Application for EFAST Electronic Signature and Codes for EFAST Transmitters and Software Developers

Instructions for
Form EFAST-1

U.S. Department of Labor
Employee Benefits Security Administration

Application for EFAST Electronic Signature
and Codes for EFAST Transmitters and
Software Developers

GENERAL INSTRUCTIONS

Before completing the application, please read all
instructions. Failure to provide the requested
information may result in the return of the application.

PURPOSE OF FORM
WHERE TO FILE
Form EFAST-1 may be used by individuals to apply
under the ERISA Filing Acceptance System for an
EFAST electronic signature and by companies,
trades, businesses, or other persons to apply for
codes needed by EFAST transmitters and software
developers. Materials will be mailed to accepted
applicants within one week of receiving a completed
Form EFAST-1.

Mail the Form EFAST-1 application to:
EBSA
P.O. Box 7047
Lawrence, KS 66044-7047
You may also send it by private delivery service to: EBSA,
Attn: EFAST-1, 3833 Greenway Drive, Lawrence, KS,
66046-1290;

WHO MAY FILE
1. An individual who signs Form 5500 Annual
Returns/Reports of Employee Benefit Plan or
Form 5500-EZ Annual Returns of One-Participant
(Owners and Their Spouses) Retirement Plan needs
an EFAST electronic signature to file electronically via
modem, FTP, magnetic tape, floppy diskette, or
CD-ROM. That individual must apply for an EFAST
electronic signature by submitting a completed Form
EFAST-1 signed by that individual.
2. A company, trade, business, or other person
applying for EFAST Transmitter codes required to
transmit Forms 5500 and 5500-EZ for filing via
modem or FTP (an Encryption Key, Electronic Filing
Identification Number (EFIN), and Password) must
submit a completed Form EFAST-1 signed by an
authorized representative; or

Or fax your EFAST-1 application to 785-838-2185 (this is
not a toll-free number). This fax number is for EFAST-1
applications ONLY.

HOW TO FILE
Use black or blue ink. Do not write in the upper right corner
of the form above the words “Official Use Only” or on or
near the bar code at the bottom of the form. If completing
by hand, enter one letter or number per box as shown on
the first line of the illustration below. If typing, ignore the
vertical green lines and type anywhere within the boxes as
shown on the second line of the illustration below. Do not
enter commas or type more characters than the number of
boxes. If there are not a sufficient number of boxes,
abbreviate as necessary.

3. A company, trade, business, or other person
applying for codes required to be an EFAST Software
Developer (Software Developer ID, EFIN, Password,
and Personal Identification Number (PIN) and
Encryption Key needed for testing electronic filing
components of the software) must submit a
completed Form EFAST-1 signed by an authorized
representative.

Rev. 03/07

SPECIFIC INSTRUCTIONS

Layouts Guide and the Form 5500 Electronic Filer User’s
Guide for more information concerning EFAST transmitter
procedures.

Part I - Type of Application
Enter an “X” in the box on the appropriate lines to
indicate the type of application you are filing. You
may check more than one box in certain
circumstances. See the instructions for Part I below
on completing Lines A, B, and C, and for Part II on
signing the Applicant Agreement.
Line A - Check the box on line A if you are an
individual applying for an EFAST electronic signature.
Only one electronic signature is required for each
individual, even if that individual signs more than one
Form 5500 and/or Form 5500-EZ, for example, as the
administrator of several different plans, or signs a
single Form 5500 in several capacities, for example,
as plan administrator and as the employer. See the
Form 5500 Electronic Filer User’s Guide for more
information concerning electronic filing procedures.
Only individuals may apply for EFAST
electronic signatures. Electronic signatures
will NOT be issued to companies, trades,
businesses, or other persons. If the ”person”
required to file a Form 5500 or Form 5500-EZ is an
organization, an individual authorized to sign on
behalf of the organization must sign the Form 5500 or
Form 5500-EZ. A Form 5500 may require more than
one signature. In order to file such a Form 5500
electronically, each individual who signs must obtain
his or her electronic signature by individually
submitting a separate Form EFAST-1. The unique
EFAST electronic signature assigned to such
individual must be on the Form 5500 or Form 5500EZ filed electronically. See the instructions for the
Form 5500 or Form 5500-EZ for more information on
persons required to sign annual returns/reports and
on the requirement that plan administrators filing
electronically must keep as part of the plan’s records
a copy of the return/report including all required
handwritten signatures.

