CHECKLIST - IS THE SUBMISSION COMPLETE? 

Instructions The application must include a completed checklist placed on top of the application. 

This will help ensure that the application is complete. Answer each question in the checklist by 

circling Y for yes, N for no or N/A for not applicable, as appropriate, in the blank next to the 

item. Also insert in the appropriate blank next to each item the page number or numbers where 

the item appears in the application. 

Application for Approval of Benefit Suspension for the International Association of Machinists Motor City Pension Fund

Response Item 

number

Description of item Page number 

in application

Yes 

No 

N/A

1. Does the application include an original signature of the plan 

sponsor or an authorized representative of the plan sponsor. See 

section 2.01.

Page 1.1

Yes 

No 

N/A

2. Does the application include a description of the proposed benefit 

suspension - calculated as if no other limitations apply - that 

includes: 

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

applicable), 

• a description of the different categories or groups of 

individuals affected, and 

• how the suspension affects these individuals differently. 

See section 2.02.

Pages 2.1 to 

2.3

Yes 

No 

N/A

3. Does the application include a penalties-of-perjury statement 

signed by an authorized trustee on behalf of the board of trustees. 

See Section 2.03.

Page 3.1

Yes 

No 

N/A

4. Does the application include a statement, signed by an authorized 

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

application and the application's supporting material will be 

publicly disclosed on the Treasury Department's website. See 

section 2.04.

Page 4.1

40.1
Yes 

No 

N/A

5. Does the application include the plan actuary's certification of 

critical and declining status and the supporting illustrations, 

including: 

• 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.

Pages 5.1 to 

5.6

Yes 

No 

N/A

6. Does the application describe the assumptions used. See section 

3.01.

Pages 6.1 to 

6.5

Yes 

No 

N/A

7. Does the application include the plan actuary's certification that 

the plan is projected to avoid insolvency if the suspension takes 

effect and the supporting illustrations, including: 

• the year-by-year projections demonstrating projected solvency 

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 3.02.

Pages 7.1 to 

7.20

Yes 

No 

N/A

8. Does the application include the plan sponsor's determination of 

projected insolvency that includes the documentation set forth in 

section 5 of the revenue procedure. See section 3.03.

Pages 8.1 to 

8.111

Yes 

No 

N/A

9. Does the application include a demonstration that the limitations 

on individual suspensions are satisfied, including calculations 

regarding: 

• the guarantee-based limitation, 

• the disability-based limitation, and 

• the age-based limitation. 

Pages 9.1 to 

9.23

40.2
See section 4.01.

Yes 

No 

N/A

10. Does the application include a demonstration that the proposed 

suspension is reasonably estimated to achieve the level necessary 

to avoid insolvency for the extended period, including illustrations 

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

section 4.02(1).

Page 10.1

Yes 

No 

N/A

11. Does the application include the required illustration utilizing 

stochastic projections. (This illustration is not required if the plan 

is not required to appoint a retiree representative under 

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

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

Yes 

No 

N/A

12. Does the application include a demonstration that the proposed 

suspension is not projected to materially exceed the level 

necessary to avoid insolvency, including illustrations regarding 

the plan's solvency ratio and available resources. See section 4.03.

Page 12.1

Yes 

No 

N/A

13. Does the application include a demonstration that the proposed 

suspension is equitably distributed, including 

• 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), 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.

Pages 13.1 to 

13.17

Yes 

No 

N/A

14. Does the application include a copy of the actual notices 

(including redacted sample calculations) that meet the 

requirements under §432(e)(9)(F). See section 4.05(1).

Pages 14.1 to 

14.31

40.3
Yes 

No 

N/A

15. Does the application include a description of the efforts that are 

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

alternate payees. See section 4.05(2).

Pages 15.1 to 

15.4

Yes 

No 

N/A

16. Does the application describe the steps the plan sponsor has taken 

to ensure that notices delivered electronically are reasonably 

accessible to the recipients. See section 4.05(3)

Page 16.1

Yes 

No 

N/A

17. Does the application include a list of each employer who has an 

obligation to contribute under the Plan and each employee 

organization representing participants under the Plan. See section 

4.05(4).

Pages 17.1 to 

17.2

Yes 

No 

N/A

18. Does the application include information on past and current 

measures taken to avoid insolvency. See section 5.01.

