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Form 15417I: 403(b) Plan 403(b)(9) Retirement Income Accounts Worksheet 16 –Determination of 403(b) Status
Internal Revenue Service Form 15417-I (4-2023) Catalog Number 94037R is a worksheet used for determining if a plan qualifies as a 403(b)(9) Retirement Income Account Plan. It requires answering questions about the plan's structure and requirements.
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IRS Form 15417I - 403(b) Plan 403(b)(9) Retirement Income Accounts Worksheet 16 –Determination of 403(b) Status
Internal Revenue Service Form 15417-I (4-2023) Catalog Number 94037R is a worksheet used for determining if a plan qualifies as a 403(b)(9) Retirement Income Account Plan. It requires answering questions about the plan's structure and requirements.
Risk Radar
Scan points- 1Always explain any “No” answer in the designated space on the worksheet, as this is required for determination.
- 2Failing to address Applicability questions (Section I) or using a plan that is not a 403(b)(9) Retirement Income Account Plan.
- 3Not explaining any "No" answer provided for eligibility under the plan (Section II).
- 4Omitting confirmation of separate accounting requirements in the underlying assets (Section III).
- 5Failing to limit commingling of retirement account assets only to amounts devoted exclusively to church purposes (Section IV, Part A).
Plain English
This worksheet helps determine if a retirement savings plan meets specific IRS criteria to be classified as a 403(b)(9) Retirement Income Account Plan. To use it, filers must confirm that the plan’s rules meet strict standards regarding asset management, funding sources, and participant eligibility.
Submission Date
- Filing date: 2025-03-05 22:10:19
- Preparation window: collect IDs, supporting records, and signatures in advance.
- Final review: verify names, dates, and required fields before submission.
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What this form is for
- Use this form when determining if a plan qualifies as a 403(b)(9) Retirement Income Account Plan, which requires using this worksheet first if the plan is such an account.
- Do not use it if the plan does not meet the structural requirements of a 403(b)(9) Retirement Income Account Plan, as the form is designed to determine status based on specific criteria.
- Check Worksheet 1A or other referenced worksheets (e.g., Worksheet 6A) when needing detailed information on eligibility, contribution limits, or nondiscrimination requirements.
Form selector
Use this form or another form?
The plan involves matching or employee after-tax contributions when determining nondiscrimination requirements.
This worksheet addresses coverage and nondiscrimination requirements for matching and after-tax provisions.
✓ Confirm the section references Worksheet 11A.
The employer is not a church or QCCO and needs to confirm general nondiscrimination language in the plan document.
The plan must contain specific nondiscrimination language, which requires consulting other worksheets for details on eligibility and minimum coverage provisions.
✓ Review the requirements listed under Worksheet 1A.
The retirement income account benefits are provided in the form of a life annuity.
This worksheet addresses restrictions on distributions applicable to annuity contracts.
✓ Ensure the plan provisions satisfy present value and benefit guarantee requirements as detailed in Worksheet 15.
Deadline or filing window
Not stated in the official source regarding filing deadlines or extensions.
Checklist
What you need before filling it out
Is the Retirement Income Account a defined contribution program?
Yes/No answer based on plan structure · Section I (p.1)
Does the plan require separate accounting for interest in underlying assets?
Yes/No answer regarding required accounting method · Section III, item a (p.2)
Are 403(b) elective deferrals the only contributions?
Yes/No answer based on plan rules · Section V, item a (p.2)
Does the plan provide that assets cannot be used for purposes other than plan benefit?
Yes/No answer regarding asset restriction · Section III, item c (p.2)
Is eligibility limited to employees of a church-related organization and their beneficiaries?
Yes/No answer based on participation rules · Section II (p.1)
Before you submit
- 1Ensure all items on Form 15417-I are completed, including explanations for any "No" answers.
- 2Verify that if the plan is a 403(b)(9) Retirement Income Account Plan, this worksheet was used first.
- 3Check Section II to confirm eligibility under the plan is limited to employees of a church-related organization and their beneficiaries.
- 4Confirm in Section III whether the plan requires separate accounting for the retirement income account’s interest in underlying assets.
- 5Review Section IV to determine if commingling of retirement account assets occurs, noting restrictions on those amounts.
- 6Verify that if the plan uses a group trust, it restricts investment assets only to specific types listed in the source.
- 7Confirm the applicability of nondiscrimination rules by checking if 403(b) elective deferrals are the only contributions.
How to file this form
- 1Complete all sections of Form 15417-I (4-2023) using the plan's official documentation.
- 2For every "No" answer provided on the worksheet, write a detailed explanation in the space designated on that section to clarify the issue.
- 3Review related worksheets, such as Worksheet 1A or Worksheet 6A, to ensure all necessary compliance requirements are addressed and documented.
- 4Keep a copy of the fully completed Form 15417-I for internal record keeping.
Known limitations
- 1The technical principles outlined in Form 15417-I may be changed by future regulations or guidelines.
- 2If a plan does not provide for commingling of retirement account assets in a common fund, Section IV is marked N/A.
- 3If the plan document does not use a group trust, Section IV is marked N/A.
- 4The form requires consulting other worksheets (e.g., Worksheet 6A) for specific limits on contributions.
Field map
Compact field-by-field guide
General Info
2 items
Full legal name and taxpayer identification number (SSN or EIN).
Current mailing address.
Details
2 items
Complete all applicable sections of this form according to the official IRS instructions.
Enter the relevant dollar amount if this form involves tax calculation.
Certification
1 items
Read and acknowledge any certifications required by this form.
