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Application for Extension of Time OMB No. 1545-0212
Form 5558
(Rev. August 2012) To File Certain Employee Plan Returns
▶ For Privacy Act and Paperwork Reduction Act Notice, see instructions. File With IRS Only
Department of the Treasury ▶ Information about Form 5558 and its instructions is at www.irs.gov/form5558
Internal Revenue Service
Part I Identification
A Name of filer, plan administrator, or plan sponsor (see instructions) B Filer’s identifying number (see instructions)
Employer identification number (EIN) (9 digits XX-XXXXXXX)
Number, street, and room or suite no. (If a P.O. box, see instructions)
Social security number (SSN) (9 digits XXX-XX-XXXX)
City or town, state, and ZIP code

C Plan name Plan Plan year ending—
number MM DD YYYY

Part II Extension of Time To File Form 5500 Series, and/or Form 8955-SSA

1 Check this box if you are requesting an extension of time on line 2 to file the first Form 5500 series return/report for the plan listed
in Part 1, C above.

2 I request an extension of time until / / to file Form 5500 series (see instructions).
Note. A signature IS NOT required if you are requesting an extension to file Form 5500 series.

3 I request an extension of time until / / to file Form 8955-SSA (see instructions).
Note. A signature IS NOT required if you are requesting an extension to file Form 8955-SSA.

The application is automatically approved to the date shown on line 2 and/or line 3 (above) if: (a) the Form 5558 is filed on or before
the normal due date of Form 5500 series, and/or Form 8955-SSA for which this extension is requested, and (b) the date on line 2
and/or line 3 (above) is not later than the 15th day of the third month after the normal due date.

Part III Extension of Time To File Form 5330 (see instructions)

4 I request an extension of time until / / to file Form 5330.
You may be approved for up to a 6 month extension to file Form 5330, after the normal due date of Form 5330.

a Enter the Code section(s) imposing the tax . . . . . . . . . . . ▶ a

b Enter the payment amount attached . . . . . . . . . . . . . . . . . . . . . . ▶ b

c For excise taxes under section 4980 or 4980F of the Code, enter the reversion/amendment date . . . ▶ c
5 State in detail why you need the extension:

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 ▶
Cat. No. 12005T Form 5558 (Rev. 8-2012)

