Lines 1 and 2: plan provider
The name of the plan provider and the provider's employer identification number.
8717-A
User Fee for Employee Plan Opinion Letter Request
Form 8717-A, User Fee for Employee Plan Opinion Letter Request, is used to make additional payments for applications submitted on Form 4461, Form 4461-A, Form 4461-B, or Form 4461-C. The instructions say it is now used only to make an additional payment when an insufficient user fee was paid for an opinion letter application submitted on one of those forms.
The instructions also say Form 8717-A is no longer attached to the Form 4461 series, because the initial user fee payments are made through www.Pay.gov. The form pays any corrected amount after a fee has been submitted and processed through Pay.gov for a pre-approved plan application. It identifies the plan provider and the plan, shows the type of user fee on line 5, and is mailed with a check or money order.
You can fill out Form 8717-A free in your browser on this page and download it without an account.

The name of the plan provider and the provider's employer identification number.
The plan number and the plan name.
Mass or non-mass submitter fees per basic plan document with one adoption agreement, per each additional adoption agreement, and per each single document plan with no adoption agreements.
A provider's identical adoption or minor modification of a mass submitter basic plan document, per adoption agreement or single document plan, and the assumption of sponsorship of a pre-approved plan.
A box at the top right where the IRS records the amount paid.
Enter the plan provider's name and EIN, the plan number and the plan name.
The instructions say to check the appropriate box on line 5 and enter the amount of additional payment due.

The instructions point to the schedule for user fees in Rev. Proc. 2024-4, 2024-1 I.R.B. 247, at www.irs.gov/irb/2024-01_IRB#RP-2024-4, or the latest annual update.
Attach a check or money order made payable to "United States Treasury" for the additional user fee. The form marks the spot: "Attach Check or Money Order Here."
Send the form and payment to the IRS address for U.S. mail, or the one for Express Mail or a private delivery service.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
Internal Revenue Service, Attn: Pre-Approved Plans Coordinator, P.O. Box 2508, Room 6-403, Group 7521, Cincinnati, OH 45201-2508.
Internal Revenue Service, Attn: Pre-Approved Plans Coordinator, 550 Main Street, Room 6-403, Group 7521, Cincinnati, OH 45202.
The instructions say that if you don't include the proper amount, your application may be returned.
The instructions say initial user fee payments for applications on Form 4461, 4461-A, 4461-B or 4461-C are made through www.Pay.gov.
The form points to www.irs.gov/Form8717A for the latest information. The IRS About page also lists Revenue Procedure 2022-04 among other useful items.
4461
54 fields, 5 pages
4461-A
55 fields, 5 pages
4461-B
32 fields, 3 pages
4461-C
66 fields, 5 pages
8717
18 fields, 2 pages
Line 1 asks for the name of the plan provider and line 2 for the provider's employer identification number.
Line 5 lists user fees for mass or non-mass submitters, per basic plan document with one adoption agreement, per each additional adoption agreement and per each single document plan.
Line 5 also covers a provider's identical adoption or minor modification of a mass submitter basic plan document.
Line 5, item (5), covers the assumption of sponsorship of a pre-approved plan, per basic plan document or single document plan.
The instructions say the initial user fee payments for Form 4461 series applications are made through www.Pay.gov. Form 8717-A covers an additional payment after an insufficient fee.
The plan provider named on line 1 completes the form and sends it with the payment to the IRS Pre-Approved Plans Coordinator.
The agency’s own page for Form 8717-A.
The IRS instructions for filling out and filing Form 8717-A.
The official blank form, to print or fill by hand.
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The instructions say it is now used only to make an additional payment when an insufficient user fee was paid for an opinion letter application submitted on Form 4461, 4461-A, 4461-B or 4461-C.
No. The instructions say it is no longer attached to those forms, because the initial user fee payments are made through www.Pay.gov.
The instructions point to the schedule for user fees in Rev. Proc. 2024-4, 2024-1 I.R.B. 247, or the latest annual update.
The instructions say to make the check or money order payable to "United States Treasury" and attach it to Form 8717-A.
To the Pre-Approved Plans Coordinator in Cincinnati, OH. The instructions give a P.O. box for U.S. mail and a street address for Express Mail or a private delivery service.