Federal Register / Vol. 72, No. 221 / Friday, November 16, 2007 / Notices 64731 

1Other filing requirements may apply to certain 

employee benefit plans and to multiple-employer 

welfare arrangements under ERISA or to other 

benefit arrangements under the Code, and such 

other filing requirements are not within the scope 

of this Notice. For example, Code sec. 6033(a) 

imposes an additional reporting and filing 

obligation on organizations exempt from tax under 

Code sec. 501(a), which may be related to 

retirement trusts that are qualified under sec. 401(a) 

of the Code. 

2The Agencies also received a comment letter 

from the United States Department of Commerce, 

Economic and Statistics Administration, Bureau of 

Economic Analysis (BEA), that indicated that the 

BEA relies on the information collected in the Form 

5500 to prepare certain statistics. 

DEPARTMENT OF LABOR 

Employee Benefits Security 

Administration 

DEPARTMENT OF THE TREASURY 

Internal Revenue Service 

PENSION BENEFIT GUARANTY 

CORPORATION 

RIN 1210–AB06 

Revision of Annual Information Return/ 

Reports 

AGENCIES: Employee Benefits Security 

Administration, Labor, Internal Revenue 

Service, Treasury, Pension Benefit 

Guaranty Corporation. 

ACTION: Notice of adoption of revisions 

to annual return/report forms. 

SUMMARY: This document contains 

revisions to the Form 5500 Annual 

Return/Report forms, including the 

Form 5500 Annual Return/Report of 

Employee Benefit Plan and a new Form 

5500–SF, Short Form Annual Return/ 

Report of Small Employee Benefit Plan 

(Short Form 5500 or Form 5500–SF), 

filed for employee pension and welfare 

benefit plans under the Employee 

Retirement Income Security Act of 1974, 

as amended (ERISA), and the Internal 

Revenue Code of 1986, as amended 

(Code). The Form 5500 Annual Return/ 

Report forms, including the schedules 

and attachments, are an important 

source of financial, funding, and other 

information about employee benefit 

plans for the Department of Labor, the 

Pension Benefit Guaranty Corporation, 

and the Internal Revenue Service (the 

Agencies), as well as for plan sponsors, 

participants and beneficiaries, and the 

general public. The revisions to the 

Form 5500 Annual Return/Report forms 

contained in this document, including 

the new Short Form 5500, are intended 

to streamline the annual reporting 

process, reduce annual reporting 

burdens, especially for small businesses, 

update the annual reporting forms to 

reflect current issues and agency 

priorities, incorporate new reporting 

requirements contained in the Pension 

Protection Act of 2006, and facilitate 

electronic filing. Some of the forms 

revisions will apply on a transitional 

basis for the 2008 reporting year before 

all of the forms revisions are fully 

implemented for the 2009 reporting year 

as part of the switch under the ERISA 

Filing Acceptance System (EFAST) to a 

wholly electronic filing system 

(EFAST2). The forms revisions affect 

employee pension and welfare benefit 

plans, plan sponsors, administrators, 

and service providers to plans subject to 

annual reporting requirements under 

ERISA and the Code. 

DATES: Effective January 15, 2008. 

FOR FURTHER INFORMATION CONTACT: 

Elizabeth A. Goodman or Michael I. 

Baird, