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Application for Group or
Form 5316 Pooled Trust Ruling OMB No. 1545-2166
(Rev. December 2021)
Department of the Treasury (Under section 401(a) and 501(a) of the Internal Revenue Code)
Internal Revenue Service ▶ Go to www.irs.gov/Form5316 for the latest information.
Review instructions and the Procedural Requirements Checklist before completing For Internal Use Only
this application. Submit all required attachments.

1a Name of the trust sponsor

b Address of trust sponsor (if a P.O. Box, see instructions) c City d State e Zip Code

f Country

g Trust sponsor’s employer identification number (EIN) h Telephone number i Fax number

j Name of trust (If trust name exceeds 70 characters, including spaces, see instructions)

k Enter date trust agreement was executed l Group trust EIN

2 Person to contact if more information is needed. Contact person’s name

For this group or pooled trust ruling, prepare an attachment providing a detailed explanation of your request. Be sure to include the
trust sponsor’s name and EIN on each additional sheet. See instructions.

Under penalties of perjury, I declare that I have examined this application, including accompanying statements and schedules, and to
the best of my knowledge and belief, it is true, correct, and complete.

SIGN HERE ▶ Date ▶

Type or print name Type or print title

For Paperwork Reduction Act Notice, see instructions. Cat. No. 49983G Form 5316 (Rev. 12-2021)

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Form 5316 (Rev. 12-2021)                                                                                               Page 2
   Yes No
3        Is the group trust adopted as part of each adopting group trust retiree benefit plan? (See instructions.)
         Does the group trust instrument expressly limit participation to: pension, profit-sharing, and stock bonus trusts 
4
         or custodial accounts qualifying under section 401(a) that are exempt under section 501(a); individual 
         retirement accounts that are exempt under section 408(e); eligible governmental plan trusts or custodial 
         accounts under section 457(b) that are exempt under section 457(g); custodial accounts under section     
         403(b)(7); retirement income accounts under section 403(b)(9); section 401(a)(24) governmental plans; and 
         section 414(e)(3)(A) church plan assets as defined by section 336(e) of the PATH Act effective December 18, 
         2015?

5        Does the group trust instrument expressly prohibit any part of its corpus or income that equitably belongs to 
         any adopting group trust retiree benefit plan from being used for, or diverted to, any purpose other than for the 
         exclusive benefit of the participants and the beneficiaries of the group trust retiree benefit plan?

6        Is each group trust retiree benefit plan entity which adopts the group trust itself a trust, a custodial account, or 
         a similar entity that is tax-exempt under section 408(e) or section 501(a) (or is treated as tax-exempt under 
         section 501(a))?

7        Does each group trust retiree benefit plan which adopts the group trust expressly provide in its governing 
         document that it is impossible for any part of the corpus or income of the group trust retiree benefit plan to be 
         used for, or diverted to, purposes other than for the exclusive benefit of the plan participants and their 
         beneficiaries?

8        Does the group trust instrument expressly limit the assets that may be held by the group trust to assets that 
         are contributed by, or transferred from, a group trust retiree benefit plan to the group trust (and the earnings on 
         such assets), and does the group trust instrument expressly provide for separate accounts (and appropriate 
         records) to reflect the interest which each adopting group trust retiree benefit plan has in the group trust?
9        Does the group trust instrument expressly prohibit an assignment by an adopting group trust retiree benefit 
         plan of any part of its equity or interest in the group trust?  
10       Was the group trust created or organized in the United States and is the group trust maintained at all times as 
         a domestic trust in the United States?

                                                                         Form 5316 (Rev. 12-2021)

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Form 5316 (Rev. 12-2021)                                                                                             Page 3
                          Procedural Requirements Checklist

Use this list to ensure that your application package is complete. The application will be reviewed to determine if it is complete. If your 
application is incomplete, it will be closed, in which case it won’t be returned and any user fee won’t be refunded. See Rev. Proc. 
2021-4 (updated annually).
1. Is Form 8717, User Fee for Employee Plan Determination Letter Request, attached to your submission? Is the appropriate 
   user fee for your submission or a copy of the payment confirmation from www.pay.gov as described in section 10.07 of 
   Rev. Proc. 2021-4 (updated annually) attached to Form 8717?

2. Is Form 2848, Power of Attorney and Declaration of Representative, Form 8821, Tax Information Authorization, or a 
   privately designated authorization attached? (For more information, see theDisclosure Request by Taxpayer in the 
   instructions and Rev. Proc. 2021-4 updated annually.) If the authorized representative would like to receive notices and 
   communications, check the box on Form 2848, line 2, for each individual.

