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The form you are looking for begins on the next page of this file. Before viewing it, 
please see the important update information below.

                           New Mailing Address

The mailing address for certain forms have change since the forms were last published. 
The new mailing address are shown below. 

Mailing Address for Forms 1023, 1024, 1024-A, 1028, 5300, 5307, 5310, 5310-A, 5316, 
8717, 8718, 8940:

Internal Revenue Service   
TE/GE Stop 31A Team 105                              
P.O. Box 12192       
Covington, KY 41012–0192

Deliveries by private delivery service (PDS) should be made to:

Internal Revenue Service 
7940 Kentucky Drive 
TE/GE Stop 31A Team 105 
Florence, KY 41042

This update supplements these forms’ instructions. Filers should rely on this update for 
the change described, which will be incorporated into the next revision of the form’s 
instructions.

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                                              Application for Group or              
            Form 5316                                                                                 OMB No. 1545-2166
            (June 2011)                               Pooled Trust Ruling
            Department of the Treasury (Under section 401(a) and 501(a) of the Internal Revenue Code)
            Internal Revenue Service
Review the Procedural Requirements Checklist on page 3 before submitting this    For Internal Use Only
application.

1a Name of the trust sponsor 

1b Address of trust sponsor (if a P.O. Box, see instructions) 1c City                            1d   State 1e         Zip Code

1f Country

1g Trust sponsor's employer identification number (EIN)       1h Telephone number         1i Fax number

2a Person to contact if more information is needed, see instructions  
   (If a Power of Attorney is attached, check box and do not complete this line.)

   Contact person’s name

2b Contact person’s address                                   2c City                            2d   State 2e         Zip Code

2f Telephone number                                           2g Fax number

If more space is needed for any item, attach additional sheets the same size as this form. Identify each additional sheet with the trust 
sponsor’s name and EIN and identify each item.

3a Name of trust (If trust name exceeds 70 characters, including spaces, see instructions)

3b Enter date trust agreement was executed

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 (6-2011)

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Form 5316 (6-2011)                                                                                                               Page 2
   Yes No
4                  Is the group trust adopted as part of each adopting group trust retiree benefit plan? (See instructions.)

5                  Does the group trust instrument expressly limit participation to: pension, profit-sharing, and stock bonus trusts 
                   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); and section 401(a)(24) governmental plans?

6                  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?

7                  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))?

8                  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?

9                  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?
10                 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?  

11                 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 (6-2011)

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Form 5316 (6-2011)                                                                                                       Page 3
                                  Procedural Requirements Checklist
Use this list to ensure that your submitted package is complete. Failure to supply the appropriate information may result in a delay in 
the processing of the application.

1. Is Form 8717, User Fee for Employee Plan Determination, Opinion, and Advisory Letter Request, attached to your 
   submission?

2. Is the appropriate user fee for your submission attached to Form 8717?

3. If appropriate, 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 the Disclosure Request by 
   Taxpayer in the instructions and Rev. Proc. 2011-4.)

4. Is a copy of your group trust's determination letter, if any, attached?

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

6. Is the Employer Identification Number (EIN) of trust sponsor entered on line 1g?

7. Does line 3b provide the trust’s original effective date?

8. Is the application signed and dated? (Stamped signatures are not acceptable; see Rev. Proc. 2011-4.)

                                                                                                       Form 5316 (6-2011)

