Checklist Item #30 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 

indicate whether the plan is 

a plan described in 

§432(e)(9)(D)(vii)(III) and,

if so, how is that fact

reflected in the proposed

benefit suspension.

See section 6.07.

The Iron Workers Local 17 Pension Fund is not a 

plan described in Internal Revenue Code Section 

432(e)(9)(D)(vii)(III), so the application does not 

include any separate provisions for employees 

under withdrawn employers. 

IW17PF_362
Checklist Item #31 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 required plan 

sponsor information, 

including

• name

• address

• telephone number

• email address

• fax number

• employer

identification

number (EIN) and

• 3-digit plan number

(PN).

See section 7.01.

The following information is being provided for the 

application on behalf of the Iron Workers Local 17 

Pension Fund:

Plan Sponsor: 

Board of Trustees for the Iron Workers Local 17 

Pension Fund

3250 Euclid Avenue, Room 150

Cleveland OH 44115

Mailing Address: 

PO Box 6327

Cleveland OH 44101-1327

(216) 241-1086

(800) 788-8406

(216) 241-2904 fax

The Board of Trustees does not have a separate 

email; however, correspondence can be sent 

electronically to the Fund Administrative Manager 

at iron_edfox@ameritech.net. 

Plan EIN: 51-0161467

Plan No.: 001

IW17PF_363
Checklist Item #32 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 required plan 

identification information. 

See section 7.02.

The following information is being provided for the 

application on behalf of the Iron Workers Local 17 

Pension Fund:

Plan Name:

Iron Workers Local 17 Pension Fund

Plan No.: 001

Plan EIN: 51-0161467

IW17PF_364
Checklist Item #33 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 required 

retiree representative 

information (if applicable). 

See section 7.03.

The Iron Workers Local 17 Pension Fund is not a 

plan described in Internal Revenue Code Section 

432(e)(9)(B)(v)(I), so the appointment of a Retiree 

Representative is not required. Due to the size of 

the Plan and cost involved, the Board of Trustees 

did not voluntarily elect to appoint a Retiree 

Representative. 

IW17PF_365
Checklist Item #34 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 required 

enrolled actuary 

information. 

See section 7.04.

The following information is being provided for the 

application on behalf of the Iron Workers Local 17 

Pension Fund:

Plan Actuary:

Henry Wong, ASA, MAAA, FCA

Vice President and Consulting Actuary

Enrolled Actuary No. 14-05951

Segal Consulting

IW17PF_366

Redacted by the U.S. 

Redacted 

 of the Treasury

by the U.S. 

Redacted by the 

U.S. Department 

of the Treasury