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Form 5558 (Rev. 8-2012) Page 2
postmark date generally is the date the • Employers who do not have an EIN may
General Instructions private delivery service records in its database apply for one by attaching a completed Form
Section references are to the Internal Revenue or marks on the mailing label. The private SS-4, Application for Employer Identification
Code unless otherwise noted. delivery service can tell you how to get written Number, to this form.
proof of this date.
What's New Social security number (SSN). If you made
The following are designated private excess contributions to a section 403(b)(7)(A)
The June 2011 version of Form 5558 required delivery services: custodial account or you are a disqualified
a signature for extensions of time to file Form person other than an employer, and you are
8955-SSA. A signature is no longer required • DHL Express (DHL): DHL Same Day Service.
applying for an extension of time to file Form
for an extension to file Form 8955-SSA. As • Federal Express (FedEx): FedEx Priority 5330, enter your nine-digit SSN in an XXX-XX-
under the June 2011 version of Form 5558, a Overnight, FedEx Standard Overnight, FedEx XXXX format. Do not enter your SSN for Form
signature is also not required to extend the 2 Day, FedEx International Priority, and FedEx 5500, Form 5500-SF, Form 5500-EZ, or Form
time to file Form 5500 series; however, a International First. 8955-SSA.
signature is still required to extend the time to • United Parcel Service (UPS): UPS Next Day C. Plan Information
file Form 5330. Air, UPS Next Day Air Saver, UPS 2nd Day
The June 2011 version of the Form 5558 Air, UPS 2nd Day Air A.M., UPS Worldwide Complete the plan name, plan number, and
provided space for the names of three plans; Express Plus, and UPS Worldwide Express. plan year ending for the plan included on this
as a result a single Form 5558 could be used Form 5558.
to extend the time to file returns for three Specific Instructions
plans. The Form 5558 now limits the Part II. Extension of Time To File
extension to a single plan. Applications for Part I. Identification Form 5500 Series and/or Form
extensions of other plans must be submitted A. Name and Address 8955-SSA
on additional Forms 5558. As under current
rules, lists of other plans should not be Enter your name and address in the heading if Use Form 5558 to apply for a one-time
attached to a Form 5558. Lists attached to you are requesting an extension of time to file extension of time to file the Form 5500 series
Form 5558 will not be processed. Only the the Form 5500, Form 5500-SF, Form 5500-EZ (Form 5500, Form 5500-SF, Form 5500-EZ)
plan listed on Form 5558 will be processed. and/or Form 8955-SSA or Form 5330. and/or Form 8955-SSA.
A new checkbox has been added for The plan sponsor (generally, the employer Do not include the Form 5500
recently adopted plans that are requesting an for a single-employer plan) or plan series (Form 5500, Form
5500-SF, Form 5500-EZ) or the
extension of time to file a Form 5500 series administrator listed on the application should ▲CAUTION! Form 8955-SSA with this form.
return/report where a Form 5500 series be the same as the plan sponsor or plan
return/report is being filed for that plan for the administrator listed on the annual return/ Exception: Form 5500, Form 5500-SF, Form
first time. report filed for the plan. 5500-EZ, and Form 8955-SSA filers are
Future Developments Include the suite, room, or other unit automatically granted extensions of time to
number after the street address. If the Post file until the extended due date of the federal
For the latest information about developments Office does not deliver mail to the street income tax return of the employer (and are
related to Form 5558 and its instructions, address and you have a P.O. box, show the not required to file Form 5558) if both of the
such as legislation enacted after they were box number instead of the street address. following conditions are met: (1) the plan year
