File Form 5330

Return of Excise Taxes Related to Employee Benefit Plans. $20 flat, manually reviewed. Currently in preview.

Filer (liable for the tax)

EIN (entity)…or SSN (individual)Business name (with EIN)Person name (with SSN)Name controlIn care ofStreetStreet 2CityState (US)ZIPForeign countryProvince (foreign)Postal code (foreign)Phone

Signer

NameTitlePhoneEmail5-digit PIN (auto if blank)Signature date

Plan information

Tax yearC — Plan nameD — Plan sponsor (business)…or sponsor (individual)E — Plan sponsor EINF — Plan year-end dateG — Plan number

D — Plan sponsor address

StreetStreet 2CityState (US)ZIPForeign countryProvince (foreign)Postal code (foreign)

Amended return

Part II — Tax computation

L17 — Total tax (auto from section if blank)L12 — Total Section B taxes (Section B only)L18 — Total paymentsL19 — Tax due (auto if blank)L20a — Overpayment (auto if blank)

Reported excise tax

Which excise tax is reported (exactly one)?

Schedule H L1 — Excess contributions (CODA)L2 — Tax (10%)

Direct deposit of refund (optional)

Include