Department of the Treasury - Internal Revenue Service
                                                                                                            OMB Number 
Form 15315                   Annual Certification for Multiemployer                                              1545-2111
(December 2022)
                                      Defined Benefit Plans
                       This Form is required to be filed under Internal Revenue Code (IRC) Section 432(b)(3)
                                      Complete all entries in accordance with the instructions
For calendar plan year        or fiscal plan year beginning                     and ending
Part I – Basic Plan Information
1a. Name of plan                                                               1b. Three-digit plan number (PN)

1c. Plan sponsor’s name                                                        1d. Employer identification number (EIN)

1e. Plan sponsor’s telephone number   1f.  Plan sponsor's address, city, state, ZIP code

Part II – Plan Actuary’s Information
2a. Plan actuary’s name               2b. Plan actuary’s firm name

2c. Plan actuary’s firm address, city, state, ZIP code

2d. Plan actuary’s enrollment number                        2e. Plan actuary’s telephone number

Part III – Plan Status
3. Check the appropriate box to indicate the plan’s IRC Section 432 status
Neither endangered nor critical       Not endangered due to special rule in IRC Section 432(b)(5)
Endangered                            Critical due to election under IRC Section 432(b)(4)
Seriously endangered                  Plans that are not currently in critical status, but are projected to be in critical status within 
                                      the next five years under 432(b)(3)(D)(v)
Critical
Critical and declining
Part IV – Scheduled Progress in Funding Improvement Plan or Rehabilitation Plan
4. Check the appropriate box to indicate whether the plan is making the scheduled progress in meeting the requirements of an 
applicable funding improvement plan (FIP) or rehabilitation plan (RP)
                                                                                                                 Yes No            N/A
Funding Improvement Plan
Rehabilitation Plan
Part V – Sign Here
Statement by Enrolled Actuary
To the best of my knowledge, the information supplied in this actuarial certification is complete and accurate. As required by IRC 
Section 432(b)(3)(B)(iii), the projected industry activity is based on information provided by the plan sponsor. The projections are based 
on reasonable actuarial estimates, assumptions and methods that (other than projected industry activity) offer my best estimate of 
anticipated experience under the plan.
Actuary’s signature                                                                              Date

Catalog Number 35051D                                 www.irs.gov                                           Form 15315 (12-2022)

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Instructions for Form 15315, Annual Certification for Multiemployer Defined Benefit Plans

Purpose of Form
The Form 15315, Annual Certification for Multiemployer Defined Benefit Plans, is used to report the actuarial certification of a 
multiemployer plan’s status. The plan actuary must file this form annually with the IRS to satisfy the reporting requirements of IRC 
Section 432(b)(3).
The Pension Protection Act of 2006 (PPA), Pub. L. 109-280, added IRC Section 432 to the Internal Revenue Code. IRC Section 432(b) 
generally provides for a determination by the enrolled actuary for a multiemployer plan as to whether the plan is in endangered status or 
in critical status for a plan year. IRC Section 432(b)(3) requires the plan actuary to submit a certification each plan year to the Secretary 
of the Treasury and to the plan sponsor. The plan actuary must certify whether the plan is in endangered status for the plan year (or 
would be in endangered status for the plan year but for the application of the special rule under IRC Section 432(b)(5)); whether the 
plan is or will be in critical status for the plan year or for any of the succeeding five plan years; and whether the plan is in critical and 
declining status for the plan year. The certification should include a statement as to whether the plan is making the scheduled progress 
in meeting the requirements of its funding improvement or rehabilitation plan. The actuarial projections, statements, and exhibits that 
are relevant to the determination of the plan status can be attached to this form.

Who Must File Form
The enrolled actuary of a multiemployer plan must annually certify the plan’s status and file this form with the IRS.

When to File
The Form 15315 must be filed no later than the 90th day after the beginning of the plan year for which the certification is made.
Note. If the filing due date falls on a Saturday, Sunday or legal holiday, the Form 15315 may be filed on the next day that is not a 
Saturday, Sunday or legal holiday.

