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Form  4461-B                           Application for Approval of Master or                                       OMB No. 1545-0169 
(Rev. January 2012)
                               Prototype or Volume Submitter Plans 
Department of the Treasury                                                                          This Form Is Open to Public Inspection 
Internal Revenue Service      Mass Submitter Adopting Sponsor or Practitioner 
File This Form With the Internal Revenue Service                                                      For IRS Use Only 

Section references are to the Internal Revenue Code unless otherwise noted. 

Complete every applicable item on this form. 
1     Enter amount of user fee submitted 
      $ 
2 a   Name of applicant                                                                               2 b     Employer identification number 
                                                                                                              of applicant 
      Address (number, street, room or suite no.) (If a P.O. box, see the instructions.) 
                                                                                                      2 c     Applicant’s telephone no. 
      City                                                                State     ZIP code 

3a    Name of person to be contacted                                                                  3  b    Telephone number 

3 c   If a power of attorney is attached, check the box ▶

4 a   Basic plan document number                                                  b Adoption agreement number 

5     This plan is:         Word-for-word identical to an M&P plan or volume submitter plan 
                            A minor modification to an M&P plan only (see instructions to line 5 for  
                            specific requirements) 
6     Name of mass submitter 

7     Enter the following information for the mass submitter’s plan on which this plan is based (if this application is submitted  
      simultaneously with the mass submitter’s application, see instructions). 
      File folder number 
      Letter serial number 
      Date of letter 

8     Type of plan: 
            Money purchase             Target benefit                                        Profit-sharing/401(k) 
            Profit-sharing             Defined benefit (with permitted disparity)            Defined benefit (without permitted disparity) 

9     Filing status of plan (see General Instructions) 
            Standardized plan 
            Nonstandardized plan 
            Volume submitter governmental plan (i.e., described in section 414(d))
            Volume submitter nongovernmental plan 

For  Master  or  Prototype:  Under  penalties  of  perjury,  I  declare  that  the  sponsor  has  adopted  a  master  or  prototype  plan  that  is  word-for-word  identical  to,  or  a  minor 
modification of the mass submitter plan indicated in items 6 and 7 above. 

For Volume Submitter: Under penalties of perjury, I declare that the practitioner has adopted a volume submitter plan that is word-for-word identical to the mass submitter
plan indicated in items 6 and 7 above. 

Signature ▶                                                               Title 
(Sponsor or Practitioner)                                                       ▶                     Date ▶

(Mass Submitter)  
Signature ▶                                                               Title ▶                     Date ▶
For Paperwork Reduction Act Notice, see the instructions.                           Cat. No. 10235P                Form 4461-B (Rev. 1-2012)

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Form 4461-B (Rev. 1-2012) Page 2
General Instructions approval, you must provide the IRS plan documents and associated
office of jurisdiction with a written adoption agreements for which it
Purpose of Form request that contains: requests opinion letters, regardless of
• The taxpayer’s name, address, the number of identical adopters of such
Use Form 4461-B to apply for approval employer identification number, and plan other plans.
of a plan submitted by a mass submitter number(s). Affiliation is determined under sections
on behalf of an adopting sponsor or 414(b) and (c). Additionally, the following
practitioner, which is based on a plan • The name, address, social security
submitted by the mass submitter. number, and telephone number(s) of the will be considered to be affiliated: any
person or persons whom you are law, accounting, consulting firm, etc.
Completing Form 4461-B authorizing to receive return information. with its partners, members, associates,
etc.
Be sure to submit a complete and • A paragraph that clearly describes the
accurate application. Complete every return or return information that you For purposes of determining whether
applicable line on the application. If your authorize the IRS to disclose. 30 (or 10, if applicable) unaffiliated
sponsors or practitioners sponsor on a
application is not complete, we will • An authorized signature (see Signature word-for-word identical basis the same
return it without processing it. The above). basic plan document or the same
application must be typed.
As an alternative to providing the specimen plan, the mass submitter is
User fee. All applications must be above statement, Form 2848, Power of treated as an unaffiliated sponsor or
accompanied by the appropriate user Attorney and Declaration of practitioner.
fee from the schedule set forth in Rev. Representative, may be submitted. Sponsor. Any person that has an
Proc. 2012-8, 2012-1 I.R.B. 235, (or the
established place of business in the
most recent version, updated annually); Definitions United States where it is accessible
and Form 8717, User Fee for Employee
Plan Determination Letter Request. Mass submitter. As set forth in Rev. during every business day and
Applications submitted without the Proc. 2011-49, 2011-44 I.R.B. 608, any represents to the IRS that it has at least
proper user fee will not be processed entity that submits applications on 30 employer-clients each of which is
and will be returned to the applicant. behalf of at least 30 unaffiliated reasonably expected to adopt the
sponsors or practitioners each of which sponsor’s basic plan document and one
Do not submit a copy of the plan, is sponsoring, on a word-for-word or more of the adoption agreements
except as provided under the identical basis, the same basic plan associated with that basic plan
instructions to line 5 later. document and one or more of the document. Once a person represents to
adoption agreements associated with the IRS that at least 30 employers are
Who May File that basic plan document or in the case reasonably expected to adopt its basic
Only mass submitters may file this form. of VS plans, one or more of the same plan document, it will be treated as a
lead specimen plans. For a mass sponsor for all the basic plan documents
Where To File submitter of a Master or Prototype (M&P) and associated adoption agreements for
plan, once the mass submitter has which it requests opinion letters,
Send applications for opinion and submitted applications on behalf of 30 regardless of the number of employers
advisory letters to: unaffiliated sponsors for any basic plan that are expected to adopt such other
Internal Revenue Service document, it will be treated as a mass plans.
P.O. Box 2508, Room 5106 submitter for all the other basic plan Notwithstanding the above, any
Cincinnati, OH 45201 documents and associated adoption person that has an established place of
Add “Attn: Pre-approved Plans agreements for which it requests opinion business in the United States where it is
Coordinator.” letters, regardless of the number of accessible during every business day
identical adopters of such other plans. A and is a word-for-word identical adopter
Applications shipped by Express Mail mass submitter of a Volume Submitter or minor modifier adopter of an M&P
or delivery service should be sent to the (VS) plan will be treated as such for each plan of a mass submitter will be treated
attention of the Pre-approved Plans specimen plan for which the 30 as a sponsor for such plan, regardless of
Coordinator to: unaffiliated practitioner requirement is the number of employers that are
Internal Revenue Service separately met. expected to adopt such plan.
550 Main Street, Room 5106 Notwithstanding the above, for an Practitioner. Any person that has an
P.O. Box 2508 M&P plan, any entity that received a established place of business in the
Cincinnati, OH 45202 favorable Tax Reform Act of 1986 United States where it is accessible
Signature. The application must be opinion letter for a plan as an M&P mass during every business day and
signed by the mass submitter and submitter under Rev. Proc. 89-9, 1989-1 represents to the IRS that it has at least
sponsor or practitioner. If a power of C.B. 780, will continue to be treated as a 30 employer-clients each of which is
attorney authorizes the mass submitter mass submitter if it submits applications reasonably expected to adopt a plan
to sign the form on behalf of the on behalf of at least 10 sponsors that is substantially similar to the VS
sponsor or practitioner, attach the power (regardless of affiliation) each of which is practitioner’s specimen plan.
of attorney to Form 4461-B. sponsoring, on a word-for-word identical
Disclosure requested by taxpayer. A basis, the same basic plan document The required number of employer-
taxpayer may request the IRS to and one or more of the adoption clients is reduced to 10 for a money
disclose and discuss the return or return agreements associated with that basic purchase pension specimen plan in the
information with any person or persons plan document. Once the mass case of a VS practitioner that has
whom the taxpayer designates in a submitter has submitted applications on specimen plans for two or more separate
written request. If you want to designate behalf of 10 sponsors for any basic plan categories of plans (profit sharing,
a person(s) to assist in an application for document, it will be treated as a mass money purchase, target benefit, defined
submitter for all the other basic benefit), one of which is a money
purchase plan, and the 30 employer-
clients requirement has been satisfied for
the other specimen plan.

