Form 8905

(January 2012)

Department of the Treasury 

Internal Revenue Service 

Certification of Intent To Adopt a Pre-approved Plan

Eligibility for the six (6) year remedial amendment cycle as 

described in Part IV of IRS Revenue Procedure 2007-44

OMB No. 1545-2011

For IRS Use Only

▶ Attach to Form 5300, 5307, 5310

Part I Plan Sponsor Information - Enter all requested information

1a Employer name

1b Employer Identification Number (EIN)

1c Employer’s plan name

1d Plan number 1e Plan type - Enter 1 for DCP or 2 for DBP

Part II Master and Prototype (M&P) Sponsor or Volume Submitter Practitioner Information - Enter all requested

information

2a Name of M&P sponsor or volume submitter practitioner

2b M&P sponsor or volume submitter practitioner EIN

2c Name of M&P plan or volume submitter specimen plan (see instructions)

Part III Certifications

This certification must be signed and dated by both parties before the end of the employer’s applicable five-year remedial amendment cycle as determined under Part III of 

Revenue Procedure 2007-44 (see instructions regarding who must sign).

3 Under penalties of perjury the employer identified in line 1a, certifies that it intends to adopt the plan identified in line 2c.

Signature / Title of employer Date

4 The M&P sponsor or volume submitter practitioner, listed above, certifies that an application for an opinion or advisory 

letter for the M&P plan or volume submitter specimen plan identified above was filed on or will be filed by

M M D D Y Y Y Y

Preparer’s signature / Title of M&P sponsor or volume submitter practitioner Date

For Paperwork Reduction Act Notice, see instructions. Cat. No. 37714B Form 8905 (1-2012)

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Form 8905 (1-2012) Page 2

General Instructions

Purpose of Form

Use Form 8905 to treat an employer as 

eligible for the 6-year remedial 

amendment cycle under Part IV of Rev. 

Proc. 2007-44, 2007-28 I.R.B. 54.

Who May File

An adopter of an individually designed 

plan or pre-approved plan (not otherwise 

entitled to the 6-year remedial 

amendment cycle) files this form when 

necessary to request that their 5-year 

remedial amendment cycle be converted 

to the 6-year remedial amendment cycle 

(as described under Parts III and IV of 

Rev. Proc. 2007-44).

When To Complete

Complete Form 8905 before the end of 

the employer’s 5-year remedial 

amendment cycle as determined under 

Part III of Rev. Proc. 2007-44.

How To File

File the completed Form 8905 by 

attaching it to one of the following 

applications.

• Form 5300, Application for 

Determination for Employee Benefit Plan

• Form 5307, Application for 

Determination for Adopters of Master or 

Prototype or Volume Submitter Plans

• Form 5310, Application for 

Determination for Terminating Plan

▲!

CAUTION

If no Form 5300, 5307, or 5310 

filing is made, the employer 

should keep the original 

certification in their records 

and should not file Form 8905 with the 

IRS.

Filing a Complete 

Certification

Certifications are screened for 

completeness. The certification must be 

signed and dated by the employer and 

the pre-approved plan sponsor or 

practitioner.

▲!

CAUTION

You must retain a complete 

certification until it is filed with 

the appropriate application.

Specific Instructions

Part I – Plan Sponsor 

Information

Line 1a – Employer name. Enter the

company (employer’s) complete name.

Line 1b – Employer Identification 

Number (EIN). Enter the 9-digit EIN

assigned to the plan sponsor/employer.

▲!

CAUTION

Do not use a social security 

number or the EIN of the trust.

Line 1c – Employer’s plan name. Enter

the name of the employer’s plan which

will be amended or restated by the

adoption of a pre-approved plan.

Line 1e – Plan Type.

• Enter “1” for a defined contribution 

plan (DCP).

• Enter “2” for a defined benefit plan 

(DBP).

Part II – M&P Sponsor or 

Volume Submitter 

Practitioner

Line 2a – Name of M&P sponsor or 

volume submitter practitioner. Enter

the name of the M&P sponsor or volume 

submitter practitioner whose plan you 

will be adopting.

Line 2b – M&P sponsor or volume 

submitter practitioner EIN. Enter the 9-

digit EIN assigned to the M&P sponsor

or volume submitter practitioner.

Line 2c – Name of the M&P plan or 

volume submitter specimen plan. 

Enter the name of the M&P plan or 

volume submitter specimen plan the 

employer intends to adopt.

Example. Volume Submitter Profit

Sharing Plan.

Part III – Certifications

The employer and the M&P sponsor or 

volume submitter practitioner must sign 

and date this certification before the end 

of the employer’s applicable 5-year 

remedial amendment cycle as 

determined under Part III, of Rev. Proc. 

2007-44. The employer must manually 

sign the form. Scanned or stamped 

signatures will not be accepted. The 

M&P sponsor and the volume submitter 

practitioner may use a stamped, 

scanned, or electronic signature.

Line 4. Enter the date by which the

opinion or advisory letter application for

the M&P plan or volume submitter 

specimen plan being adopted by the 

employer was or must be submitted as 

determined under Part IV of Rev. Proc. 

2007-44.

Paperwork Reduction Act Notice. We

ask for the information on this form to

carry out the Internal Revenue laws of

the United States. You are required to

give us the information. We need it to

ensure that you are complying with these 

laws and to allow us to figure and collect 

the right amount of tax.

You are not required to provide the 

information requested on a form that is 

subject to the Paperwork Reduction Act 

unless the form displays a valid OMB 

control number. Books or records 

relating to a form or its instructions must 

be retained as long as their contents 

may become material in the 

administration of any Internal Revenue 

law. Generally, tax returns and return 

information are confidential, as required 

by Internal Revenue Code section 6103.

The time needed to complete and file 

this form will vary depending on 

individual circumstances. The estimated 

average time is:

Recordkeeping . . . 3 hr., 21 mins.

Learning about the law 

or the form . . . . . . 12 mins.

Preparing, copying, 

assembling, and sending 

the form to the IRS . . . 15 mins.

If you have comments concerning the 

accuracy of these time estimates or 

suggestions for making this form 

simpler, we would be happy to hear from 

you. You can write to the Internal 

Revenue Service, Tax Products 

Coordinating Committee, 

SE:W:CAR:MP:M:T:S, 1111 Constitution 

Ave., NW, IR-6526, Washington, DC 

20224. Do not send Form 8905 to this 

address; instead, see the instructions for 

the application with which this form is 

filed.