Signatures
1 items
Sign and date. Unsigned forms cannot be processed.
Almost done reviewing the fields?
Fillable formOpen in Editor->The current edition of IRS Form 15417-I is dated 04/23. The official source excerpts do not mention any changes or point to a page with the latest information.
What changed or needs a fresh check
- Edition date — confirm the revision date reads 04/23.
- Form number — Confirm the form is Form 15417-I (4-2023).
- Mailing address — Not stated in the official source.
- Signature — The provided source excerpts do not specify a signing requirement.
Quick Facts
Downloads
After you file
- 1Retain Form 15417-I to document the determination of the plan’s status.
- 2Keep a copy of the completed worksheet in the organization's records.
- 3If any "No" answers were provided, retain the written explanation detailing why the requirement was not met.
- 4Use the current edition of Form 15417-I (4-2023) to ensure accuracy.
Sources
- SRCThe worksheet determines status for a 403(b)(9) Retirement Income Account Plan, and this worksheet should be used first if the plan is one [Form p.1].
- SRCA "Yes" answer generally indicates a favorable conclusion is warranted, while a "No" answer indicates a problem exists [Form p.1].
- SRCIf answering "No," the user must use the space on the worksheet to explain the issue [Form p.1].
- SRCThe technical principles in this worksheet may be changed by future regulations or guidelines [Form p.1].
- SRCFor determining eligibility, the plan must address whether it is limited only to employees of a church-related organization and their beneficiaries [Form p.1].
- SRCIf the plan provides for commingling assets, they are allowed to be commingled only with amounts devoted exclusively to church purposes [Form p.2].
- SRCThe form requires checking if the plan document specifies that only certain trust assets may be invested in a group trust (e.g., retirement income account assets) [Form p.2].
- SRCIf the plan provides for benefits as a life annuity, it must satisfy present value and benefit guarantee requirements of section 1.403(b)-9(a)(5) [Form p.3].
Common confusion points
Is my plan structure acceptable if I am not a church or QCCO?
The eligibility requirements for sponsoring employers are highly specific, listing multiple types of organizations (e.g., conventions or associations of churches) [Form p.1].
→ Confirm that the adopting employer meets one of the detailed descriptions listed in Section II regarding church-related status.
Can I use general funds to supplement my retirement account assets?
The rules governing commingling are strict, requiring specific limitations on what can be combined with dedicated retirement assets [Form p.2].
→ Review Section IV, part A, to confirm that any common fund assets used for the plan are devoted exclusively to church purposes.
What must I do if I answer 'No' on a question?
The worksheet is designed such that an answer of 'No' indicates a problem or deficiency in the plan's compliance [Form p.1].
→ Use the space provided on the worksheet to explain any 'No' answers thoroughly, detailing why the requirement was not met.
Do I need to track all my plan’s contributions?
The form requires checking compliance against multiple contribution types (elective deferrals, matching, and after-tax) [Form p.2].
→ Refer to the specialized worksheets listed in Section V to ensure all required nondiscrimination provisions are addressed.
Are there specific rules for how I must handle distributions?
If the plan provides benefits as a life annuity, the provisions must meet complex present value and benefit guarantee requirements [Form p.3].
→ Check Section VII to confirm that the plan's distribution structure satisfies all relevant statutory and actuarial assumptions.
Does this worksheet apply only if I am a minister or chaplain?
The form addresses eligibility for various types of self-employed individuals in addition to general employees [Form p.1].
→ Review Section II to ensure the plan's eligibility is correctly limited to the intended participants, including beneficiaries.
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Questions about IRS Form 15417I
What is IRS Form 15417I used for?
This worksheet helps determine if a retirement savings plan meets specific IRS criteria to be classified as a 403(b)(9) Retirement Income Account Plan. To use it, filers must confirm that the plan’s rules meet strict standards regarding asset management, funding sources, and participant eligibility.
What information does IRS Form 15417I require?
The form collects details across seven sections: Applicability, Employer Eligibility to Sponsor/Employee Eligibility to Participate, Requirements to be a 403(b)(9) Retirement Income Account Plan, Funding Vehicles, Nondiscrimination, Limits, and Distributions.
How do I complete IRS Form 15417I?
Users must complete all items across seven sections (I through VII). For each item, they must indicate "Yes," "No," or "N/A" and use the space provided to explain any "No" answer.
What happens if IRS Form 15417I is filed incorrectly?
The source does not specify penalties for filing errors; it only notes that the technical principles may be changed by future regulations or guidelines.
Is my plan structure acceptable if I am not a church or QCCO?
The eligibility requirements for sponsoring employers are highly specific, listing multiple types of organizations (e.g., conventions or associations of churches) [Form p.1]. Confirm that the adopting employer meets one of the detailed descriptions listed in Section II regarding church-related status.
Can I use general funds to supplement my retirement account assets?
The rules governing commingling are strict, requiring specific limitations on what can be combined with dedicated retirement assets [Form p.2]. Review Section IV, part A, to confirm that any common fund assets used for the plan are devoted exclusively to church purposes.
What must I do if I answer 'No' on a question?
The worksheet is designed such that an answer of 'No' indicates a problem or deficiency in the plan's compliance [Form p.1]. Use the space provided on the worksheet to explain any 'No' answers thoroughly, detailing why the requirement was not met.
Do I need to track all my plan’s contributions?
The form requires checking compliance against multiple contribution types (elective deferrals, matching, and after-tax) [Form p.2]. Refer to the specialized worksheets listed in Section V to ensure all required nondiscrimination provisions are addressed.
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