Checklist Item #40 Resubmitted Application for Approval of a

Suspension of Benefits Under MPRA

Iron Workers Local 17 Pension Fund EIN: 51-0161467

Plan No.: 001

Does the application 

include the most recent 

actuarial valuation report. 

See section 7.10

The application for the Iron Workers Local 17 

Pension Fund includes a copy of the Actuarial 

Valuation for the Plan Year Beginning May 1, 2015

for the Iron Workers Local 17 Pension Fund. This 

is the most recent actuarial valuation prepared for 

the Board of Trustees. This Actuarial Valuation 

Report was initially filed in the December 23, 2015 

Application with Checklist Item #26 and can be 

found at pages IW17PF_286 – IW17PF_353. 

IW17PF_944
Checklist Item #41 Resubmitted Application for Approval of a

Suspension of Benefits Under MPRA

Iron Workers Local 17 Pension Fund EIN: 51-0161467

Plan No.: 001

Does the application 

include this checklist, 

completed and placed 

on top of the 

application. 

See section 7.11. 

The completed checklist on behalf of the Iron Workers 

Local 17 Pension Fund is included at the beginning of 

the application packet. The Checklist is numbered as 

IW17PF_ .946 - IW17PF_950

IW17PF_945
IW17PF_946

SUBMISSION CHECKLIST ON BEHALF OF IRON WORKERS LOCAL 17 PENSION FUND 

Response Item Description of item Page number in 

number application 

~ 1. Does the application include an original signature of the plan IW17PF _760-761 sponsor or an authorized representative of the plan sponsor. See 

N/A section 2.01. 

I~ 2. Does the application include a description of the proposed benefit IW17PF _762-766 

suspension -calculated as if no other limitations apply- that 

N/A includes: 

• the suspension's effective date (and its expiration date, if 

applicable}, 

• whether the suspension provides for different treatment of 

participants and beneficiaries; 

• a description of the different categories or groups of 

individuals affected, and 

• how the suspension affects these individuals differently . 

See section 2.02. 

~ 

- 3. Does the application include a penalties-of-perjury statement signed IW17PF _767-768 

No by an authorized trustee on behalf of the board of trustees. See 

N/A Section 2.03. 

~ 4. Does the application include a statement, signed by an authorized IW17PF _769-770 

trustee on behalf of the board of trustees, acknowledging that the 

N/A application and the application's supporting material will be publicly 

disclosed on the Treasury Department's website. See section 2.04. 

~ 5. Does the application include the plan actuary's certification of critical IW17PF _011 -025 

No and declining status and the supporting illustrations, including: IW17PF _771-777 

N/A • the year-by-year projections demonstrating projected 

insolvency during the relevant period, and 

• separately identifying the available resources (and the 

market value of assets and changes in cash flow) during 

each of those years. 

See section 3.01. 

I~ 6. Does the application describe the assumptions used including the IW17PF_778 

new entrant profile, the total contribution base units, and the average 

N/A contribution rates. See section 3.01. 

!~ 7. Does the application include the plan actuary's certification that the IW17PF _779-800 

No plan is projected to avoid insolvency if the suspension takes effect 

N/A and the supporting illustrations, including: 

• the year-by-year projections demonstrating projected 

solvency during the relevant period, 

• a description of the assumptions used, including the new 

entrant profile, the total contribution base units, and the 

average contribution rates; and 

• separately identifying the available resources (and the 

market value of assets and changes in cash flow)during 

each of those years. 

See section 3.02. 

~ 8. Does the application include the plan sponsor's determination of IW17PF _58 -198 

No projected insolvency that includes the documentation set forth in 

N/A section 5 of the revenue procedure. See section 3.03. 
IW17PF_947

WP 9. Does the application include a demonstration that the limitations on IW17PF _801-813 

individual suspensions are satisfied, including calculations regarding: 

N/A • the guarantee-based limitation, 

• the disability-based limitation, and 

• the age-based limitation . 

See section 4.01. 

,...., 

·cr;;p 10. Does the application include a demonstration that the proposed IW17PF_814 

suspension is reasonably estimated to achieve the level necessary 

N/A to avoid insolvency for the extended period, including illustrations 

regarding the plan's solvency ratio and available resources. See 

section 4.02(1 ). 

