Private delivery services (PDSs).

In addition to the United States mail, you can use the private delivery services designated by the IRS to meet the “timely mailing as timely filing/paying” rule for tax returns and payments. Go to IRS.gov/PDS for the current list of designated services.

The PDS can tell you how to get written proof of the mailing date.

Private delivery services must send Form 8955-SSA to:

Mandatory electronic filing.

For 2013 and prior years, filers had the option of filing Form 8955-SSA electronically. Beginning with the 2014 Form 8955-SSA, however, some filers are now required to file the form electronically. A filer must electronically file the 2023 Form 8955-SSA if the filer is required to file 250 returns of any type during the calendar year that includes the first day of the plan year. “Returns” for this purpose include information returns (for example, Forms W-2 and 1099), income tax returns, employment tax returns (including quarterly Forms 941), and excise tax returns. If a filer is required to file a Form 8955-SSA electronically but does not, the filer is considered not to have filed the form even if a paper return is submitted.

The requirement to file the 2023 Form 8955-SSA electronically does not apply to filers filing for relief under Notice 2014-35, 2014-23 I.R.B. 1072 (relating to filers who qualify for relief under the Department of Labor’s Delinquent Filer Voluntary Compliance Program). See Regulations section 301.6057-3 for more information on the mandatory electronic filing of Form 8955-SSA.

The IRS may waive the requirements to file Form 8955-SSA electronically in cases of undue economic hardship. For information on filing a request for a hardship waiver, see Rev. Proc. 2015-47, 2015-39 I.R.B. 419, available at IRS.gov/irb/2015-39_IRB/ar16.html, and IRS.gov/Retirement-Plans/FAQs-Regarding-Form-8955-SSA.

Electronic and paper filing.

You can:

Processing tips.

To reduce the possibility of correspondence and penalties:

Line A.

Check this box if you are electing to file this form voluntarily. The plan administrators of plans, such as governmental plans and non-electing church plans, not subject to the vesting standards of section 203 of ERISA are not required to file this form but may elect to do so. If such a plan administrator so elects, the plan administrator is encouraged to provide as much information as possible, but no specific requirements are imposed.

Line B.

Check this box if this Form 8955-SSA amends a previously filed Schedule SSA (Form 5500) or Form 8955-SSA.

Line C.

Check the appropriate box if an extension of time has been filed using Form 5558, or if an automatic or special extension has been granted. If a special extension has been granted, enter the description of the special extension exactly as it is listed in the announcement. See Other Extensions of Time To File, earlier, for additional information regarding special extensions.

Line 1a.

Enter the formal name of the plan or enough information to identify the plan. Abbreviate if necessary.

Line 1b.

Enter the three-digit number that the employer or plan administrator assigned to the plan and uses to file the plan's Form 5500 return/report.

Line 2a.

Enter the name of the plan sponsor. The term “plan sponsor” means:

Line 2b.

Enter the sponsor's nine-digit EIN. Do not use a social security number (SSN). Sponsors without an EIN must apply for one as soon as possible.

EINs are issued by the IRS. You can apply for an EIN:

A multiple-employer plan or plan of a controlled group of corporations should use the EIN of the sponsor identified on line 2a. The EIN must be used in all subsequent filings of Form 8955-SSA. (See the instructions for line 5 about changes in EIN.)

If the plan sponsor is a group of individuals, get a single EIN for the group (providing the group name).

Line 2c.

Enter the plan sponsor's trade name if that trade name is different from the plan sponsor's name entered on line 2a.

Line 2e.

If you want a third party to receive mail for the plan, enter “C/O” followed by the third party's name and complete the applicable mailing address on lines 2f through 2l.

Line 2f.

Enter the plan sponsor's street address. A post office box may be entered if the Post Office does not deliver mail to the plan sponsor's street address.

Line 2g.

Enter the name of the city.

Line 2h.

Enter the two-character abbreviation for the U.S. state or territory.

Line 2j.

Enter the foreign province or state, if applicable.

Line 2k.

Enter the foreign country, if applicable.

Line 2l.

Enter the foreign postal code, if applicable. Leave the U.S. state and ZIP code blank if completing line 2k or line 2l.

Line 3a.

Enter the plan administrator's name. Enter “Same” if the plan administrator identified on line 3a is the same as the plan sponsor identified on line 2a and leave lines 3b through 3k blank.

“Plan administrator” for this purpose means:

Line 3b.

Enter the plan administrator's nine-digit EIN. Plan administrators who do not have an EIN must apply for one as described in the instructions for line 2b.

Line 3c.

If you want a third party to receive mail for the plan administrator, enter “C/O” followed by the third party's name and complete the applicable mailing address on lines 3e through 3k.

Line 3e.

Enter the plan administrator's street address. A post office box may be entered if the Post Office does not deliver mail to the sponsor's street address.