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Form 5316 (6-2011) Page 4
What’s New • United Parcel Service (UPS): UPS Next Day Air, UPS Next Day Air
Saver, UPS 2nd Day Air, UPS 2nd Day Air A.M., UPS Worldwide
This is a new form. Prior to this form, a letter was submitted in lieu Express Plus, and UPS Worldwide Express.
of a form. Review the Procedural Requirements Checklist and these
instructions before completing the application. The private delivery service can tell you how to get written proof
of the mailing date.
Public inspection. The group trust is open to public inspection.
Disclosure request by taxpayer. The Tax Reform Act of 1976 How To Complete the Application
permits a taxpayer to request the IRS to disclose and discussthe Applications are screened for completeness. The application must
taxpayer’s return and/or return information with any person(s)the be signed by the employer or plan administrator.
taxpayer designates in a written request. Use Form 2848,Power of
Attorney and Declaration of Representative, if therepresentative is Stamped signatures are not acceptable; see Rev. Proc.
qualified to sign, or Form 8821, Tax InformationAuthorization, for 2011-4, 2011-1 I.R.B. 123, available at
this purpose. See Pub. 947, Practice Beforethe IRS and Power of ▲! www.irs.gov/irb/2011-01_IRB/ar09.html.
Attorney, for more information. CAUTION
Incomplete applications may be returned to the applicant. For this
reason, it is important that an appropriate response be entered for
General Instructions each line item (unless instructed otherwise). In completing the
Section references are to the Internal Revenue Code unless application, pay careful attention to the following:
otherwise noted. • N/A (not applicable) is accepted as a response only if an N/A
block is provided.
Purpose of Form • If a number is requested, a number must be entered.
Group/pooled trust sponsors file this form to request a • If an item provides a choice of boxes to check, check only one
determination letter from the IRS for a determination that the trust is box unless instructed otherwise.
a group trust arrangement as described in Rev. Rul. 81-100, 1981-1
C.B. 326, as clarified and modified by Rev. Rul. 2004-67, 2004-2 • If an item provides a box to check, written responses are not
C.B. 28, and as modified by Rev. Rul. 2011-1, 2011-2 I.R.B. 251, acceptable.
available at www.irs.gov/irb/2011-02_IRB/ar08.html. • The IRS may, at its discretion, require a plan restatement or
additional information any time it is deemed necessary.
Type of Trust • The application has formatted fields that will limit the number of
A group/pooled trust is a trust that meets the qualification characters entered per field.
requirements of Rev. Rul. 81-100 as modified and clarified by Rev. • All data input will need to be entered in Courier 10 point font.
Rul. 2004-67 and as modified by Rev. Rul. 2011-1.
• Alpha characters should be entered in all capital letters.
Who May File • Enter spaces between any words. Spaces do count as characters.
This form should be filed by the sponsor of a group/pooled trust. • All date fields are entered as an 8-digit field (MMDDYYYY).
Where To File The IRS annually updates the revenue procedure which sets forth
the procedures for issuing determination letters to qualified plans,
File Form 5316 at the address indicated below: including determination letters for group trusts. The annual revenue
Internal Revenue Service procedure may be found in the Internal Revenue Bulletin. For
P.O. Box 12192 example, the revenue procedure for 2011 is Rev. Proc. 2011-6,
Covington, KY 41012-0192 2011-1 I.R.B. 123, available at www.irs.gov/irb/2011-01_IRB/
ar11.html.
Requests shipped by express mail or a delivery service should be
sent to: What To File
Internal Revenue Service 1. A check for the appropriate user fee and Form 8717, User Feefor
201 West Rivercenter Blvd. Employee Plan Determination, Opinion, and Advisory Letter
Attn: Extracting Stop 312 Request. Attach a check or money order payable to the “United
Covington, KY 41011 States Treasury” for the full amount of the user fee.
Private delivery services. In addition to the U.S. mail,you can use 2. A completed Form 5316.
certain private delivery services designated by theIRS to meet the
“timely mailing as timely filing/paying” rule fortax returns and 3. A copy of the trust’s latest determination letter.
payments. The list of designated private deliveryservices includes 4. The trust instrument and related documents.
only the following:
• DHL Express (DHL): DHL Same Day Service.
• Federal Express (FedEx): FedEx Priority Overnight, FedEx
Standard Overnight, FedEx 2Day, FedEx International Priority, and
FedEx International First.
Form 5316 (6-2011)

