Return of Excise Taxes Related to Employee Benefit Plans

• Legal Form Number: 5330
• Year: 2025
• Issuer: Treasury Department
• Section: Treasury Department

Form 5330

(Rev. December 2022)

Return of Excise Taxes Related to Employee Benefit Plans

Department of the Treasury

Internal Revenue Service

(under sections 4965, 4971, 4972, 4973(a)(3), 4975, 4976, 4977, 4978, 4979,

4979A, 4980, and 4980F of the Internal Revenue Code)

Go to www.irs.gov/Form5330 for instructions and the latest information.

OMB No. 1545-0575

Filer tax year beginning , and ending ,

A Name of filer (see instructions)

Number, street, and room or suite no. (If a P.O. box or foreign address, see instructions.)

City or town, state or province, country, and ZIP or foreign postal code

B Filer’s identifying number (Enter either the

EIN or SSN, but not both. See instructions.)

Employer identification number (EIN)

Social security number (SSN)

C Name of plan

D Name and address of plan sponsor

E Plan sponsor’s EIN

F Plan year ending (MM/DD/YYYY)

G Plan number

H If this is an amended return, check here ................

Part I Taxes. You can only complete one section of Part I for each Form 5330 filed. See instructions.

Section A. Taxes that are reported by the last day of the 7th month after the end of the tax year

of the employer (or other person who must file the return)

FOR

IRS

USE

ONLY

1Section 4972 tax on nondeductible contributions to qualified plans (from Schedule A, line 12) . 161 1

2 Section 4973(a)(3) tax on excess contributions to section 403(b)(7)(A) custodial accounts (from

Schedule B, line 12) ......................... 164 2

3 a Section 4975(a) tax on prohibited transactions (from Schedule C, line 3) . . . . . . . . 159 3a

b Section 4975(b) tax on failure to correct prohibited transactions . . . . . . . . . . . 224 3b

4 Section 4976 tax on disqualified benefits for funded welfare plans . . . . . . . . . . 200 4

5 a Section 4978 tax on ESOP dispositions . . . . . . . . . . . . . . . . . . . 209 5a

b The tax on line 5a is a result of the application of: Sec. 664(g) Sec. 1042 5b

6 Section 4979A tax on certain prohibited allocations of qualified ESOP securities or ownership of

synthetic equity ........................... 203 6

7 Total Section A taxes. Add lines 1 through 6. Enter here and on Part II, line 17 . . . . . . 7

Section B. Taxes that are reported by the 15th day of the 10th month after the last day of the plan year

8 a

Section 4971(a) tax on failure to meet minimum funding standards (from Schedule D, line 2) . . .

163 8a

b Section 4971(b) tax for failure to correct minimum funding standards . . . . . . . . . 225 8b

9 a Section 4971(f)(1) tax on failure to pay liquidity shortfall (from Schedule E, line 4) . . . . . 226 9a

b Section 4971(f)(2) tax for failure to correct liquidity shortfall . . . . . . . . . . . . 227 9b

10 a Section 4971(g)(2) tax on failure to comply with a funding improvement or rehabilitation plan (see

instructions) ............................ 450 10a

b Section 4971(g)(3) tax on failure to meet requirements for plans in endangered or critical status

(from Schedule F, line 1c) . . . . . . . . . . . . . . . . . . . . . . . 451 10b

c Section 4971(g)(4) tax on failure to adopt rehabilitation plan (from Schedule F, line 2d) . . . 452 10c

d Section 4971(h) tax on failure of a CSEC plan sponsor to adopt funding restoration plan (from

Schedule L, line 2) .......................... 453 10d

Section B1. Tax that is reported by the last day of the 7th month after the end of the calendar year in which the excess fringe

benefits were paid to the employer’s employees

11 Section 4977 tax on excess fringe benefits (from Schedule G, line 4) . . . . . . . . . 201 11

12 Total Section B taxes. Add lines 8a through 10d or 11. Enter here and on Part II, line 17 . . 12

Section C. Tax that is reported by the last day of the 15th month after the end of the plan year

13 Section 4979 tax on excess contributions to certain plans (from Schedule H, line 2). Enter here

and on Part II, line 17 . . . . . . . . . . . . . . . . . . . . . . . . . 205 13

For Privacy Act and Paperwork Reduction Act Notice, see instructions. Cat. No. 11870M Form 5330 (Rev. 12-2022)