Form 8717-A

(August 2014)

Department of the Treasury 

Internal Revenue Service

User Fee for Employee Plan Opinion 

or Advisory Letter Request

▶ Attach to applicable Form 4461, 4461-A, or 4461-B. 

▶ For the latest information about this form, go to www.IRS.gov/form8717.

For 

IRS 

Use 

Only

OMB No. 1545–1772

Amount paid

1 Name of plan sponsor/practitioner

2 Sponsor’s/practitioner's employer identification number 3 Plan number

4 Plan name

Applications Fee Schedule

Attach Check or Money Order Here

5a Volume submitter

(1a) Specimen plan (nonmass) with no/one adoption agreement . . . . . . . . . . . (1a) $ 14,000

(1b) Specimen plan (nonmass) – per each additional adoption agreement . . . . . . . . (1b) $ 11,000

(2a) Mass submitter specimen plan with no/one adoption agreement . . . . . . . . . (2a) $ 16,000

(2b) Mass submitter – per each additional adoption agreement . . . . . . . . . . . . (2b) $ 2,000

(3) Specimen plan identical to mass submitter specimen plan . . . . . . . . . . . . (3) $ 400

(4) Assumption of sponsorship of an approved specimen plan – per basic plan document . . (4) $ 300

(5) Change in name and/or address of practitioner of an approved specimen plan – per basic 

plan document . . . . . . . . . . . . . . . . . . . . . . . . . . (5) $ 0

(6) Mass submitter/nonmass submitter practitioner – per trust document in excess of 10 . . . (6) $ 1,000

5b Master & Prototype (M&P):

(1a) Mass Submitter – per basic plan document with one adoption agreement . . . . . . . (1a) $ 16,000

(1b) Mass Submitter – per each additional adoption agreement . . . . . . . . . . . (1b) $ 2,000

(2) Sponsor’s identical adoption of mass submitter basic plan document – per adoption 

agreement . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) $ 400

(3) Sponsor’s minor modification of mass submitter basic plan document – per adoption 

agreement . . . . . . . . . . . . . . . . . . . . . . . . . . . (3) $ 1,000

(4a) Nonmass submitter – per basic plan document with one adoption agreement . . . . . (4a) $ 14,000

(4b) Nonmass submitter – per each additional adoption agreement . . . . . . . . . . (4b) $ 11,000

(5) Opinion letter for additional optional provisions – per mass submitter basic plan document . (5) $ 1,000

(6) Assumption of sponsorship of an approved M&P plan – per basic plan document . . . . (6) $ 300

(7) Change in name and/or address of sponsor of an approved M&P plan – per basic plan 

document . . . . . . . . . . . . . . . . . . . . . . . . . . . . (7) $ 0

(8) Mass submitter/nonmass submitter sponsor – per trust document in excess of 10 . . . . (8) $ 1,000

Cat. No. 60826Q Form 8717-A (8-2014)
Form 8717-A (8-2014) Page 2

Instructions

(Section references are to the Internal 

Revenue Code unless otherwise noted.)

Generally, a user fee is required with each 

application for an opinion or advisory letter. 

The user fees are shown on page 1. 

Information on this Form was previously 

requested on Form 8717. For more 

information, see Rev. Proc. 2014-8, 

2014-1 I.R.B. 242 (available at 

www.irs.gov/pub/irs-irbs/irb14-01.pdf) or 

latest annual update.

Effective Date

The user fee schedule in this revision of Form 

8717-A is effective for opinion and advisory 

letter applications postmarked on or after 

February 1, 2014, unless the user fee 

schedule is changed through subsequent 

guidance. Use of this revision of Form 8717-A 

is mandatory for applications postmarked on 

or after August 1, 2014. If using the prior 

version of Form 8717-A before August 1, 

2014, please ensure that the current user fee 

is paid as specified in Rev. Proc. 2014-8. 

Always check the user fee Revenue 

Procedure for updates and use the correct 

fee.

Check the appropriate box on line 5 and 

attach a check or money order payable to 

“United States Treasury” for the full amount of 

the user fee to Form 8717-A. If you do not 

include the full amount, your application may 

be returned.

Attach Form 8717-A to the opinion or 

advisory letter application for Forms 4461, 

4461-A, and 4461-B.

If you have multiple plans, submit a 

separate opinion or advisory letter application 

and Form 8717-A for each plan.

Where To File

Include Form 8717-A and user fee with your 

request or application.

Send your request or application to one 

of the following:

If sent via U.S. mail,

Internal Revenue Service 

P.O. Box 2508 

Attn: Pre-Approved Plans Coordinator 

Room 5106, Group 7521 

Cincinnati, OH 45201

If sent via Express Mail or Private 

Delivery Service,

Internal Revenue Service 

550 Main Street 

Attn: Pre-Approved Plans Coordinator 

Room 5106, Group 7521 

Cincinnati, OH 45202

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 are not 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 . . . . 1 hr., 12 min.

Learning about the law 

or the form . . . . . . . . 34 min.

Preparing, copying, 

assembling, and sending 

the form to the IRS . . . 1 hr., 48 min.

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 send your 

comments to the Internal Revenue Service, 

Tax Forms and Publications Division, Room 

6526, 1111 Constitution Ave. NW, 

Washington, DC 20224. 

Do not send this form to this address. 

Instead, see Where To File, earlier.