~ 11. Does the application include the required illustration utilizing IW17PF_815 stochastic projections. (This illustration is not required if the plan is 

N/A not required to appoint a retiree representative under 

§ 432(e)(9)(B)(v)(l) and stochastic projections were not used in 

making the required determination.} See section 4.02(2}. 

!qrp 12. Does the application include a demonstration that the proposed IW17PF_816 

suspension is not projected to materially exceed the level necessary 

N/A to avoid insolvency, including illustrations regarding the plan's 

solvency ratio and available resources. See section 4.03. 

~ 13. Does the application include a demonstration that the proposed IW17PF _817-826 

suspension is equitably distributed, including 

N/A • information on he effect of the suspension on the plan in 

the aggregate, 

• information on the effect of the suspension for different 

categories or groups, 

• a list of the factors taken into account, 

• an explanation of why none of the factors listed in 

§432(e)(9)(D)(vi) were taken into account (if applicable), 

• for each factor taken into account that is not one of the 

factors listed in §432(e)(9)(D)(vi), an explanation why the 

factor is relevant; and 

• how any difference in treatment among categories or 

groups of individuals results from a reasonable application 

of the relevant factors. 

See section 4.04. 

~ 14. Does the application include a copy of the actual notices (including IW17PF 827-842 

redacted sample calculations) that meet the requirements under 

N/A §432(e)(9)(F). See section 4.05(1). 

c;;p 15. Does the application include a description of the efforts that are IW17PF_226 

being taken to contact participants, beneficiaries in pay status, and 

N/A alternate payees. See section 4.05(2). 

C'f;P 16. Does the application describe the steps the plan sponsor has taken IW17PF _227 

to ensure that notices delivered electronically are reasonably 

N/A accessible to the recipients. See section 4.05(3) 

WiP 17. Does the application include a list of each employer who has an IW17PF _228-232 

obligation to contribute under the Plan and each employee 

N/A organization representing participants under the Plan. See section 

4.05(4). 
IW17PF_948

~ 18. Does the application include information on past and current IW17PF _233-239 

measures taken to avoid insolvency. See section 5.01. 

N/A 

rrcp 19. Does the application include the plan information required by section IW17PF _240-244 

5.02. 

N/A 

-

~ 20. Does the application describe how the plan sponsor took into IW17PF _245-247 

account- or did not take into account- the factors listed in section 

N/A 5.02 in the determination that all reasonable measures were taken to 

avoid insolvency. See section 5.03. 

~ 21. Does the application describe how the plan sponsor took into IW17PF _248-249 

account - or did not take into account - in the determination that all 

N/A reasonable measures have been taken to avoid insolvency the 

impact of 

• benefit and contribution levels on retaining active 

participants and bargaining groups under the plan, and 

• past and anticipated contribution increases under the plan 

on employer attrition and retention levels. 

See section 5.03. 

~ 22. Does the application include a discussion of any other factors the IW17PF _250 

plan sponsor took into account including how and why those factors 

N/A were taken into account. See section 5.04. 

I~ 23. Does the application include a copy of the proposed ballot excluding IW17PF843-852 

the information regarding the statement in opposition, the 

N/A individualized estimates, and the voting procedures. See section 

6.01. 

I~ 24. Does the application indicate whether the plan sponsor is requesting IW17PF_260 

approval from the PBGC of a proposed partition under section 4233 

N/A of ERISA. See section 6.02. 

~ 25. If the answer to item 24 is yes, does the application specify the IW17PF_261 

effective date of the proposed partition and include a year-by-year 

N/A projection of the amount of the reduction in benefit payments 

attributable to the partition. See section 6.02. 

I~ 26. Does the application describe the plan's experience with certain IW17PF _853-

No critical assumptions. including a disclosure for each of the 1 0 plan 877 

N/A years immediately preceding the application that separately 

identifies 

• total contributions, 

• total contribution base units, 

• average contribution rates, 

• withdrawal liability payments, and 

• the rate of return on plan assets . 

See section 6.03. 

