A plan sponsor must pay the fee by check payable to The United States Treasury. The check should be attached to Form 14704, Transmittal Schedule – Form 5500-EZ Delinquent Filer Penalty Relief Program (Revenue Procedure 2015-32). The applicant’s Employer Identification Number (EIN) and the plan number should be written on the check.
Sources:
Notice 2011-35
§ 4376. Self-insured health plans
§ 46.4376-1. Fee on sponsors of self-insured health plans.
Notice 2002-1
LTR 8704058
Notice 2011-3