3. Have you included a copy of the group trust instrument and all amendments since your last determination letter?

                                                                                                    Form 5316 (Rev. 12-2021)

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Form 5316 (Rev. 12-2021) Page 4
Future Developments Private delivery services (PDS). Filers can use certain PDS
designated by the IRS to meet the “timely mailing as timely filing/
For the latest information about developments related to Form paying” rule for tax returns and payments. Go to www.irs.gov/PDS
5316, such as legislation enacted after the form was published, go for the current list of designated services.
to www.irs.gov/Form5316.
The private delivery service can tell you how to get written proof
Reminders of the mailing date.
Review the Procedural Requirements Checklist and these How To Complete an Application
instructions before completing the application.
Applications are screened for completeness. The application must
Public inspection. The group trust is open to public inspection. be signed by the employer or plan administrator.
Disclosure request by taxpayer. The Tax Reform Act of 1976 Stamped signatures are not acceptable; see Rev. Proc.
permits a taxpayer to request the IRS to disclose and discuss the 2021-4, 2021-1 I.R.B. 157, available at
taxpayer’s return and/or return information with any person(s) the www.irs.gov/irb/2021-01_IRB.
taxpayer designates in a written request. Use Form 2848, Power of ▲!
CAUTION
Attorney and Declaration of Representative, if the representative is
qualified to sign, or Form 8821, Tax Information Authorization, for The application will be reviewed to determine if it is complete. If
this purpose. See Pub. 947, Practice Before the IRS and Power of your application is incomplete, it will be closed, in which case it
Attorney, for more information. won’t be returned and any user fee won’t be refunded. For this
reason, it is important that an appropriate response be entered for
each line item (unless instructed otherwise). In completing the
General Instructions application, pay careful attention to the following:
Section references are to the Internal Revenue Code unless • The IRS may, at its discretion, require a plan restatement or
otherwise noted. additional information any time it is deemed necessary.
• The application has formatted fields that will limit the number of
Purpose of Form characters entered per field.
Group/pooled trust sponsors file this form to request a • All data input will need to be entered in Courier 10 point font.
determination letter from the IRS for a determination that the trust is • Alpha characters should be entered in all capital letters.
a group trust arrangement as described in Rev. Rul. 81-100, 1981-1 • Enter spaces between any words. Spaces do count as characters.
C.B. 326, as clarified and modified by Rev. Rul. 2004-67, 2004-2
C.B. 28, and as modified by Rev. Rul. 2011-1, 2011-2 I.R.B. 251, • All date fields are entered as an 8-digit field (MMDDYYYY).
available at www.irs.gov/irb/2011-02_IRB/ar08.html. See also Rev. The IRS annually updates the revenue procedure which sets forth
Rul. 2014-24. the procedures for issuing determination letters to qualified plans,
including determination letters for group trusts. The annual revenue
Type of Trust procedure may be found in the Internal Revenue Bulletin. For
A group/pooled trust is a trust that meets the qualification example, the revenue procedure for 2021 is Rev. Proc. 2021-4 .
requirements of Rev. Rul. 81-100 as modified and clarified by Rev.
Rul. 2004-67 and as modified by Rev. Rul. 2011-1. What To File
1. A Form 8717, User Fee for Employee Plan Determination Letter
Who May File Request, and a check for the appropriate user fee (unless payment
This form should be filed by the sponsor of a group/pooled trust. was made through www.pay.gov). Make checks payable to “United
States Treasury.”
Where To File Note. If the user fee is paid using www.pay.gov, a copy of the
File Form 5316 at the address indicated below: payment confirmation must be submitted along with the paper
Internal Revenue Service Form 8717.
Attn: EP Determination Letters Stop 31 2. Form 2848 or 8821.
P.O. Box 12192 3. A completed Form 5316.
Covington, KY 41012-0192 4. A copy of the trust’s latest determination letter.
Requests shipped by a private delivery service should be sent to: 5. The trust instrument and related documents.
Internal Revenue Service
Attn: EP Determination Letters Stop 31
201 West Rivercenter Blvd.
Covington, KY 41011

Form 5316 (Rev. 12-2021)

