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INTERNAL REVENUE SERVI --° LASE NO 84713300EP
P.O. bOX 2135 CONT _ DATE 05-10-77
AUSTIN , TX 75767 I-0'>M NJ 5300
E^•P ID ND d4-6060001
PLAN NArtE WELD COUNTY RETIi2ENENT PLAN
PLAN N3 001
FILE NO 640001884
WELD COUNTY • DATE OF THIS LETTER
P 0 BOX 75R
GREELEY, CO 80631 AUG 2 1877
Dear Applicant:
Based on the information supplied, we have made a favorable determination •
on your application identified above. Please keep this letter in your permanent records.
Continued qualification of the plan will depend on its effect in operation
under its present form. (See section 1.401-1(b)(3) of the Income Tax Regulations.)
The status of the plan in operation will be reviewed periodically.
The enclosed Publication 794 describes some events that could occur after
you receive this letter that would automatically nullify it without specific notice
from us. The publication also explains how operation of the plan may affect a favorable
determination letter, and contains information about filing requirements.
This letter relates only to the status of your plan under the Internal Revenue Code.
It is not a determination regarding the effect of other Federal or local statutes.
Please see Form 5616, enclosed, which is an integral part of this determination letter.
Sincerely yours,
Rk-C;ce4.772), r 110 =eats.
DISTRICT DIRECTOR
Enclosures:
Publication 794
Form 5616
770486
PCoote
FORM 5869 ('REV. 4-77)
.5616 Departnx nt of the Treasury - Inter rr Revenue Service Case Nunilu•r
Form 8471330051
(Rev. 6-771 Enclosure, ,i Favorable D termination fitter
Date%AFI2ir}iN Anvnded Person to Contact Telephone. Number
March 16, 1977 James Heinrich (303)837-3195
For your information, we have listed the following items that may apply to your plan, including some which may
cause a plan to become disqualified in operation. If no items` are checked, none apply to your plan.
!l C. This determination is not an indication that the Internal Revenue Service is in any way passing on the actuarial
soundness of the plan or on the reasonableness of the actuarial computations.
El D. This determination letter is conditioned upon your adoption of the proposed amendments submitted in your letter
dated . The adoption of the proposed amendments should be made on or before the date prescribed
by the regulations under section 401W) of the Internal Revenue Code.
E. This determination letter is conditioned upon your adoption of the proposed amendments submitted in your repre-
sentative's letter dated June 8, 1977 The adoption of the proposed amendments should be made on or before
the date prescribed by the regulations under section 401(b) of the Internal Revenue Code.
' ] F. This plan is considered as applying only to employees who can retire and obtain benefits during the term for
which it is drawn; no other employees are considered covered. Therefore, the provision of section 404 of the
Internal Revenue Code will be applied only to covered employees.
G. The trust, not having been created or organized in the United States, is not a qualified trust under section
401(a) and is not exempt under section 501(a) of the Internal Revenue Code. Based on the information you sub-
mitted, however, we have determined that the trust is part of a plan which meets the requirements of section
401(a) in all other respects and that it would qualify for exemption under section 501(a) except for the fact that
it is created ur organized outside the United States. Therefore, distributions to beneficiaries will be taxable
as though made through an exempt trust, as provided in section 402(e). Deductions for contributions made by
the employer, who is a domestic corporation or resident of the United States, are allowable as provided in
section 404(a)(4) of thee Code.
H. This determination tenor is not applicable beginning with any yi.ar in which discrimination prohibited by section
401(a)(4) of the Internal Revenue Code arises because of the yams of service weighing factor applied in allocat-
ing employer contributions. (See Rev, Rul. G3-653, 1968-2 C.B. 177.)
J. Your plan does not consider total compensation for purposes of computing benefits. This provision may, in
operation, discriminate in favor of employees who are stockholders, officers, or highly compensated. If this
discrimination occurs, your plan will not remain qualified, (See Rev, Rul. 69-503, 1969-2 C.B. 94.)
IC K. This determination applies to tax years beginning after
1 L. We have sent a copy of this letter to your representative as indicated in the power of attorney.
;l M.
If you have any questions, please contact the person whose name and telephone number are shown on the top of
this form and refer to the EIN-Plan Number and File Folder Number in the heading of the letter.
