PSA Instructions

Important: The PSA must be signed in the designated sections by the Plan Sponsor, Plan Administrator and Responsible Plan Fiduciary.

Note that in many cases the same individual serves in all three capacities. If so, the individual should complete the Plan Sponsor section and check the box below it indicating they serve in all capacities. There is no need to complete the other sections.

If the Plan Administrator or Responsible Plan Fiduciary is someone other than the Plan Sponsor (e.g., a plan committee), the PSA must be separately signed by or on behalf of the Plan Administrator or Responsible Plan Fiduciary (e.g., by an authorized committee member).

PLAN SPONSOR – A designated party, usually a company or employer that sets up a retirement plan for the benefit of the organization’s employees.

PLAN ADMINISTRATOR – An individual responsible for managing the day-to-day affairs and the strategic decisions involved with a group’s pension fund/plan. More specifically, the plan administrator ensures that money is being contributed into the fund, the proper asset allocation decisions are made and that payouts are promptly distributed among all qualified plan participants or beneficiaries.

RESPONSIBLE PLAN FIDUCIARY – An individual exercising discretionary authority or control with respect to a plan or the disposition of its assets or has discretionary authority or responsibility in the administration of such plan. Neither title nor office controls the legal designation of fiduciary. But, some positions, such as plan administrator or trustee, may require any person who holds them to perform defined fiduciary functions and thereby undertake fiduciary status.