-...:"'"'\ 

~ 27. Does the application include deterministic projections of the IW17PF _878 

sensitivity of the plan's solvency ratio throughout the extended 

N/A period by taking into account more conservative assumptions of 

investment experience and future contribution base units than 

assumed elsewhere in the application. See section 6.04. 
IW17PF_949

~ 28. Does the plan include deterministic projections for each year in the IW17PF_879 

extended period of 

N/A • the value of plan assets, 

• the plan's accrued liability, and 

• the plan's funded percentage . 

See section 6.05. 

~ 29. Does the application include the plan sponsor's representation that, IW17PF 880-885 

if it receives the Treasury Department's final authorization to 

N/A suspend and then chooses to implement the suspension, it will also 

amend the plan 

• to indicate that the suspension will cease upon the plan 

sponsor's failure to determine that both all reasonable 

measures continue to be taken to avoid insolvency and that 

the plan is projected to become insolvent without a 

suspension, 

• to require that any future benefit improvements must satisfy 

§ 432(e)(9)(E), and 

• to specify that the plan sponsor will not modify these 

amendments, notwithstanding any other provision of the 

plan document. 

See section 6.06. 

~ 30. Does the application indicate whether the plan is a plan described in IW17PF _362 

§ 432(e)(9)(D)(vii)(lll) and, if so, how is that fact reflected in the 

N/A proposed benefit suspension. See section 6.07. 

~ 31 . Does the application include the required plan sponsor information, IW17PF _363 

No including 

N/A • name 

• address 

• telephone number 

• email address 

• fax number 

• employer identification number (EIN) and 

• 3-digit plan number (PN) . 

See section 7.01. 

~ 32. Does the application include the required plan identification IW17PF _364 

information. See section 7.02. 

N/A 

~ 33. Does the application include the required retiree representative IW17PF_365 

No information (if applicable). See section 7.03. 

N/A 

~ 

- 34. Does the application include the required enrolled actuary IW17PF _366 

No information. See section 7.04. 

N/A 

~ 35. Does the application include a designation of power of attorney for IW17PF _886-888 

each authorized representative who will represent the plan sponsor 

N/A in connection with the application. See section 7.05 and Appendix 

B. 
"Yes:) 36. Does the application include 

1W • the required plan documents, 

NIA • any recent amendments, 

• the summary plan description (SPD), 

• the summary of material modifications, and 

• the most recent determination letter . 

See section 7.06. 

~ 37. Does the application include the required excerpts from the relevant 

collective bargaining agreements and side agreements. See section 

N/A 7.07. 

~ 38. Does the application include the required excerpts from the most recently filed Form 5500. See section 7.08. 

N/A 

~ 39. Does the application include the most recently updated rehabaitation 

plan. See section 7.09. 

N/A 

I 

cT:P 40. Does the application include the most recently updated actuarial 

valuation report. See section 7.10. 

I N/A 

I 

~ 41. Does the application include this checklist, completed and placed on 

top of the application. See section 7 .11. 

N/A 

CYJP 42. Does the application being submitted for resubmission review, include: 

N/A • a statement that the application is being submitted for 

resubmission review, and 

• the date on which the Treasury Department gave approval 

to submit an application for resubmission review?, 

See section 8. 

resentative for the 

Iron Workers Local 17 Pension Fund 

IW17PF_950 

IW17PF 370-667 

IW17PF _889-

892 

IW17PF _668-698 

IW17PF _: 893-943 

IW17PF _741 751 

IW 17PF 286-353 

IW17PF=944 

IW17PF _ 945-950 

IW17PF _951-953 
Checklist Item #42 Resubmitted Application for Approval of a

Suspension of Benefits Under MPRA

Iron Workers Local 17 Pension Fund EIN: 51-0161467

Plan No.: 001

Does the application 

being submitted for 

resubmission review 

include: 

• A statement that

the application is

being submitted for

resubmission

review, and

• The date on which

the Treasury

Department gave

approval to submit

an application for

resubmission

review?

See section 8. 

The Iron Workers Local 17 Pension Fund requested 

approval to file this resubmission from the Treasury 

Department which was granted July 12, 2016. The 

information regarding the resubmission review is included 

at the beginning of the application packet on IWPF_761. 