Line 3f.

Enter the name of the city.

Line 3g.

Enter the two-character abbreviation for the U.S. state or territory.

Line 3i.

Enter the foreign province or state, if applicable.

Line 3j.

Enter the foreign country, if applicable.

Line 3k.

Enter the foreign postal code, if applicable. Leave the U.S. state and ZIP code blank if completing line 3j or line 3k.

Line 4.

If the plan administrator's name and/or EIN have changed since the most recent Schedule SSA (Form 5500) or Form 8955-SSA was filed for this plan, enter the plan administrator's name and EIN as they appeared on the most recently filed Schedule SSA (Form 5500) or Form 8955-SSA.

Failure to indicate on line 4 that a plan administrator was previously identified by a different name or EIN could result in correspondence from the IRS.

Line 5.

If the plan sponsor's name and/or EIN have changed since the most recently filed Schedule SSA (Form 5500) or Form 8955-SSA for this plan, enter the plan sponsor's name, EIN, and the three-digit plan number as they appeared on the most recently filed Schedule SSA (Form 5500) or Form 8955-SSA.

Failure to indicate on line 5 that a plan sponsor was previously identified by a different name or EIN could result in correspondence from the IRS.

Line 6a.

For a plan to which only one employer contributes, provide the total number of participants entitled to a deferred vested benefit who separated from service in the 2022 plan year and who were not previously reported. For a plan to which more than one employer contributes, provide the total number of participants entitled to a deferred vested benefit who completed the second of two consecutive 1-year breaks in service in the 2023 plan year and who were not previously reported.

Line 6b.

For a plan to which only one employer contributes, provide the total number of participants entitled to a deferred vested benefit who separated from service under the plan in the 2023 plan year and who are reported in Part III of this form. For a plan to which more than one employer contributes, provide the total number of participants entitled to a deferred vested benefit who separated from service under the plan in 2023 or who completed the first 1-year break in service in the 2023 plan year and who are reported in Part III of this form. See When To Report a Separated Participant.

Do not include any participants on line 6a or 6b who were previously reported on a Form 8955-SSA or a Schedule SSA (Form 5500). Accordingly, only those participants who are listed with an Entry Code A on page 2 should be included on line 6a or 6b.

Line 7.

The sum of lines 6a and 6b should equal the number on line 7.

Line 8.

Check the appropriate box as to whether the plan administrator provided the individual statement to each participant required to receive one. See Penalties.

Signature.

Form 8955-SSA must be signed and dated by the plan sponsor and by the plan administrator. If the plan administrator and the plan sponsor are the same person, include only the signature as plan administrator on the form. If more than one page 2 of the form is filed for one plan, only one page 1 of Form 8955-SSA should be signed and filed with the pages 2 for the plan.

Line 9, column (a).

Enter the appropriate code from the following list.

Line 9, column (b).

Enter the full nine-digit SSN of each participant listed. Please do not enter only the last four digits of the SSN. If the participant is a foreign national employed outside the United States who does not have an SSN, enter the word “FOREIGN”.

Line 9, column (c).

Enter each participant's name exactly as it appears on the participant's social security card. Do not enter periods; however, initials, if on the social security card, are permitted.

After the last name column, there is a checkmark column. Check the box for each participant whose information is based on incomplete records. Information for a participant may be based on incomplete records where more than one employer contributes to the plan and the records at the end of the plan year are incomplete regarding the participant's service. Check the box next to a participant's name if:

Line 9, column (d).

From the following list, select the code that describes the type of annuity that will be provided for the participant. Enter the code that describes the type of annuity that normally accrues under the plan at the time of the participant's separation from service covered by the plan (or, for a plan to which more than one employer contributes, at the time the participant incurs the second consecutive 1-year break in service under the plan).

Type of Annuity Code

Line 9, column (e).

From the following list, select the code that describes the benefit payment frequency during a 12-month period.

Type of Payment Code

Line 9, column (f).

For a defined benefit plan, enter the amount (in whole dollars) of the periodic payment that a participant is entitled to receive.

In general, a deferred vested benefit under a defined benefit plan would be reported under line 9, column (f), as the periodic payment that the participant is entitled to receive. The plan administrator may, however, report a different form of benefit if the plan administrator considers it more appropriate. For example, the plan administrator of a cash balance plan may report a participant's benefit as the participant's hypothetical account balance. In that case, the plan administrator may enter Code A (a single sum) in column (d) and Code A (a lump sum) in column (e).

For a multiemployer plan, if the amount of the periodic payment cannot be accurately determined because the plan administrator does not maintain complete records of covered service, enter an estimated amount.

Line 9, column (g).

For defined contribution plans, enter the value (in whole dollars) of the participant's account.

Line 9, columns (h) and (i).

Show the EIN and plan number of the plan under which the participant was previously reported.