I request an extension of time until / / to file Form 5500 or Form 5500-EZ.

OMB No. 1545-0212 Form 5558 Application for Extension of Time

To File Certain Employee Plan Returns (Rev. January 2007)

Department of the Treasury

Internal Revenue Service File With IRS Only © For Paperwork Reduction Act Notice, see instructions on page 3.

1

2

Plan name Plan year ending—

Enter the Code section(s) imposing the tax © a

Under penalties of perjury, I declare that to the best of my knowledge and belief, the statements made on this form are true, correct, and complete, and that I am

authorized to prepare this application.

Signature © Date ©

This application for extension to file Form 5330 IS approved to the date shown on line 2.

(You must attach an approved copy of this form to each Form 5330 that was granted an extension.)

This application for an extension for Form 5330 is not approved, because:

The application was not signed.

No reason was given on this application or the reason was not acceptable.

Other ©

Employer identification number (EIN).

Filer’s identifying number (see instructions).

Applicants for extension of Form 5330: Complete if you want this Form 5558 returned to an address other than the address shown above.

Name

Print

or

Type

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

City or town, state, and ZIP code

A 10-day grace period is granted from the date shown below or the due date of the return, whichever is later.

(You must attach a copy of this form to each return you file that is granted a grace period.)

Notice to

Applicant

To Be

Completed 

by the IRS

if Part III

is

Completed

The date entered on line 2 is more than the 6-month maximum time allowed for Form 5330. This application is approved 

to (You must attach an approved copy

of this form to each Form 5330 that was granted an extension.)

The application for an extension for Form 5330 is not approved, because it was filed after the normal due date of the

return. (A 10-day grace period is not granted.)

The application is automatically approved to the date shown on line 1 (above) if: (a) the Form 5558 is filed on or before the

normal due date of Form 5500 or 5500-EZ for which this extension is requested, and (b) the date on line 1 is no more than 21⁄2

months after the normal due date.

To Be Completed by the IRS if Part III is completed Ä

You must attach a copy of this Form 5558 to each Form 5500 and 5500-EZ filed after the due date for the plans listed in C above.

MM DD

Name of filer, plan administrator, or plan sponsor (see instructions)

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

City or town, state, and ZIP code Social security number (SSN)

No reason was given on this application or the reason was not acceptable.

No payment was attached for the tax due on Form 5330.

A B

C

I request an extension of time until / / to file Form 5330.

You may be approved for up to a six (6) month extension to file Form 5330, after the normal due date of Form 5330.

b Enter the payment amount attached ©

c For excise taxes under section 4980 or 4980F of the Code, enter the reversion/amendment date ©

3 State in detail why you need the extension

a

b

c

Part III

Part I

Part II Extension of Time to File Form 5500 or Form 5500-EZ (see instructions)

Identification

Extension of Time to File Form 5330 (see instructions)

1

2

3

(Date) (Director)

By:

YYYY

Plan

number

Note. A signature is not required if you are requesting an extension to file Form 5500 or Form 5500-EZ.
Form 5558 (Rev. 1-2007) Page 2

Purpose of Form

An extension of time to file a Form

5500 or Form 5500-EZ does not

operate as an extension of time to file

the PBGC Form 1.

Exception: Form 5500 and Form

5500-EZ filers are automatically

granted extensions of time to file until

the extended due date of the federal

Use Form 5558 to apply for a

one-time extension of time to file Form

5500, Form 5500-EZ, or Form 5330.

How to file. In general, a separate

Form 5558 is used for each return for

which you are requesting an

extension. However, if you are a single

employer and all your plan years end

on the same date, file only one Form

5558 to request an extension of time

to file more than one Form 5500 or

Form 5500-EZ. Attach a photocopy of

the completed extension request to

your Form 5500 or Form 5500-EZ.

Where To File

General Instructions

File Form 5558 with the Internal

Revenue Service Center, Ogden, UT

84201-0027.

Private Delivery Services. You can

use certain private delivery services

designated by the IRS to meet the

“timely mailing treated as timely

filing/paying” rule for tax returns and

payments. If you use a private delivery

service designated by the IRS (rather

than the U.S. Postal Service) to send

your return, the postmark date

generally is the date the private

delivery service records in its database

or marks on the mailing label. The

private delivery service can tell you

how to get written proof of this date.

