The form you are looking for begins on the next page of this file. Before viewing it, 

please see the important update information below.

New Mailing Address

The mailing address for certain forms have change since the forms were last published. 

The new mailing address are shown below. 

Mailing Address for Forms 1023, 1024, 1024-A, 1028, 5300, 5307, 5310, 5310-A, 5316, 

8717, 8718, 8940:

Internal Revenue Service 

TE/GE Stop 31A Team 105 

P.O. Box 12192 

Covington, KY 41012–0192

Deliveries by private delivery service (PDS) should be made to:

Internal Revenue Service 

7940 Kentucky Drive 

TE/GE Stop 31A Team 105 

Florence, KY 41042

This update supplements these forms’ instructions. Filers should rely on this update for 

the change described, which will be incorporated into the next revision of the form’s 

instructions.
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Form 8717

(Rev. September 2017)

Department of the Treasury 

Internal Revenue Service

User Fee for Employee Plan Determination 

Letter Request

▶ Attach to determination letter application. 

▶ Go to www.irs.gov/Form8717 for the latest information.

For 

IRS 

Use 

Only

OMB No. 1545-1772

Amount paid

1 Name of plan sponsor (employer if single-employer plan)

2 Sponsor’s employer identification number 3 Plan number 4 Plan name

Caution: If you qualify for the exemption from user fees for small business employers, complete only the certification below. See the instructions on 

page 2 for details. For all other applications, leave the certification blank and check the appropriate box and enter the user fee in column B of line 5.

Certification

I certify that the application for a determination letter on the qualified status of the plan listed above meets the conditions for 

exemption from user fees described in section 7528(b)(2)(B) of the Internal Revenue Code.

Sign Here ▶ Date ▶

Type or print name and title ▶

Form Submitted

User Fee

A B 

Attach Check or Money Order Here

5a Form 5300: $ 

b Form 5307: $

c Form 5310: $

d

e Multiple employer plans (Form 5300) . . . . . . . . . . . . . $

f Multiple employer plans (Form 5310) . . . . . . . . . . . . . $

g Reserved

(1a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(1b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(2a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(2b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Reserved

(1a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(1b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(4a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(4b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Form 5316: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

Cat. No. 64727O Form 8717 (Rev. 9-2017)
Form 8717 (Rev. 9-2017) Page 2

Section references are to the Internal Revenue 

Code unless otherwise noted.

Future Developments

For the latest information about developments 

related to Form 8717 and its instructions, 

such as legislation enacted after they were 

published, go to www.irs.gov/Form8717. 

What’s New

Specific user fee amounts are no longer listed 

on Form 8717. You must now enter the 

appropriate user fee when completing line 5. 

Notice 2011-86 is obsoleted. 

Note: www.pay.gov can be used to pay your 

user fee. Be sure to include the payment 

confirmation page along with Form 8717.

General Instructions

Purpose of Form

Generally, a user fee is required with each 

application for a determination letter. Use 

Form 8717 to submit the appropriate user fee.

Note: Don't use any part of the form that is 

shaded in gray. Those portions of the form are 

no longer functional.

Specific Instructions

Exemption From User Fee

The exemption from the user fee applies to all 

eligible employers (defined later) who request 

a determination letter within the first 5 plan 

years or, if later, by the end of any remedial 

amendment period with respect to the plan 

that begins within the first 5 plan years 

(“qualifying open remedial amendment 

period”). The IRS will treat an application for a 

determination letter as being filed within a 

qualifying open remedial amendment period if 

the plan was first in existence no earlier than 

January 1 of the 10th calendar year preceding 

the year in which the application is filed (the 

“10-year rule”). 

Example. If a determination letter 

application for a plan that was first in 

existence during 2007 is filed on 

December 1, 2017, then the IRS will treat the 

application as having been filed within a 

qualifying open remedial amendment period.

If an application does not satisfy the 10-

year rule requirements, but the application 

satisfies the user fee exemption requirements 

under section 7528(b)(2)(B) (for example, in a 

case in which a qualifying open remedial 

amendment period ends more than 10 years 

after the year in which the plan is first in 

existence), then no user fee is required. The 

applicant should complete only the 

Certification and explain in a cover letter how 

the application satisfies the user fee 

exemption requirements under 

section 7528(b)(2)(B).

Where To File (Include Form 8717 and user fee with your request or 

application.)

IF you have this type of 

request or application . . .

THEN use this address if you send it by:

U.S. mail Express Mail or 

private delivery service

Determination letter 

(Form 5307, 5300, 5310, 5310-A, 

or 5316)

Internal Revenue Service 

Attn: EP Determination 

Letters, Stop 31 

P.O. Box 12192 

Covington, KY 41012-0192

Internal Revenue Service 

Attn: EP Determination 

Letters, Stop 31 

201 West Rivercenter Blvd. 

Covington, KY 41011

See Notice 2002-1, 2002-1 C.B. 283 as 

amplified by Notice 2017-1, 2017-2 I.R.B. 

367.

An eligible employer as defined in section 

408(p)(2)(C)(i)(l) is an employer which had no 

more than 100 employees who received at 

least $5,000 of compensation from the 

employer for the preceding year. In addition, 

an eligible employer must have at least one 

employee who is not a highly compensated 

employee (as defined in section 414(q)) and is 

participating in the plan.

The determination of whether an employer 

is an eligible employer is made as of the date 

of the request described above. If your 

application meets these requirements for an 

exemption, complete only the Certification.

Don't complete any part of line 5.

Payment of User Fee

If you don't meet the conditions for exemption 

discussed earlier, a user fee is due.

Line 5. User fee. To determine the 

appropriate user fee to enter on line 5, go to 

www.irs.gov/Retirement-Plans/User-FeesFor-Employee-Plans-Determination-OpinionAnd-Advisory-Letters. The schedule for user 

fees is also set forth in Rev. Proc. 2017-4, 

2017-1 I.R.B. 146, available at www.irs.gov/

irb/2017-01_IRB/ar10.html, or the latest 

annual update.

Check the appropriate box and enter the 

user fee in column B of line 5. Attach to the 

left side of the form a check or money order 

payable to “United States Treasury” for the 

full amount of the user fee to Form 8717, if 

applicable. If payment was made through 

www.pay.gov, a copy of the payment 

confirmation must also be submitted. If you 

don't include the full amount, your application 

may be returned. Attach Form 8717 to your 

determination letter application.

If you have multiple plans, submit a 

separate determination letter application and 

Form 8717 for each plan.

Paperwork Reduction Act Notice. We ask

for the information on this form to carry out

the Internal Revenue laws of the United

States. If you want to have your plan

approved by the IRS, you are required to give

us the information. We need it to determine

whether you meet the legal requirements for

plan approval. Section 7528 authorizes us to 

charge a user fee.

You aren't required to provide the 

information requested on a form 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 section 6103. 

The time needed to complete and file this 

form will vary depending on individual 

circumstances. The estimated average time is:

Recordkeeping . . . . .8 hr., 7 min.

Learning about the law 

or the form . . . . . . . . 57 min.

Preparing, copying, assembling 2 hr., 4 min.

Sending the form to the IRS . . 16 min.

If you have comments about 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/FormsPubs. Click on “More 

Information” and then on “Give us feedback.” 

Or you can write to:

Internal Revenue Service 

Tax Forms and Publications 

1111 Constitution Ave. NW, IR-6526 

Washington, DC 20224

Don't send this form to this address. 

Instead, see Where To File, earlier.