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Form 5316 (Rev. 12-2021) Page 5
group trust retiree benefit plan may invest directly in the group trust
Specific Instructions or through a separate account maintained by an insurance
Line 1a and 1b. Enter the name and address of the trust sponsor. company. See Rev. Rul 2014-24. The Path Act section 336(e)
Address should include the suite, room, or other unit number after permits Church Plans to invest in group trusts after December 18,
the street address. If the post office does not deliver mail to the 2015 with the group trust permitted to hold: (1) the assets of a
street address and the plan has a P.O. box, show the box number church plan, and (2) the assets of a church-controlled organization
instead of the street address. The address should be the address of described in IRC section 414(e)(3)(A) if the principal purpose or
the sponsor/employer. function is the administration of the plan described in (1). The assets
eligible for investment in a group trust also include church assets
Line 1g. Enter the 9-digit trust employer identification number (EIN) eligible to be commingled for investment purposes.
assigned to the trust sponsor.
Line 5. The group trust instrument must expressly prohibit any part
The trust sponsor must have an EIN. To apply for an EIN: of its corpus or income that equitably belongs to any adopting
• Online—Generally, a plan sponsor can receive an EIN by Internet group trust retiree benefit plan from being used for, or diverted to,
and use it immediately to file a return. Go to www.irs.gov/EIN. any purpose other than for the exclusive benefit of the participants
• By mail or fax—Send in a completed Form SS-4, Application for and the beneficiaries of the group trust retiree benefit plan. Plan
Employer Identification Number, to apply for an EIN. assets are treated as used for, or diverted to, a purpose other than
for the exclusive benefit of the plan participants or beneficiaries if
Note. This EIN must be used in all subsequent filings of the trust the assets of one group trust retiree benefit plan are used to provide
determination letter requests. benefits under another group trust retiree benefit plan even if the
Line 1j. Due to space restrictions this field is limited to 70 plan participant or beneficiary receiving the benefits is a participant
characters, including spaces. Please complete this item with how or beneficiary under both plans. The Path Act effective December
the trust name should read on the trust determination letter to the 18, 2015 permits assets that are permitted to be commingled with
extent permitted. Due to this restriction, please keep in mind that Church Plan assets to be held in a group trust.
“Employees” and “Trust” are not needed and will be left off if space Line 6. A group trust retiree benefit plan that is a governmental plan
does not permit. for purposes of section 401(a)(24) is treated as meeting the
Line 1k. Enter the date the trust agreement was executed. requirement to be tax exempt if it is not subject to federal income
Line 1l. Identify the EIN of the group trust. Enter “N/A” if the trust taxation.
does not have a separate EIN. Line 7. Each group trust retiree benefit plan which adopts the group
Line 2. Complete this line with the contact person, and attach a trust must expressly provide in its governing document that it is
power of attorney or other written designation. The contact person impossible for any part of the corpus or income of the group trust
will receive copies of all correspondence as authorized. See retiree benefit plan to be used for, or diverted to, purposes other
instructions for Form 2848 or Form 8821. than for the exclusive benefit of the plan participants and their
beneficiaries. For more information see Rev. Rul. 2011-1.
Line 3. A group trust retiree benefit plan is defined as a pension,
profit-sharing, and stock bonus trust or custodial account qualifying Line 8. The group trust instrument must expressly limit the assets
under section 401(a) that is exempt under section 501(a); an that may be held by the group trust to assets that are contributed
individual retirement account that is exempt under section 408(e); by, or transferred from, a group trust retiree benefit plan to the
an eligible governmental plan trust or custodial account under group trust (and the earnings on the assets), and the group trust
section 457(b) that is exempt under section 457(g); a custodial instrument must expressly provide for the separate accounts (and
account under section 403(b)(7); a retirement income account under appropriate records) to reflect the interest which each adopting
section 403(b)(9); a section 401(a)(24) governmental plan; and a group trust retiree benefit plan has in the group trust. This includes
retirement plan that is qualified under the Puerto Rico Code and separate accounting for contributions to the group trust from the
described in section 1022(i)(1) of the Employee Retirement Income adopting plan, disbursements made from the adopting plan's
Security Act of 1974. account in the group trust, and investment experience of the group
trust allocable to that account. A transaction or accounting method
Line 4. The group trust instrument must expressly limit participation which has the effect of directly or indirectly transferring value from
in the group trust to group trust retiree benefit plans. The group the account of one adopting plan into the account of another
trust instrument may also limit participation in the group trust to adopting plan violates this separate accounting requirement.
certain types of group trust retiree benefit plans. For example, the However, a transaction that merely exchanges investments at fair
group trust instrument may limit participation in the group trust to market value between the accounts of one adopting plan to another
pension, profit-sharing, and stock bonus trusts qualifying under account of that adopting plan does not violate this separate
section 401(a) that are exempt under section 501(a), and individual accounting requirement.
retirement accounts exempt under section 408(e). See Rev. Rul.
2011-1 for information on the assets of commingled trust funds. A

Form 5316 (Rev. 12-2021)

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Form 5316 (Rev. 12-2021) Page 6
How To Get Forms, Publications, and The time needed to complete and file this form will vary
depending on individual circumstances. The estimated average time
Assistance is:
Getting tax forms, instructions, and publications. Visit Recordkeeping . . . . . . . . . . . . 6 hr., 42 min.
www.irs.gov/Forms to download current and prior-year forms, Learning about the law or the form . . . . . 3 hr., 2 min.
instructions, and publications.
Preparing, copying, assembling, and sending
Ordering tax forms, instructions, and publications. Go to the form to the IRS . . . . . . . . . . . 9 hr., 15 min.
www.irs.gov/OrderForms to order current forms, instructions, and
publications. If you have comments concerning the accuracy of these time
estimates or suggestions for making this form simpler, we would be
For questions regarding this form, call the Employee Plans happy to hear from you. You can send us comments from
Customer Service, toll-free, at 877-829-5500. www.irs.gov/FormComments. Or you can write to:
Paperwork Reduction Act Notice. We ask for the information on Internal Revenue Service
this form to carry out the Internal Revenue laws of the United Tax Forms and Publications Division
States. If you want to have your group trust approved by the IRS, 1111 Constitution Ave. NW, IR-6526
you are required to give us the information. We need it to determine Washington, DC 20224
whether you meet the legal requirements for the group trust Do notsend any of these forms or schedules to this address.
approval. Instead, see Where To File.
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 section 6103.

Form 5316 (Rev. 12-2021)

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