Qualified Retirement Plan Forms Checklist

Ascensus’ forms and documents are constantly monitored to accommodate changes brought about by new tax laws and, equally important, to respond to your requests and needs. This Forms Checklist provides you with the date of the most current version of the designated form or document. Versions which are technically inaccurate because of subsequent law changes or IRS pronouncements are listed in the column entitled “Obsolete Version.” If no date appears in the obsolete column, all existing versions may be used and so, the current version of preprinted forms are generally available upon the depletion of existing inventory supplies. This checklist will be updated periodically.

If you need assistance or would like to update your forms inventory, contact a Customer Service Representative at 800-346-3860, option 2, suboption 1.

 

PROFIT SHARING and MONEY PURCHASE PENSION – PROTOTYPE

No. Name Current Version Obsolete Version
PPA 01 – QRP
4200 Basic Plan Document 01 4/2014
ADOPTION AGREEMENTS
4210 Super Simplified Profit Sharing Standardized 4/2014
4211 Super Simplified Money Purchase Pension Standardized 4/2014
4220 Simplified Profit Sharing Standardized 4/2014
4221 Simplified Money Purchase Pension Standardized 4/2014
4223 Simplified Profit Sharing Nonstandardized 4/2014
4224 Simplified Money Purchase Pension Nonstandardized 4/2014
4230 Flexible Profit Sharing Standardized 4/2014
4231 Flexible Money Purchase Pension Standardized 4/2014
4233 Flexible Profit Sharing Nonstandardized 4/2014
4234 Flexible Money Purchase Pension Nonstandardized 4/2014
4240 Comprehensive Profit Sharing Standardized 4/2014
4241 Comprehensive Money Purchase Pension Standardized 4/2014
4243 Comprehensive Profit Sharing Nonstandardized 4/2014
4244 Comprehensive Money Purchase Pension Nonstandardized 4/2014
SUMMARY PLAN DESCRIPTIONS
4210-SD Super Simplified Profit Sharing Standardized 4/2014
4211-SD Super Simplified Money Purchase Pension Standardized 4/2014
4220-SD Simplified Profit Sharing Standardized 4/2014
4221-SD Simplified Money Purchase Pension Standardized 4/2014
4223-SD Simplified Profit Sharing Nonstandardized 4/2014
4224-SD Simplified Money Purchase Pension Nonstandardized 4/2014
4230-SD Flexible Profit Sharing Standardized 4/2014
4231-SD Flexible Money Purchase Pension Standardized 4/2014
4233-SD Flexible Profit Sharing Nonstandardized 4/2014
4234-SD Flexible Money Purchase Pension Nonstandardized 4/2014
4240-SD Comprehensive Profit Sharing Standardized 4/2014
4241-SD Comprehensive Money Purchase Pension Standardized 4/2014
4243-SD Comprehensive Profit Sharing Nonstandardized 4/2014
4244-SD Comprehensive Money Purchase Pension Nonstandardized 4/2014

 

Key
Amendments are required to be used in conjunction with this, each as applicable. Refer to your QRP Supplemental Forms and Instructions materials for more information.
SMMs may be required to be used in conjunction with these SPDs, each as applicable. Refer to your QRP Supplemental Forms and Instructions materials for more information.
May require Loan, 404(c) Information Sheets and/or Fee Disclosure, each as applicable. Refer to your QRP Supplemental Forms and Instructions materials for more information.

 

401(k) – PROTOTYPE

No. Name Current Version Obsolete Version
PPA 01 – QRP
4200 Basic Plan Document 01 4/2014
ADOPTION AGREEMENTS
4212 Super Simplified Individual 401(k) Profit Sharing Standardized 4/2014
4222 Simplified 401(k) Profit Sharing Standardized 4/2014
4225 Simplified 401(k) Profit Sharing Nonstandardized 4/2014
4232 Flexible 401(k) Profit Sharing Standardized 4/2014
4235 Flexible 401(k) Profit Sharing Nonstandardized 4/2014
4242 Comprehensive 401(k) Profit Sharing Standardized 4/2014
4245 Comprehensive 401(k) Profit Sharing Nonstandardized 4/2014
SUMMARY PLAN DESCRIPTIONS
4212-SD Super Simplified Individual 401(k) Profit Sharing Standardized 4/2014
4222-SD Simplified 401(k) Profit Sharing Standardized 4/2014
4225-SD Simplified 401(k) Profit Sharing Nonstandardized 4/2014
4232-SD Flexible 401(k) Profit Sharing Standardized 4/2014
4235-SD Flexible 401(k) Profit Sharing Nonstandardized 4/2014
4242-SD Comprehensive 401(k) Profit Sharing Standardized 4/2014
4245-SD Comprehensive 401(k) Profit Sharing Nonstandardized 4/2014
PPA 02 – INDIVIDUAL(k)
4300 Basic Plan Document 02 – Individual 401(k) 4/2014
4312 Adoption Agreement 4/2014
4312-SD Summary Plan Description 4/2014

 

Key
Amendments are required to be used in conjunction with this, each as applicable. Refer to your QRP Supplemental Forms and Instructions materials for more information.
SMMs may be required to be used in conjunction with these SPDs, each as applicable. Refer to your QRP Supplemental Forms and Instructions materials for more information.
Requires Loan and/or 404(c) Information Sheets, each as applicable. Refer to your QRP Supplemental Forms and Instructions materials for more information.

