Form 5306 

(Rev. November 2019) 

Department of the Treasury 

Internal Revenue Service 

Application for Approval of Prototype or Employer 

Sponsored Individual Retirement Arrangement (IRA) 

(Under section 408(a), (b), (c), or (p) or section 408A of the Internal Revenue Code) 

▶ Go to www.irs.gov/Form5306 for the latest information.

OMB No. 1545-0390 

For IRS Use Only 

1 Enter amount of user fee submitted. See Specific Instructions ▶ $ File folder number

Part I Identifying Information (see instructions before completing this part) 

2 Approval requested for: 

a Type of individual retirement arrangement— 

(1) Prototype traditional IRA under section 408(a) or 408(b) (2) Prototype Roth IRA under section 408A 

(3) Prototype dual-purpose IRA (4) Prototype SIMPLE IRA under section 408(p) 

(5) Roth or traditional IRA established by employer or 

employee association under section 408(c)

b Initial application 

c Amendment—Enter ▶ (1) Latest letter serial number (2) Date letter issued (3) File folder number 

3a Name of applicant 

Number, street, and room or suite no. (if a P.O. box, see instructions) 

City or town, state, and ZIP code 

3b Employer identification 

number of applicant 

4a Name of person to be contacted 4b Telephone number 

4 c Email address 

4d If a power of attorney is attached, check box . . ▶

5 a Type of sponsoring organization (if you are applying for a ruling under section 408(c), do not complete this item): 

(1) Insurance company 

(2) Trade or professional association 

(3) Savings and loan association that qualifies as a bank 

(4) Bank 

(5) Regulated investment company 

(6) Federally insured credit union 

(7) Approved non-bank trustee (attach copy of approval letter)

b Type of submission (check one box):

(1) Not a mass submitter (2) Mass submitter

(3) Identical adoption of a mass submitter (4) Minor modification of a mass submitter

6 Name of trustee or custodian 

Number, street, and room or suite no. (if a P.O. box, see instructions) 

City or town, state, and ZIP code 

7 Type of funding entity: 

a Trust 

b Custodial account 

c Insurance company

Annuity contract or endorsement number (see instructions) ▶

Sign 

Here 

Under penalties of perjury, I declare that I have examined this application, including accompanying statements, and, to the best of my knowledge and belief, 

it is true, correct, and complete. 

▲

Signature of officer Date ▲

Title 

For Privacy Act and Paperwork Reduction Act Notice, see instructions. Cat. No. 11830C Form 5306 (Rev. 11-2019) 
Form 5306 (Rev. 11-2019) Page 2 

Part II Plan Information 

Attach a copy of the plan documents and indicate the article or section reference and the page number 

where the following provisions appear. If an item does not apply, enter “N/A.” Sample language, or a listing 

of required modifications (LRMs), is available at www.irs.gov/LRMS. Sponsors are encouraged to use LRM 

language.

Article or 

Section 

Reference 

Page 

Number 

For IRS 

Use 

Only 

8a Does the IRA provide that the trust is created for the exclusive benefit of the participant 

or his or her beneficiaries, or that the annuity contract must be owned only by the 

annuitant? . . . . . . . . . . . . . . . . . . . . . . . . . 1/13 

b Does the IRA describe the type of allowable contributions (that is, only cash except 

for rollovers) and maximum limitation? . . . . . . . . . . . . . . . . 2/14 

c Does the IRA prohibit the investment of trust assets in collectibles, or contain a 

statement informing individuals that an investment in collectibles, except for 

investments in certain coins and precious metals, will be treated as a taxable 

distribution? . . . . . . . . . . . . . . . . . . . . . . . . . 3 

d Does the IRA prohibit investment in life insurance contracts? . . . . . . . . . 4 

e Does the IRA provide the rules on required distributions commencing before death? . 5/15 

f Does the IRA provide the rules on required distributions commencing after death? . 6/16 

g Does the IRA provide that the account is nonforfeitable? . . . . . . . . . . 7/17 

h Does the IRA provide that the contract is nontransferable? . . . . . . . . . 18 

i Does the IRA provide for application of premium refund (other than refunds attributable 

to excess contributions) before the end of the calendar year following the year of the 

refund toward the payment of future premiums or the purchase of additional benefits? 19 

j Does the IRA prohibit commingling assets of trusts? . . . . . . . . . . . 8 

k Does the IRA provide that annuity contracts must have flexible premiums? . . . . 20 

l Does the IRA provide for a separate accounting for the interest of each employee or 

member of the association? . . . . . . . . . . . . . . . . . . . . 9 

m Does the IRA provide for annual calendar-year reports by trustees or issuers? . . . 10/21 

n Does the IRA require substitution of non-bank trustee or custodian when notified by 

the Commissioner of the Internal Revenue Service? . . . . . . . . . . . . 11 

o Does the IRA define compensation? . . . . . . . . . . . . . . . . . 12/22 

Form 5306 (Rev. 11-2019) 
Form 5306 (Rev. 11-2019) Page 3 

General Instructions

Section references are to the Internal 

Revenue Code unless otherwise noted. 