'Checkbox code letters are for Internal Revenue Service use, Form 5616 (Rev. 6-77)
Favorable
Determination Publication 794
Letter (Revised November 1976)
Operational Features which Affect the Qualified
Status of a Plan and Plan Reporting Requirements
Part I. Significance of a Favorable Oroo epehcatron, a favorable determination letter may not
Determination Letter apply.
A nbn ‘‘,/ill be considered as meeting these coverage
An employer may a=e a favorable determination letter requirements during the whole taxable year if on any
as a basis for deducting on the income tax return the ono day of en' h quarter it satisfies the requirements,
contributions to a p'an The qualification n' a plan is de- Allocation or Forfeitures. II employee turnover results 'n
termined from the inrnrmahon in the ;'Pion plan doom- the ,Iln-atinn e! forfeitures principally In Ihr pear! I
mont and supporting information submitted 1'y Inc em- inihrr's, chnreholde'r. and h'phly compensated empla,go•_.,
player. and ind,cat':s !tint the features or the plan con- a favorable deterrnm,it,on will not apply,
form with the requirements of In!c'nal Revenue Code Se,-
Amendments to the Plan. A Revenue Ruling can also ad-
lion 401(a). But it is the actual carryAron of the plan that versela attest a favorable determination letter but only for
governs its continued qualification' years alter the Ruling is issued. Hence, all plans mm-,•
A plan qualifies in operation it iI is maintained ac- he nmonded In comply with relevant Rulings. The amend-
cording to the terms and limitations on which a favorable men! must ne otterl,ve not later than the first day of the
determination letter was issued However, many con- I'rrt taxable year beginning after the Ruling is published.
d'tions can develop durino operation that are inconsistent •
,with the features in the v.ritten plan document, and they Part II. Reporting Requirements
may Jeopardize the plan's qualiiiration. The following
items are examples of the more common cperahnn:II tea- E rt h plan administrator or employer who maintain`, Oq
tures that adversely affect a favorable determination emplr'ace benefit I-in must til
e e an annual re'urni rnpori
c.i bnill the Internal Revenue Service aril the De-
Coverage Requirements. If coverage is based on the per-
p,r�l„ant of Libor. The forms developed for his purpose
cen!age requirement of Section 4701 bl(PIA) of the Code, are Fenn 5500 rCerperate or Keogh plan with 100 or more
and this requirement is nor met alter the issuance of the
parer t tints;. Four, 5500-0 (Corporate Or Keogh plan with
participants
determination letter. the taxpayer may not rely loan toil none el ;Ahem I:, .tin nv,nei-
on the letter. pmp'oygei. and Form 5500-K (Keogh plan with fever than
Similarly, if coverage is based on the requirement of 100 participants and at least one owner-employee The
Section 410(bil11(B) of the Code and the coverage of return 'report is published in a package v.hich inclu.i's
employees in the lower and middle compensation ranges the necessary attachments as well as filing requirements
is reduced materially in any stbsequent year from that in and instructions.
f
U.S. DEPARTMENT (II LABOR ‘,,,°t '4;
Pension and Welfare Benefit Programs ° ,A
'F
Washington, D.C. 20216 rp lh 24§,-
r
To: Administrators of Employee Pension
and Welfare Benefit Plans
The Employee Retirement Income Security Act of 1974 (ERISA) requires
administrators of employee pension benefit plans (pension, profit
sharing and other plans that provide retirement income to employees
or result in a deferral of income by employees for periods extending
to the termination of covered employment or beyond) , and employee
welfare benefit plans (medical, surgical, hospital , sickness, accident,
disability, death, unemployment, vacation, apprenticeship, day care
centers, scholarship funds, prepaid legal services, etc.) to meet
certain reporting and disclosure requirements. Within 120 days after
a new plan comes into existence, plan administrators are to file a
plan description with the Secretary of Labor on Form EBS-1. A summary
plan description must he filed with the Secretary of Labor and
furnished each plan participant and beneficiary. An exception to the
foregoing is that a Form EBS-1 need not be filed with the Secretary
of Labor for a non-trusteed welfare plan with fewer than 100 partici-
pants.
To obtain a copy of Plan Description Form FIBS-1 or information about
the srmnnary plan description and other reporting and disclosure
requirements of ERISA, contact the nearest Area Office of the Labor
Department 's Labor-Management Services Administration (see list on
reverse side) .
Administrator
Pension and Welfare
Benefit Programs
U.S. Department of Labor
• LMSA 645 (4/77)
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