The following are designated private

delivery services:

An extension of time to file

does not extend the time

to pay the tax due. Any tax

due must be paid with this

application. Additionally, interest is

charged on taxes not paid by the due

date even if an extension of time to file

is granted.

CAUTION

B. Filer’s Identifying Number

Enter your name and address in the

heading if you are a single employer

requesting an extension of time to file

the Form 5500 or Form 5500-EZ. If

you are filing for other than a single

employer, enter the plan

administrator’s or plan sponsor’s

name and address on the application.

The plan sponsor listed on this

Include the suite, room, or other unit

number after the street address. 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. If you

want this form returned to a different

name and/or address, also complete

the name/address section at the

bottom of the form.

Employer Identification Number

(EIN). Enter the nine-digit EIN

assigned to the employer for all

applications filed for Form 5500 or

Form 5500-EZ. Also enter the EIN for

applications filed for Form 5330 (see

Social Security Number (SSN) below

for exceptions).

Specific Instructions

A. Name and Address

● Federal Express (FedEx): FedEx

Priority Overnight, FedEx Standard

Overnight, FedEx 2 Day, FedEx

International Priority, and FedEx

International First.

● United Parcel Service (UPS): UPS

Next Day Air, UPS Next Day Air Saver,

UPS 2nd Day Air, UPS 2nd Day Air

A.M., UPS Worldwide Express Plus,

and UPS Worldwide Express.

Part I. Identification

The online application process is

not yet available for corporations with

addresses in foreign countries or

Puerto Rico.

● By telephone at 1-800-829-4933

from 7:00 a.m. to 10:00 p.m. in the

employer’s local time zone.

● Employers who do not have an EIN

may apply for one by attaching a

completed Form SS-4, Application for

Employer Identification Number, to this

form.

Social Security Number (SSN). If you

made excess contributions to a Code

section 403(b)(7)(A) custodial account

or you are a disqualified person other

than an employer, enter your SSN.

If the employer does not have an

EIN, the employer must apply for one.

An EIN can be applied for:

● Online by clicking the Employer ID

Numbers (EINs) link at

www.irs.gov/businesses/small. The EIN

is issued immediately once the

application information is validated.

C. Plan Information

Complete the entire table (plan name,

plan number, and plan year ending) for

all plans included on this Form 5558.

Part II. Extension of Time to

File Form 5500 or Form

5500-EZ

Use Form 5558 to apply for a

one-time extension of time to file

Form 5500 or Form 5500-EZ.

● DHL Express (DHL): DHL Same Day

Service, DHL Next Day 10:30 am, DHL

Next Day 12:00 pm, DHL Next Day

3:00 pm, and DHL 2nd Day Service.

When to file. To request an extension

of time to file Form 5500 or Form

5500-EZ, file Form 5558 on or before

the return’s normal due date. The

normal due date is the date the Form

5500 or Form 5500-EZ would

otherwise be due, without extension.

application should be the same as the

plan sponsor listed on the annual

return/report filed for the plan.

income tax return of the employer (and 

are not required to file Form 5558) if

all the following conditions are met: (1)

the plan year and the employer’s tax

year are the same; (2) the employer

has been granted an extension of time

to file its federal income tax return to a

date later than the normal due date for

filing the Form 5500 or Form 5500-EZ;

and (3) a photocopy of the IRS

extension of time to file the federal

income tax return is attached to the

Form 5500 or Form 5500-EZ. An

extension granted under this exception

cannot be extended further by filing a

Form 5558 after the normal due date

of the Form 5500 or Form 5500-EZ.

Approved copies of Form 5558,

requesting an extension to file Form

5500 or Form 5500-EZ, will not be

returned to the filer from the IRS.

Line 1. Enter on line 1 the due date

for which you are requesting to file

Form 5500 or Form 5500-EZ. This

date should not be more than 21⁄2

months after the normal due date of

the return.

Applications for extension of time to

file Form 5500 and Form 5500-EZ that

are filed on or before the

return/report’s normal due date on a

properly completed Form 5558 will be

automatically approved to the date

that is not more than 21⁄2 months after

the return/report’s normal due date.