 

VOLUME SUBMITTER

No. Name Current Version Obsolete Version
4400 Basic Plan Document – Volume Submitter 4/2014
ADOPTION AGREEMENTS
4442 Volume Submitter 401(k) Profit Sharing 4/2014
4441 Volume Submitter Money Purchase Pension 4/2014
SUMMARY PLAN DESCRIPTIONS
4442-SD Volume Submitter 401(k) Profit Sharing 4/2014
4441-SD Volume Submitter Money Purchase Pension 4/2014

 

Key
Amendments are required to be used in conjunction with this, each as applicable. Refer to your QRP Supplemental Forms and Instructions materials for more information.
SMMs may be required to be used in conjunction with these SPDs, each as applicable. Refer to your QRP Supplemental Forms and Instructions materials for more information.
Requires Loan and/or 404(c) Information Sheets, each as applicable. Refer to your QRP Supplemental Forms and Instructions materials for more information.

 

ANCILLARY FORMS

Unless noted otherwise, these ancillary forms can generally be used with all Ascensus prototype and volume submitter plan documents.
No. Name Current Version Obsolete Version
203 QRP Deposit Form 8/2001 Any prior version
208 QRP Employee Data Worksheet 1/2002 Any prior to 8/2001
221 QRP and 403(b) Loan Kit 3/2014 Any prior to 8/2001
222 QRP Transfer Request 1/2002 Any prior to 8/2001
223 QRP Withholding Reminder Notice 8/2001 Any prior version
235 QRP Certification for Late Rollover Contribution 10/2016
237 QRP Plan Administrator’s Guide 10/2016 Any prior to 10/2015
270-C Participant Notice – 401(k) Safe Harbor (Comprehensive) 4/2014 Any prior version
270-F Participant Notice – 401(k) Safe Harbor (Flexible) 4/2014 Any prior version
270-S Participant Notice – 401(k) Safe Harbor (Simplified) 4/2014 Any prior version
270-C Participant Notice – 401(k) Safe Harbor (Comprehensive) 4/2014 Any prior version
270pa-F Participant Notice – 401(k) Safe Harbor (Flexible) 4/2014 Any prior version
270pa-S Participant Notice – 401(k) Safe Harbor (Simplified) 4/2014 Any prior version
271 401(k) Safe Harbor Contribution Reduction/Elimination Form 9/2016 Any prior version
272AEN-C Participant Notice – ACA (Comprehensive) 11/2016 Any prior to 4/2014
272AEN-F Participant Notice – ACA (Flexible) 11/2016 Any prior to 4/2014
272AEN-S Participant Notice – ACA (Simplified) 11/2016 Any prior to 4/2014
272EACA-C Participant Notice – EACA (Comprehensive) 11/2016 Any prior to 4/2014
272EACA-F Participant Notice – EACA (Flexible) 11/2016 Any prior to 4/2014
272EACA-S Participant Notice – EACA (Simplified) 11/2016 Any prior to 4/2014
272QACA-C Participant Notice – QACA (Comprehensive) 11/2016 Any prior to 4/2014
272QACA-F Participant Notice – QACA (Flexible) 11/2016 Any prior to 4/2014
272QACA-S Participant Notice – QACA (Simplified) 11/2016 Any prior to 4/2014
279 401(k) Plan Administrator’s Guide 10/2016 Any prior to 10/2015
281 QRP Notice to Interested Parties 1/2013 Any prior version
285 Notice of Plan Blackout Period 11/2009
481 QRP Designation of Beneficiary 4/2010 Any prior version
482 QRP Distribution Notice 10/2018 Any prior to 7/2018 
482-AR Automatic Rollover Notice 8/2012
485 QRP Beneficiary Distribution Election 10/2006 Any prior version
486 QRP Application for Distribution 3/2016 Any prior to 4/2010
488 QRP Rollover Certification 4/2006 Any prior version
493 QRP Direct Rollover Request 3/2014
529 Notice of Right to Diversify Employer Securities 1/2008 Recommend current version
530 Designation of Successor Plan Administrator/Trustee 1/2012
760 ERISA Section 404(c) Employee Investment Handbook 10/2015
761 ERISA Section 404(c) Employer Guidelines 6/2012
762 ERISA Section 404(c) Employee Information Sheet 4/2014
763 Notice of Default Investments 9/2011
764 Participant Fee Disclosure and 404(c) Employee Information Sheet 3/2012
4023 SIMPLE 401(k) Contribution Notice 8/2004
6487 401(k)/403(b) Direct In-Plan Roth Rollover Request 5/2011
8270-PS Cross-Tested Trustee Contribution Notice 2/2008
SCBR.ER Prototype Sample Corporate Board Resolution (for amendments) 1/2008
SCBR.PPS Prototype Sample Corporate Board Resolution (for amendments) 1/2011
VSSCBR.ER Volume Submitter Sample Corporate Board Resolution (for amendments) 7/2008
VSSCBR.P Volume Submitter Sample Corporate Board Resolution (for amendments) 11/2011

 

Key
A truth in lending disclosure may be required for use with nonAscensus plan documents.
Only available via custom print or electronically.
The prior version forms should be used with caution, particularly if a plan participant is rolling plan assets into a SIMPLE IRA.

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2017 Printed Forms Checklist