Pages 18.1 to 

18.7

Yes 

No 

N/A

19. Does the application include the plan information required by 

section 5.02.

Pages 19.1 to 

19.6

Yes 

No 

N/A

20. Does the application describe how the plan sponsor took into 

account – or did not take into account – the factors listed in 

section 5.02 in the determination that all reasonable measures 

were taken to avoid insolvency. See section 5.03.

Pages 20.1 to 

20.2

Yes 

No 

N/A

21. Does the application describe how the plan sponsor took into 

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

all reasonable measures have been taken to avoid insolvency the 

Pages 21.1 to 

21.2

40.4
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.

Yes 

No 

N/A

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

plan sponsor took into account including how and why those 

factors were taken into account. See section 5.04.

Page 22.1

Yes 

No 

N/A

23. Does the application include a copy of the proposed ballot. See 

section 6.01.

Pages 23.1 to 

23.5

Yes 

No 

N/A

24. Does the application indicate whether the plan sponsor is 

requesting approval from the PBGC of a proposed partition under 

section 4233 of ERISA. See section 6.02.

Yes 

No 

N/A

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

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

projection of the amount of the reduction in benefit payments 

attributable to the partition. See section 6.02.

Yes 

No 

N/A

26. Does the application describe the plan's experience with certain 

critical assumptions, including a disclosure for each of the 10 plan 

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.

Page 26.1

40.5
Yes 

No 

N/A

27. Does the application include deterministic projections of the 

sensitivity of the plan's solvency ratio throughout the extended 

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.

Pages 27.1 to 

27.8

Yes 

No 

N/A

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

the extended period of 

• the value of plan assets, 

• the plan's accrued liability, and 

• the plan's funded percentage. 

See section 6.05.

Pages 28.1 to 

28.2

Yes 

No 

N/A

29. Does the application include the plan sponsor's representation 

that, if it receives the Treasury Department's final authorization to 

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.

Pages 29.1 to 

29.4

Yes 

No 

N/A

30. 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.

Yes 31. Does the application include the required plan sponsor Page 31.1

40.6
No 

N/A

information, including 

• name 

• address 

• telephone number 

• email address 

• fax number 

• employer identification number (EIN) and 

• 3-digit plan number (PN). 

See section 7.01.

Yes 

No 

N/A

32. Does the application include the required plan identification 

information. See section 7.02.

Page 32.1

Yes 

No 

N/A

33. Does the application include the required retiree representative 

information (if applicable). See section 7.03.

Yes 

No 

N/A

34. Does the application include the required enrolled actuary

information. See section 7.04.

Page 34.1

Yes 

No 

N/A

35. Does the application include a designation of power of attorney 

for each authorized representative who will represent the plan 

sponsor in connection with the application. See section 7.05 and 

Appendix B.

Pages 35.1 to 

35.4

Yes 

No 

N/A

36. Does the application include 

• the required plan documents, 

• any recent amendments, 

• the summary plan description (SPD), 

• the summary of material modifications, and 

• the most recent determination letter. 

See section 7.06.

Pages 36.1 to 

36.125

40.7
@ 

No 

N/A 

(Q 

No 

N/A 

(Q 

No 

N/A 

37. 

38. 

39. 

Does the application include the required excerpts from the 

relevant collective bargaining agreements and side agreements. 

See section 7.07. 

Does the application include the required excerpts from the most 

recently filed Form 5500. See section 7.08. 

Does the application include the most recently updated 

rehabilitation plan. See section 7.09. Does the application include 

the two most recent actuarial valuation reports. See section 7.1 0. 

Pages 37.1 to 

37.188 

Pages 38.1 to 

38.40 

Pages 39.1 to 

39.136 

-----------------------------------~---- ·~-------------· 

@ 

No 

N/A 

Yes 

No 

~ 

40. 

41. 

Does the application include this checklist, completed and placed 

on top of the application. See section 7.11. 

If the application is being submitted for resubmission review, does 

the application 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. 

Redacted by the U.S. Department of the 

Treasury 

~ 

• • . . . . .. International Association of Machinists 

Motor City Pension Pian 

40.8 

Pages 40.1 to 

40.8 

Page 41.1