In addition, the Pension Fund is providing only those 

sections of the application which were changed from the 

original filing on December 23, 2015. The Cross reference 

to the unchanged provisions of the December 23, 2015 

Application, which is based upon our interpretation of the 

requirements under Revenue Procedure 2016-27, Section 

8.01 is provided at pages IW17_952 – IW17PF_943. 

IW17PF_951
Resubmitted Application for Approval of a Suspension of Benefits Under 

MPRA

Cross-Reference to December 23, 2015 Application

Iron Workers Local 17 Pension Fund EIN: 51-0161467

Plan No.: 001

The following information is unchanged from the initial Application filed 

December 23, 2016 which is withdrawn and resubmitted on July 26, 2016 

pursuant to Section 8.01. 

Checklist Item 

#5

IRC Section 432 Certification – May 1, 

2015 Report is still the most recent report 

so it is unchanged, however, the 

supplemental report which provided 

additional information required by Rev. 

Proc. Section 3.01 has been updated.

IW17PF_011-25 

IW17PF_ 

771-777

Checklist Item 

#8 

Plan Sponsor’s Determination of Projected 

Insolvency – Rev. Proc. Section 3.03

IW17PF_58 –

IW17PF_198

Checklist Item 

# 15

Plan Efforts regarding contacting 

Participants – Rev. Proc. Section 4.05(2)

IW17PF_226

Checklist Item 

#16

Plan Information on Electronic Notice –

Rev. Proc. Section 4.05(3)

IW17PF_227

Checklist Item 

#17

Contributing Employer Listing – Rev. Proc. 

Section 4.05(4)

IW17PF_228 –

IW17PF_232

Checklist Item 

#18

Plan Sponsor Measures Taken to Avoid 

Insolvency – Rev Proc. Section 5.01

IW17PF_233 –

IW17PF_239

Checklist Item 

#19

Plan Information Required by Rev. Proc. 

Section 5.02

IW17PF_240 –

IW17PF_244

Checklist Item 

#20

Plan Sponsor’s accounting for Section 5.02 

Factors in determining all reasonable 

measures were taken – Rev. Proc. Section 

5.03

IW17PF_245 –

IW17PF_247 

Checklist Item 

#21

Plan Sponsor’s treatment of contribution 

increases or benefit reductions in 

determining all reasonable measures taken 

– Rev. Proc. Section 5.03

IW17PF_248 –

IW17PF_249

Checklist Item 

#22

Other Factors considered by Plan Sponsor 

–Rev. Proc. Section 5.04

IW17PF_250

IW17PF_952
Checklist Item 

#24

Plan Sponsor request for partition – Rev. 

Proc. Section 6.02

IW17PF_260

Checklist Item 

#25

Post-partition projections – Rev. Proc. 

Section 6.02

IW17PF_261

Checklist Item 

#30

Special Provision for Section 

432(e)(9)(D)(vii)(III) Plans – Rev. Proc. 

Section 6.07

IW17PF_362

Checklist Item 

#31

Plan and Plan Sponsor Contact 

Information – Rev. Proc. Section 7.01

IW17PF_363

Checklist Item 

#32

Plan Identification Information – Rev. Proc. 

Section 7.02

IW17PF_364

Checklist Item 

#33

Retiree Representative Contact 

Information – Rev. Proc. Section 7.03

IW17PF_365

Checklist Item 

#34

Plan’s Actuary Contact Information – Rev. 

Proc. Section 7.04

IW17PF_366

Checklist Item 

#36

Plan Documents and IRS Determination 

Letters – added IRS Determination Letter 

issued January 20, 2016. All other 

documents previously provided remain 

unchanged – Rev. Proc. Section 7.06

IW17PF_370 – 

IW17PF_667 

IW17PF_ 

889-892

Checklist Item 

#37

Excerpts from Collective Bargaining and 

Participation Agreements – Rev. Proc. 

Section 7.07

IW17PF_668-

IW17PF_698

Checklist Item 

#39

Plan’s Current Rehabilitation Plan – Rev. 

Proc. Section 7.09

IW17PF_741-

IW17PF_751

New

Checklist Item 

#40

Most Recent Actuarial Valuation Report –

Rev. Proc. Section 7.10 –Report previously 

provided as part of Checklist Item #26

IW17PF_286- 

IW17PF_353 

IW17PF_944

IW17PF_953