When using Form 5558 to request

an extension of time to file Form 5500

or Form 5500-EZ plan sponsors or

plan administrators are not required to

sign the form. If Form 5558 is timely

filed and complete, you will be granted

an additional 21⁄2 months to file Form

5500 or Form 5500-EZ.
Form 5558 (Rev. 1-2007) Page 3

We ask for the information on this

form to carry out the Internal Revenue

laws of the United States. We need it

to determine if you are entitled to an

extension of time to file Form 5500,

5500-EZ, or 5330. If you want an

extension, you are required to give us

the information. Section 6109 requires

you to provide your taxpayer

identification number (SSN or EIN). If

you fail to provide this information in a

timely manner, you may be liable for

penalties and interest.

Privacy Act and Paperwork

Reduction Act Notice

Line 2. On line 2, enter the requested

due date. If your application for

extension of time to file Form 5330 is

approved, you may be granted an

extension of up to 6 months after the

normal due date of Form 5330. Signature. If you are filing Form 5558

for an extension to file Form 5330, the

form must be signed. The person who

signs this form may be an employer,

plan sponsor, plan administrator, a

disqualified person required to file

Form 5330, an attorney or certified

public accountant qualified to practice

before the IRS, a person enrolled to

practice before the IRS, or a person

holding a power of attorney.

Line 2a. Indicate the Code section(s)

for the excise tax you are requesting

an extension.

Line 2b. Enter the amount of tax

estimated to be due with Form 5330

and attach your payment to this form.

If we grant you an

extension of time to file

Form 5330 and later find

that the statements made

on this form are false or misleading,

the extension will be null and void. A

late filing penalty associated with the

form for which you filed this extension

will be charged.

CAUTION

Applications for extension of time to

file Form 5330 will be returned to you

as approved or not approved.

When to file. To request an extension

of time to file Form 5330, file Form

5558 in sufficient time for the Internal

Revenue Service to consider and act

on it before the return’s normal due

date.

The normal due date is the date the

Form 5330 would otherwise be due,

without extension.

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 Code section 6103.

The time needed to complete and

file this form will vary depending on

individual circumstances. The

estimated average time: 33 minutes.

If you have comments concerning

the accuracy of this time estimate 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:T:T:SP, 1111

Constitution Ave., NW, IR-6406,

Washington, DC 20224. Do not send

the tax form to this address. Instead,

see Where To File on page 2.

However, section 6103 allows or

requires the Internal Revenue Service

to disclose or give the information

shown on your tax return to others as

described in the Code. For example,

we may disclose your tax information

to the Department of Justice to

enforce the tax laws, both civil and

criminal, and to cities, states, the

District of Columbia, U.S.

commonwealths or possessions, and

certain foreign governments to carry

out 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 law, or to federal law

enforcement and intelligence agencies

to combat terrorism.

If you changed your mailing address

after you filed your last return, use

Form 8822, Change of Address, to

notify the IRS of the change. You can

get Form 8822 by calling

1-800-829-3676 or you can access

the IRS website at www.irs.gov 24

hours a day, 7 days a week.

that you are unable to file Form 5330

because of circumstances beyond

your control. Clearly describe these

circumstances. Generally, an

application will be considered on the

basis of your own efforts to fulfill this

filing responsibility, rather than the

convenience of anyone providing help

in preparing the return. However,

consideration will be given to any

circumstances that prevent your

practitioner, for reasons beyond his or

her control, from filing the return by

the normal due date, and to

circumstances in which you are unable

to get needed professional help in

spite of timely efforts to do so.

File one Form 5558 to request an

extension of time to file Form 5330 for

excise taxes with the same filing due

date. For specific information on

excise tax due dates, see the

Instructions for Form 5330.

Part III. Extension of Time to

File Form 5330

Make your check or money order

payable to the “United States

Treasury.” Do not send cash. On all

checks or money orders, write your

name, Filer’s identifying number (EIN

or SSN), Plan number, Form 5330

Section number, and the tax year to

which the payment applies.

Line 3. The IRS will grant a

reasonable extension of time (not to

exceed 6 months) for filing Form 5330

if you file a timely application showing