Line C - Check box C if you are applying for EFAST
software developer codes. You may check the boxes on
both line C and line A only if the individual applying for an
electronic signature is also authorized to sign the Applicant
Agreement on behalf of the person applying to be an
EFAST Software Developer. An EFAST Software
Developer is a company, trade, business, or other person
that creates, programs, or otherwise modifies computer
software to be used to complete Forms 5500 and/or Forms
5500-EZ in compliance with EFAST specifications. See the
File Specifications, Validation Criteria, and Record Layouts
Guide and the Form 5500 Electronic Filer User’s Guide for
more information concerning EFAST software developer
procedures.
Line D - Check the box on line D if the Form EFAST-1 is
being filed to update information previously submitted on a
Form EFAST-1 for an EFAST Transmitter or EFAST
Software Developer. Complete the entire application if you
check this box. We will use this updated information to
distribute new specifications and other information each
year to EFAST Software Developers and EFAST
Transmitters.

Part II - Applicant Agreement
The Applicant Agreement on the Form EFAST-1 must be
signed and dated. The individual applying for an electronic
signature must sign the Applicant Agreement, and enter his
or her name in the first row of boxes (last name first). If the
application is filed to be an EFAST Transmitter or Software
Developer, or both, an individual authorized to sign on
behalf of the applicant must sign and date the Applicant
Agreement and enter his or her name in the first row of
boxes (last name first) and title in the second row of boxes.
Accordingly, separate Form EFAST-1 applications must be
filed unless the individual applying for an EFAST electronic
signature is also authorized to sign on behalf of the EFAST
Transmitter and Software Developer.

Line B - Check the box on line B if you are applying
for EFAST transmitter codes. You may check the
boxes on both line B and line A only if the individual
applying for an electronic signature is also authorized
to sign the Applicant Agreement on behalf of the
person applying to be an EFAST Transmitter. An
EFAST Transmitter is a company, trade, business, or
other person that forwards Forms 5500 and/or Forms
5500-EZ for filing via modem in compliance with
EFAST electronic filing procedures. See the File
Specifications, Validation Criteria, and Record
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Rev. 03/07

Part III - EFAST Electronic Signature,
Transmitter and Software Developer
Applicant Information
Line A – Enter the name (last name first) of the
individual who is applying for an electronic signature.
If the name on Line A does not match the signature
on the Applicant Agreement, the application will not
be accepted and will be returned.
Line B - Enter the legal name of the company, trade,
business, or other person that is applying for codes to
be an EFAST transmitter or software developer.
Line C - Enter the nine-digit employer identification
number (EIN) of the company, trade, business, or
other person applying to be an EFAST transmitter or
software developer. If an EIN has not been assigned,
obtain one from the IRS before filing Form EFAST-1.
The Form SS-4, Application for Employer
Identification Number can be obtained at most IRS or
Social Security Administration (SSA) offices.
Individuals applying for an electronic signature should
leave this line blank.
Line D - Enter the business mailing address at which
you want to receive EFAST correspondence.
Line E - Enter the name of a contact person for
EFAST purposes if the contact person is not the
person who signed the Applicant Agreement.
Line F - Enter a daytime business telephone number
(including area code) for the person who signed the
Applicant Agreement or the EFAST contact person.
Line G - Enter a fax number, including area code, if
you would like to receive EFAST information via fax.
Leave this blank if you do not wish to receive
information via fax.

happen if we do not receive it and whether your response is
voluntary, required to obtain a benefit, or mandatory.
Our legal right to ask for the information is section 109(a) of
the Employee Retirement Income Security Act of 1974
(ERISA), and Internal Revenue Code sections 6001, 6011,
and 6012(a) and their related regulations. We are asking
for this information to verify your standing as a qualified
participant in the EFAST electronic filing / software
development program. Your response is voluntary.
However, if you do not provide the requested information,
you could be disqualified from participating in the EFAST
program. Also, if you provide false or fraudulent
information, you may be subject to criminal prosecution.
See section 1027, Title 18, U.S. Code (False statements
and concealment of facts in relation to documents required
by ERISA) and section 1001, Title 18, U.S. Code (Fraud
and False Statements - Statements or entries generally).
Other penalties may also apply.
PAPERWORK REDUCTION ACT NOTICE
You are not required to provide the information requested
on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number.
Books or records relating to a form or its instructions must
be retained as long as their contents may become material
in the administration of the Internal Revenue Code or are
required to be maintained under Title I or Title IV of ERISA.
The time needed to complete and file this form will vary
depending on individual circumstances. The estimated
average time is 20 minutes. If you have comments
concerning the accuracy of this time estimate or
suggestions for making this form simpler, we would be
happy to hear from you. See the “Contact Us” area on the
EFAST Web page for information on how to contact us.

Line H- Certain EFAST materials are available in
electronic format, e.g., Form 5500 Electronic Filer’s
User Guide and File Specifications, Validation
Criteria, and Record Layouts Guide. If you would like
to receive materials electronically, enter your e-mail
address in the appropriate boxes. Relevant EFAST
publications are also available through the Internet at:
www.efast.dol.gov.
PRIVACY ACT NOTICE
The Privacy Act of 1974 requires that when we ask
you for information we tell you our legal right to ask
for the information, why we are asking you for it, and
how it will be used. We must also tell you what could
Rev. 03/07

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