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Form 4461-B (Rev. 1-2012) Page 3
A VS practitioner may submit any Line 4b. Enter the three-digit number Paperwork Reduction Act Notice. We
number of specimen plans for advisory you have assigned to the adoption ask for the information on this form to
letters provided that the 30 employer- agreement, if applicable, for which this carry out the Internal Revenue laws of
clients requirement (or 10, if applicable) application is submitted. In the case of the United States. You are required to
is separately satisfied for each specimen an M&P submission, each different give us this information. We need it to
plan. For this purpose, where an adoption agreement designed to determine whether you meet the legal
adoption format is used, each adoption accompany a single basic plan requirements for plan approval.
agreement is treated as one specimen document should be given a different You are not required to provide the
plan. Notwithstanding the above, any three-digit number beginning with “001.” information requested on a form that is
person that has an established place of For example, if the first basic plan subject to the Paperwork Reduction Act
business in the United States where it is document of a sponsor has four unless the form displays a valid OMB
accessible during every business day separate adoption agreements, they control number. Books or records
may sponsor a specimen plan as a should be numbered “001” through relating to a form or its instructions must
word-for-word identical adopter of a “004” and the sponsor should submit be retained as long as their content may
specimen plan of a VS mass submitter, four separate Forms 4461. Adoption become material in the administration of
regardless of the number of employers agreements submitted with the second any Internal Revenue law. Generally, tax
that are expected to adopt the plan. or any subsequent basic plan return and return information are
documents (that are not word-for-word confidential, as required by Code section
Specific Instructions identical to a previously submitted basic 6103.
plan document) should be similarly
Line 2a. Enter the name and address of numbered beginning with “001.” The time needed to complete and file
the applicant. If the Post Office does not this form will vary depending on
deliver mail to the street address and the Line 5. In the case of an M&P sponsor individual circumstances. The estimated
applicant has a P.O. box number, show adopting a word-for-word identical plan average time is:
the box number instead of the street (including a flexible plan) to a plan of the
address. M&P mass submitter, or a VS Recordkeeping . . . . 5 hr., 58 min.
practitioner adopting a word-for-word Learning about the
Line 3a. The person to contact must be identical plan of a VS mass submitter, a law or the form . . . . . . 52 min.
an employee or an authorized copy of the plan does not have to be
representative of the mass submitter. If submitted. For the sponsor of an M&P Preparing the form . . 1 hr., 56 min.
the person to be contacted is other than plan of a mass submitter, if the plan is a Copying, assembling, and
an employee of the applicant, please minor modification, the M&P mass sending the form to the IRS . 16 min.
enclose an authorized power of attorney. submitter should submit Form 4461-B, If you have comments concerning the
See Disclosure requested by taxpayer typed as a “placeholder.” When the lead accuracy of these time estimates or
earlier. plan receives its email of preliminary suggestions for making this form
Line 4a. Enter the two-digit basic plan approval, submit a copy of the mass simpler, we would be happy to hear
document number you have assigned to submitter plan with the minor from you. You can write to the Internal
the specimen plan or basic plan modifications underlined in red, or Revenue Service, Tax Products
document that accompanies (if otherwise highlighted, as well as a Coordinating Committee,
applicable) the adoption agreement for statement indicating the location and SE:W:CAR:MP:M:T:S, 1111 Constitution
which you are requesting approval. All effect of each change. Ave. NW, IR-6526, Washington, DC
basic or specimen plan documents from Line 7. If this application is based on an 20224. Do not send this form to this
one sponsor or practitioner which are the application submitted by a mass office. Instead, see Where To File earlier.
same (word-for-word) should use the submitter and simultaneously filed with
same two-digit number on all the mass submitter’s application or filed
applications. The first basic plan before the information under line 7 is
document submitted should be available, enter in the brackets
numbered as “01,” the second as “02,” designated for the file folder number the
etc. The first specimen plan document basic plan document number and the
submitted should be numbered as “01,” adoption agreement number (if
the second as “02,” etc. applicable) of the mass submitter’s plan
on which this plan is based. Do not
complete the rest of line 7.

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