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Form 5316 (6-2011) Page 5
Line 7. A group trust retiree benefit plan that is a governmental plan
Specific Instructions for purposes of section 401(a)(24) is treated as meeting the
Line 1a and 1b. Enter the name and address of the trust requirement to be tax exempt if it is not subject to federal income
sponsor/employer. taxation.
Address should include the suite, room, or other unit numberafter Line 8. Each group trust retiree benefit plan which adopts the group
the street address. If the post office does not deliver mailto the trust must expressly provide in its governing document that it is
street address and the plan has a P.O. box, show the boxnumber impossible for any part of the corpus or income of the group trust
instead of the street address. The address should be theaddress of retiree benefit plan to be used for, or diverted to, purposes other
the sponsor/employer. than for the exclusive benefit of the plan participants and their
Line 1g. Enter the 9-digit trust employer identification number(EIN) beneficiaries. For more information see Rev. Rul. 2011-1.
assigned to the trust sponsor. Line 9. The group trust instrument must expressly limit the assets
The trust sponsor/employer must have an EIN. To apply for an that may be held by the group trust to assets that are contributed
EIN: by, or transferred from, a group trust retiree benefit plan to the
group trust (and the earnings on the assets), and the group trust
• Mail or fax Form SS-4, Application for Employer Identification instrument must expressly provide for the separate accounts (and
Number, obtained by calling 1-800-TAX-FORM (1-800-829-3676). appropriate records) to reflect the interest which each adopting
• Call 1-800-829-4933 to receive your EIN by telephone. group trust retiree benefit plan has in the group trust. This includes
• Select the Online EIN Application link at IRS.gov. The EIN is separate accounting for contributions to the group trust from the
issued immediately once the application information is validated. adopting plan, disbursements made from the adopting plan's
account in the group trust, and investment experience of the group
Note. This EIN must be used in all subsequent filings of thetrust trust allocable to that account. A transaction or accounting method
determination letter requests. which has the effect of directly or indirectly transferring value from
Line 2a. Complete this line, or check the box and attach apower of the account of one adopting plan into the account of another
attorney or other written designation. The contactperson will adopting plan violates this separate accounting requirement.
receive copies of all correspondence as authorized.See instructions However, a transaction that merely exchanges investments at fair
for Form 2848 or Form 8821. market value between the accounts of one adopting plan to another
Line 3a. Due to space restrictions this field is limited to 70 account of that adopting plan does not violate this separate
characters, including spaces. Please complete this item with how accounting requirement.
the trust name should read on the trust determination letter tothe
extent permitted. Due to this restriction, please keep in mindthat How To Get Forms, Publications, and
“Employees” and “Trust” are not needed and will be left offif space Assistance
does not permit. Internet. You can access the IRS website 24 hours a day, 7days a
Line 3b. Enter the date the trust agreement was executed. week atIRS.govto:
Line 4. Each group trust retiree benefit plan must adopt the group • Download forms, instructions, and publications;
trust as part of the plan. A group trust retiree benefit plan is defined • Order IRS products on-line;
as a pension, profit-sharing, and stock bonus trust or custodial
account qualifying under section 401(a) that is exempt under • Research your tax questions on-line;
section 501(a); an individual retirement account that is exempt • Search publications on-line by topic or keyword; and
under section 408(e); an eligible governmental plan trust or • Sign up to receive local and national tax news by email.
custodial account under section 457(b) that is exempt under section
457(g); a custodial account under section 403(b)(7); a retirement DVD of tax products. You can order Publication 1796, IRS Tax
income account under section 403(b)(9); and a section 401(a)(24) Products DVD, and obtain:
governmental plan. • Current-year forms, instructions, and publications.
Line 5. The group trust instrument must expressly limit participation • Prior-year forms, instructions, and publications.
in the group trust to group trust retiree benefit plans. The group • Tax Map: an electronic research tool and finding aid.
trust instrument may also limit participation in the group trust to
certain types of group trust retiree benefit plans. For example, the • Tax Law frequently asked questions.
group trust instrument may limit participation in the group trust to • Tax Topics from the IRS telephone response system.
pension, profit-sharing, and stock bonus trusts qualifying under • Internal Revenue Code — Title 26.
section 401(a) that are exempt under section 501(a), and individual
retirement accounts exempt under section 408(e). See Rev. Rul. • Fill-in, print, and save features for most tax forms.
2011-1 for information on the assets of commingled trust funds. • Internal Revenue Bulletins.
Line 6. The group trust instrument must expressly prohibit any part of its • Toll-free and email technical support.
corpus or income that equitably belongs to any adopting group trust • The DVD is released twice during the year.
retiree benefit plan from being used for, or diverted to, any purpose
other than for the exclusive benefit of the participants and the — The first release will ship the beginning of January.
beneficiaries of the group trust retiree benefit plan. Plan assets are — The final release will ship the beginning of March.
treated as used for, or diverted to, a purpose other than for the exclusive Purchase the DVD from the National Technical Information
benefit of the plan participants or beneficiaries if the assets of one group Service (NTIS) at www.irs.gov/cdorders for $30 (no handling fee), or
trust retiree benefit plan are used to provide benefits under another call 1-877-233-6767 toll-free to purchase the DVD for $30 (plus a $6
group trust retiree benefit plan even if the plan participant or beneficiary handling fee) (price subject to change).
receiving the benefits is a participant or beneficiary under both plans.
Form 5316 (6-2011)

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Form 5316 (6-2011) Page 6
By phone and in person. You can order forms and publications24 The time needed to complete and file this form will vary
hours a day, 7 days a week, by calling 1-800-TAX-FORM depending on individual circumstances. The estimated average time
(1-800-829-3676). You can also get most forms and publicationsat is:
your local IRS office. Recordkeeping . . . . . . . . . . . . 6 hr., 42 min.
For questions regarding this form, call the Employee Plans Learning about the law or the form . . . . . 3 hr., 2 min.
Customer Service, toll-free, at 1-877-829-5500.
Preparing, copying, assembling, and sending
the form to the IRS . . . . . . . . . . . 9 hr., 15 min.
Paperwork Reduction Act Notice. We ask for the informationon
this form to carry out the Internal Revenue laws of the United If you have comments concerning the accuracy of these time
States. If you want to have your group trust approved by theIRS, estimates or suggestions for making this form simpler, we would be
you are required to give us the information. We need it todetermine happy to hear from you. You can write to the Internal Revenue
whether you meet the legal requirements for the grouptrust Service, Tax Products Coordinating Committee,
approval. SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6526,
Washington, DC 20224.
You are not required to provide the information requested on a
form that is subject to the Paperwork Reduction Act unless the form Do not send any of these forms or schedules to this address.
displays a valid OMB control number. Books or records relating to a Instead, see Where To File.
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 (6-2011)

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