published, go to www.irs.gov/form5558. If the entity’s address is outside the United and the employer’s tax year are the same;
Purpose of Form States or its possessions, or territories, enter and (2) the employer has been granted an
in the space for city or town, state, and ZIP extension of time to file its federal income tax
Use Form 5558 to apply for a one-time code, the information in the following order: return to a date later than the normal due date
extension of time to file the Form 5500 series city, province or state, and country. Follow for filing the Form 5500, Form 5500-SF, Form
(Form 5500, Annual Return/Report of the country’s practice for entering the postal 5500-EZ, or Form 8955-SSA. An extension
Employee Benefit Plan; Form 5500-SF, Short code. Do not abbreviate the country name. granted under this exception cannot be
Form Annual Return/Report of Small extended further by filing a Form 5558 after
Employee Benefit Plan; Form 5500-EZ, If your mailing address has changed since the normal due date of the Form 5500, Form
Annual Return of One-Participant (Owners you filed your last return, use Form 8822, 5500-SF, Form 5500-EZ, or Form 8955-SSA.
and Their Spouses) Retirement Plan); Form Change of Address, to notify the IRS of the
8955-SSA, Annual Registration Statement change. A new address shown on Form 5558 An extension of time to file a Form 5500,
Identifying Separated Participants With will not update your record. Form 5500-SF, Form 5500-EZ, and/or Form
8955-SSA does not operate as an extension
Deferred Vested Benefits; or Form 5330, B. Filer’s Identifying Number of time to file the PBGC (Pension Benefit
Return of Excise Taxes Related to Employee Enter Guaranty Corporation) Form 1, Annual
Benefit Plans. Employer identification number (EIN).
the nine-digit EIN in an XX-XXXXXXX format, Premium Payment.
To avoid processing delays, the assigned to the employer for all applications How to file. A separate Form 5558 must be
most recent version of this Form filed for the Form 5500 series (Form 5500, used for each plan for which an extension is
5558 should always be used. For Form 5500-SF, Form 5500-EZ) and/or Form requested. For example, if an employer
▲CAUTION! example, this Form 5558 (Rev. 8955-SSA. Also enter the EIN for applications maintains a defined benefit plan and a profit-
August 2012) should be used instead of the filed for Form 5330 (see Social security sharing plan, a separate Form 5558 must be
June 2011 version or any other prior version. number (SSN) next for exceptions). filed for each plan. A single Form 5558 may,
To determine the most recent version of this If the employer does not have an EIN, the however, be used to extend the time to file a
Form, go to IRS.gov/retirement. employer must apply for one. An EIN can be plan's Form 5500 series return/report and its
Where To File applied for: Form 8955-SSA.
File Form 5558 with the Department of the • Online by clicking the Online EIN Application Lists of other plans should not be attached
Treasury, Internal Revenue Service Center, link at IRS.gov. The EIN is issued immediately to a Form 5558. Only the plan listed on Form
Ogden, UT 84201-0045. once the application information is validated. 5558 will be processed. Lists attached to the
Form 5558 will not be processed.
Note. The online application process is not
Private delivery services.You can use yet available for corporations with addresses When to file. To request an extension of time
certain private delivery services designated by in foreign countries. to file Form 5500, Form 5500-SF, Form 5500-
EZ, and/or Form 8955-SSA, file Form 5558 on
the IRS to meet the “timely mailing treated as • By telephone at 1-800-829-4933. or before the return/report’s normal due date.
timely filing/paying” rule for tax returns and
payments. If you use a private delivery service • By fax using the FAX-TIN numbers for your The normal due date is the date the Form
designated by the IRS (rather than the U.S. state listed in the Instructions for Form SS-4. 5500, Form 5500-SF, Form 5500-EZ, and/or
Postal Service) to send your return, the Form 8955-SSA would otherwise be due,
without extension.

