN as shown on the Form 5500
Only pooled employer plans complete.
1a. Is the pooled plan provider currently in compliance with the requirements for filing the Form PR Pooled Plan Provider Registration Statement? See Form PR Instructions and 29 CFR 2510.3-44. Yes No 1b. If "Yes" is checked in line 1a, enter the AcklD for the most recent Form PR that was required to be filed under the Form PR filing requirements. Failure to enter a valid AcklD will subject the Form 5500 filing subject to rejection as incomplete.
The following revisions are being made to the Form 5500SF instructions:
In the first paragraph of the General Instruction section, add a seventh bulleted paragraph that reads Not be a pooled employer plan. See ERISA section 343.
In the General Instruction section, under the heading Who May File Form 5500SF, add a new paragraph number 7 before the Note that reads: 7. The plan is not a pooled
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employer plan. See ERISA section 343.
In the Specific Line-By-Line Instructions Form 5500SF in instructions for Part II, Line 6, add a new paragraph number 7 that reads: 7.
The plan is not a pooled employer plan.
See ERISA section 343.
Statutory Authority Accordingly, pursuant to the authority in sections 101, 103, 104, 109,
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110, the Form 5500 Annual Return/
Report and the Form 5500SF Short Form Annual Return/Report are amended as set forth herein.
Signed at Washington, DC, this 17th day of December, 2021.
Ali Khawar, Acting Assistant Secretary, Employee Benefits Security Administration, U.S. Department of Labor.
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