Where to File
Submit your certification once per year using only one of the following methods.
Mail the form to:
Department of the Treasury 
Internal Revenue Service 
Employee Plans 
CHI-7602 - 25th Floor 
230 S. Dearborn St. 
Chicago, IL 60604
Fax the form to Employee Plans at 855-215-7122
Email the form to Employee Plans at EPCU@irs.gov with Multiemployer Certification in the subject line
Note. More than one submission will result in duplicate entries. The IRS cannot guarantee security with email submissions.

Who Must Sign
The plan's enrolled actuary must sign and date the Form 15315.

Penalties
Any failure of the plan actuary to certify the plan's status by the due date specified in IRC Section 432(b)(3)(A) will be treated for 
purposes of IRC Section 502(c)(2) of the Employee Retirement Income Security Act of 1974 as a failure or refusal by the plan 
administrator to file the annual report required to be filed with the Secretary under IRC Section 101(b)(1) of the Act. A penalty of up to 
$1,100 per day applies.
See ERISA section 502(c)(2), 29 CFR 2560.502c-2, and the Federal Civil Penalties Inflation Adjustment Act of 1990, as amended by 
the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015 (2015 Inflation Adjustment Act). Pub. L. No. 114-74; 129 
Stat. 599 and the DOL's implementing regulation at 86 FR 2964 (Jan. 15, 2021). The 2015 Inflation Adjustment Act requires agencies 
to adjust the levels of civil monetary penalties with an initial catch-up adjustment, followed by annual adjustments for inflation. Because 
the 2015 Inflation Adjustment Act requires the penalty amount to be adjusted annually, be sure to check DOL's website for any 
possible required inflation adjustments that may have been published in the Federal Register.

Specific Instructions
Part I - Basic Plan Information
Lines 1a and 1b. Enter the formal name of the plan and the three-digit plan number (PN) assigned to the plan.
Line 1c. Enter the plan sponsor’s name.
Line 1d. Enter the nine-digit employer identification number (EIN) assigned to the plan sponsor. Do not use a Social Security number in 
lieu of an EIN. A plan sponsor without an EIN must apply for an EIN from the IRS before using Form 15315.

Catalog Number 35051D                         www.irs.gov                                                    Form 15315 (12-2022)

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Line 1e. Enter the plan sponsor’s telephone number.
Line 1f. Enter the plan sponsor’s address including the room or suite number, the street address, the name of the city, the two-
character abbreviation of the U.S. State or Possession and the ZIP Code. If this is a foreign address, enter the foreign routing code and 
country name. Do not abbreviate the country name.

Part II - Plan Actuary’s Information
Line 2a. Enter the plan actuary’s name.
Line 2b. Enter the plan actuary firm’s name.
Line 2c. Enter the plan actuary firm’s address including the room or suite number, the street address, the name of the city, the two-
character abbreviation of the U.S. State or Possession and the ZIP Code. If this is a foreign address, enter the foreign routing code and 
country name. Do not abbreviate the country name.
Lines 2d and 2e. Enter the plan actuary’s enrollment number and telephone number.