Future developments. For the latest 

information about developments related 

to Form 5306 and its instructions, such 

as legislation enacted after this form and 

instructions were published, go to 

www.irs.gov/Form5306. 

Purpose of form. Sponsoring 

organizations, employers, or employee 

associations, use Form 5306 to request 

a ruling as to: 

• Whether a trust or custodial account 

agreement meets the requirements of 

section 408(a), 408(c), 408(p), or 408A; or 

• Whether an individual annuity meets 

the requirements of section 408(b), 

408(p), or 408A. 

Who May File

Opinion letters on prototype IRAs. 

Form 5306 may be filed by a sponsoring 

organization that is: 

• A bank (including savings and loan 

associations that qualify as banks and 

federally insured credit unions), 

• Any person who has IRS approval to 

act as a trustee or custodian, 

• An insurance company, 

• A regulated investment company, or 

• A trade or professional society or 

association (other than employee 

associations).

Rulings under section 408(c). 

Employers or employee associations 

who want a ruling under section 408(c) 

for a trust that will be used for individual 

retirement accounts may file this form. 

The term “employee association” means 

any organization composed of two or 

more employees, including, but not 

limited to, an employee association 

described in section 501(c)(4). 

Who does not need to file. Sponsors of 

programs that use any of the Form 5305 

series of model forms should not submit 

their programs to the IRS. These model 

forms, issued by the IRS, contain 

language that, if followed, will satisfy the 

applicable statutory requirements. 

What to file. File Form 5306 and a copy 

of the trust, custodial account, or annuity 

contract and all other applicable 

documents. If you are requesting an 

opinion letter for an annuity where all the 

Internal Revenue Code requirements are 

set forth in a separate endorsement that 

supersedes any conflicting language in 

any contract to which it may be 

attached, submit the endorsement and 

not the contract.

Where to file. File Form 5306 at this 

address.

Internal Revenue Service 

Attn: EP Opinion Letters 

TE/GE Stop 31A Team 105 

P.O. Box 12192 

Covington, KY 41012-0192

Private delivery services (PDSs). PDSs 

can’t deliver to the address shown 

above. If you choose to use a PDS, send 

Form 5306 to this address.

Internal Revenue Service 

Attn: EP Opinion Letters 

TE/GE Stop 31A Team 105 

7940 Kentucky Drive 

Florence, KY 41042

Go to www.irs.gov/PDS for the current 

list of designated services.

Address. Include the suite, room, or 

other unit number after the street 

number. If the Post Office does not 

deliver mail to the street address and 

you have a P.O. box, show the box 

number instead of the street address. 

Signature. An officer who is authorized 

to sign or another person authorized 

under a power of attorney must sign this 

application. Send the power of attorney 

with this application when you file it. 

Specific Instructions 

User fee. All applications must be 

accompanied by the appropriate user 

fee. Applications submitted without the 

proper user fee will not be processed 

and will be returned to the applicant. 

To find the proper user fee, see Rev. 

Proc. 2019-4, 2019-1 I.R.B. 146, 

available at www.irs.gov/

irb/2019-01_IRB#RP-2019-04, or the 

latest annual update.

Line 2c. If you are amending your plan, 

enter the file folder number, letter serial 

number, and date from the latest opinion 

letter you received for your plan. 

Line 7c. Identify the endorsement, the 

contract, or both for which you are 

requesting an opinion letter.

Privacy Act and Paperwork 

Reduction Act Notice 

We ask for the information on this form to 

carry out the Internal Revenue laws of the 

United States. 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. This information is needed 

to process your application and to 

determine whether your individual 

retirement account or individual 

retirement annuity meets the 

requirements of section 408(a), 408(b), 

408(c), 408(p), or 408A. You are not 

required to apply for approval; however, if 

you want to receive a ruling from the IRS 

regarding your prototype or employee 

sponsored individual retirement 

arrangement, you are required to provide 

the information requested on this form. 

Section 6109 requires you to provide the 

requested identification numbers. Failure 

to provide the information may delay or 

prevent processing your application; 

providing any false information may 

subject you to penalties.

 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 stated in 

section 6103. However, section 6103 

allows or requires the Internal Revenue 

Service to disclose or give such 

information to the Department of Justice 

for civil and criminal litigation, and to 

cities, states, the District of Columbia, 

and U.S. commonwealths and 

possessions for use in administering 

their tax laws. We may also disclose this 

information to other countries under a 

tax treaty, to federal and state agencies 

to enforce federal nontax criminal laws, 

or to federal law enforcement and 

intelligence agencies to combat 

terrorism. 

The time needed to complete and file 

this form will vary depending on 

individual circumstances. The estimated 

average time is: 

Recordkeeping . . . 11 hr., 43 min.

Learning about the 

law or the form . . . . . . 53 min.

Preparing and sending 

the form to the IRS . . 1 hr., 7 min.

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 send us comments from 

www.irs.gov/FormComments. Or you 

can write to Internal Revenue Service, 

Tax Forms and Publications Division, 

1111 Constitution Ave. NW, IR-6526, 

Washington, DC 20224. Do not send the 

form to this address. Instead, see Where 

to file, earlier.