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Form 5558 (Rev. 8-2012) Page 3
Applications for extension of time to file approved or denied. Because of this change, If you are filing Form 5558 for an extension
Form 5500, Form 5500-SF, Form 5500-EZ, we ask you to attach a photocopy of this to file Form 5500 series return/report or Form
and/or Form 8955-SSA that are filed on or notice to your Form 5330. 8955-SSA, a signature is not required.
before the return/report’s normal due date on When to file. To request an extension of time
a properly completed Form 5558 will be to file Form 5330, file Form 5558 in sufficient Privacy Act and Paperwork
automatically approved to the date that is no time for the IRS to consider and act on it Reduction Act Notice
later than the 15th day of the third month after before the return’s normal due date.
the return/report’s normal due date. We ask for the information on this form to
The normal due date is the date the Form carry out the Internal Revenue laws of the
Note. If the filing date falls on a Saturday, 5330 would otherwise be due, without United States and the Employee Retirement
Sunday, or a legal holiday, the return may be extension. Income Security Act of 1974 (ERISA). We
filed on the next day that is not a Saturday,
Sunday, or a legal holiday. Line 4. On line 4, enter the requested due need it to determine if you are entitled to an
date. If your application for extension of time extension of time to file Form 5500, Form
Approved copies of Form 5558 requesting to file Form 5330 is approved, you may be 5500-SF, Form 5500-EZ, and/or Form 8955-
an extension to file Form 5500, Form 5500- granted an extension of up to 6 months after SSA, or Form 5330. You are not required to
SF, Form 5500-EZ, and/or Form 8955-SSA the normal due date of Form 5330. request an extension; however, if you want an
will not be returned to the filer from the IRS. extension, section 6081 requires you to
Line 4a. Indicate the section(s) for the excise
Line 1. Check this box if the extension of time tax for which you are requesting an extension. provide the information. Section 6109 requires
being requested on line 2 is for the first Form you to provide your identification number.
5500 series return/report filed for the plan. Line 4b. Enter the amount of tax estimated to Failure to provide this information may delay
This box should not be checked if the plan be due with Form 5330 and attach your or prevent processing your request; providing
previously filed a Form 5500 series return/ payment to this form. false information may subject you to
report at any time for any year. Make your check or money order payable penalties.
Line 2. Enter on line 2 the due date for which to the “United States Treasury.” Do not send You are not required to provide the
you are requesting to file Form 5500, Form cash. On all checks or money orders, write information requested on a form that is
5500-SF, or Form 5500-EZ. This date should your name, filer’s identifying number (EIN or subject to the Paperwork Reduction Act
not be later than the 15th day of the third SSN), plan number, Form 5330 section unless the form displays a valid OMB control
month after the normal due date of the return/ number, and the tax year to which the number. Books or records relating to a form
report. payment applies. or its instructions must be retained as long as
When using Form 5558 to request an If you changed your mailing address after their contents may become material in the
extension of time to file Form 5500, Form you filed your last return, use Form 8822 to administration of any Internal Revenue law.
5500-SF, or Form 5500-EZ, plan sponsors or notify the IRS of the change. You can get Generally, tax returns and return information
plan administrators are not required to sign Form 8822 by calling 1-800-829-3676 or you are confidential as required by section 6103.
the form. If Form 5558 is timely filed and can access the IRS website at IRS.gov 24 However, section 6103 allows or requires
complete, you will be granted an extension hours a day, 7 days a week. the Internal Revenue Service to disclose this
not later than the 15th day of the third month Line 5. The IRS will grant a reasonable information to others. We may disclose to the
after the return/report’s normal due date to extension of time (not to exceed 6 months) for Department of Justice for civil or criminal
file Form 5500, Form 5500-SF, or Form 5500- filing Form 5330 if you file a timely application litigation, to the Department of Labor and the
EZ. showing that you are unable to file Form 5330 Pension Benefit Guaranty Corporation for the
Line 3. Enter on line 3 the due date for which because of circumstances beyond your administration of ERISA, and to cities, states,
you are requesting to file Form 8955-SSA. control. Clearly describe these circumstances. the District of Columbia, and U.S.
This date should not be later than the 15 thday Generally, an application will be considered commonwealths or possessions to carry out
of the third month after the normal due date of on the basis of your own efforts to fulfill this their tax laws. We may also disclose the
the return. filing responsibility, rather than the information to other countries under a tax
convenience of anyone providing help in treaty, to federal and state agencies to
When using Form 5558 to request an preparing the return. However, consideration enforce federal nontax criminal laws, or to
extension of time to file Form 8955-SSA, plan will be given to any circumstances that federal law enforcement and intelligence
sponsors or plan administrators are not prevent your practitioner, for reasons beyond agencies to combat terrorism.
required to sign the form. If Form 5558 is his or her control, from filing the return by the The time needed to complete and file this
timely filed and complete, you will be granted normal due date, and to circumstances in form will vary depending on individual
an extension not later than the 15th day of the which you are unable to get needed circumstances. The estimated average time:
third month after the return's normal due date professional help in spite of timely efforts to 24 minutes.
to file Form 8955-SSA. do so.
If you have comments concerning the
Part III. Extension of Time To File If we grant you an extension of accuracy of this time estimate or suggestions
Form 5330 time to file Form 5330 and later for making this form simpler, we would be
find that the statements made on happy to hear from you. You can write to the
File one Form 5558 to request an extension of ▲CAUTION! this form are false or misleading, Internal Revenue Service, Tax Products
time to file Form 5330 for excise taxes with
the same filing due date. For specific the extension will be null and void. A late filing Coordinating Committee,
information on excise tax due dates, see the penalty associated with the form for which SE:W:CAR:MP:T:M:S, 1111 Constitution Ave.,
Instructions for Form 5330. you filed this extension will be charged. NW, IR-6526, Washington, DC 20224. Do not
send the tax form to this address. Instead,
An extension of time to file does Signature see Where To File.
not extend the time to pay the If you are filing Form 5558 for an extension to
tax due. Any tax due must be file Form 5330, the Form 5558 must be
▲CAUTION! paid with this application for an signed. The person who signs this form may
extension of time to file Form 5330. be an employer, a plan sponsor, a plan
Additionally, interest is charged on taxes administrator, a disqualified person required
not paid by the due date even if an to file Form 5330, an attorney or certified
extension of time to file is granted. public accountant qualified to practice before
Note. The IRS will no longer return stamped the IRS, a person enrolled to practice before
copies of the Form 5558 to filers who request the IRS, or a person holding a power of
an extension of time to file a Form 5330. attorney.
Instead you will receive a computer generated
notice to inform you if your extension is

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