Part III - Plan Status
Line 3. Check the appropriate box to indicate the plan’s status. See IRC Section 432(b) for determination of the plan’s status.
A plan is in endangered status if the plan is not in critical status and is not described in IRC Section 432(b)(5) and, as of the beginning 
of the plan year, (1) the plan's funded percentage for the plan year is less than 80%, or (2) the plan has an accumulated funding 
deficiency for the plan year or is projected to have an accumulated funding deficiency in any of the six succeeding plan years (taking 
into account amortization extensions under IRC Section 431(d)). Under IRC Section 432(j), a plan's funded percentage is the 
percentage determined by dividing the value of the plan's assets by the accrued liability of the plan.
IRC Section 432(b)(5) describes a plan that would be in endangered status for a plan year but for which the plan's actuary certifies that: 
(1) the plan is projected to not be in endangered status as of the end of the tenth plan year ending after the plan year to which the 
certification relates; and (2) the plan was not in critical status or endangered status in the immediately preceding plan year.
In making the determinations and projections applicable under the endangered and critical status rules, the plan actuary must make 
projections for the current and succeeding plan years of the current value of the assets of the plan and the present value of all liabilities 
to participants and beneficiaries under the plan for the current plan year as of the beginning of the year. The actuary's projections must 
be based on reasonable actuarial estimates, assumptions and methods that offer the actuary's best estimate of anticipated experience 
under the plan. Any projection of activity in the industry or industries covered by the plan, including future covered employment and 
contribution levels, must be based on information provided by the plan sponsor, and the plan sponsor must act reasonably and in good 
faith. The projected present value of liabilities as of the beginning of the year must be based on either the most recent actuarial 
statement required with respect to the most recently filed annual report or the actuarial valuation for the preceding plan year.
A plan is in seriously endangered status if the plan is in endangered status and, as of the beginning of the plan year, (1) the plan's 
funded percentage for such plan year is less than 80% and (2) the endangered plan has an accumulated funding deficiency for the plan 
year or is projected to have such an accumulated funding deficiency for any of the six succeeding plan years (taking into account any 
extension of amortization periods under IRC Section 431(d)).
A plan is in critical status for a plan year if it meets any of four specified tests under IRC Section 432(b)(2)(A), (B), (C), and (D). A plan 
is in critical status for a plan year due to receipt of special financial assistance under IRC Section 432(b)(7) if the plan has received 
special financial assistance under section 4262 of ERISA in the plan year or an earlier plan year. A plan is in critical status due to the 
special rule related to benefit suspensions in IRC Section 432(e)(9)(J) if a suspension of benefits under IRC Section 432(e)(9) applies 
to the plan and the plan has not emerged from critical status. IRC Section 432(e)(9)(J) provides that a plan to which a suspension of 
benefits under IRC Section 432(e)(9) applies may not emerge from critical status under IRC Section 432(e)(4)(B) until (1) the plan is no 
longer certified to be in critical or endangered status, and (2) the plan is projected to avoid insolvency under IRC Section 418E. A plan 
is in critical status due to failure to meet requirements for emergence under IRC Section 432(e)(4)(B) if the plan was in critical status 
during the prior plan year and the criteria set forth in IRC Section 432(e)(4)(B) for emergence from critical status have not been met.
The plan sponsor of a multiemployer plan that is not in critical status and is not described in IRC Section 432(b)(5) for a plan year but 
that is projected by the plan actuary to be in critical status in any of the succeeding five plan years may, not later than 30 days after the 
date of the certification, make an election under IRC Section 432(b)(4) for the plan to be in critical status effective for the current plan 
year. The plan year in which the plan sponsor elects to be in critical status will be treated as the first year in which the plan is in critical 
status, regardless of the plan year for which the plan first satisfies the criteria for critical status, and a plan that is in critical status under 
this paragraph will not emerge from critical status except in accordance with IRC Section 432(e)(4)(B).
A plan is in critical and declining status if the plan is in critical status for a plan year and the plan is projected to become insolvent within 
the meaning of IRC Section 418E during the current plan year or any of the 14 succeeding plan years (19 succeeding plan years if the 
plan has a ratio of inactive participants to active participants that exceeds 2 to 1 or if the funded percentage of the plan is less than 
80%).

Catalog Number 35051D                                       www.irs.gov                                Form 15315 (12-2022)

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Part IV - Scheduled Progress in Funding Improvement Plan or Rehabilitation Plan
Line 4. Check the appropriate box to indicate whether the plan is making the scheduled progress in meeting the requirements of an 
applicable funding improvement plan or rehabilitation plan. If the actuarial certification is with respect to a plan year that is within the 
plan's funding improvement period or rehabilitation period arising from a prior certification of endangered or critical status, the actuary 
must certify whether the plan is making scheduled progress in meeting the requirements of its funding improvement or rehabilitation 
plan.
If the plan is not required to have a Funding Improvement Plan or Rehabilitation Plan, i.e. the funding zone is Neither Endangered nor 
Critical, this section may be skipped. If the plan is still in the adoption plan period, select “N/A.” In addition, only one selection should be 
made, depending on the funding zone. “N/A” may be selected for the other. Either a selection of “Yes” or “No” should be made for a 
Funding Improvement Plan or a Rehabilitation Plan, but not both.

Catalog Number 35051D www.irs.gov                                              Form 15315 (12-2022)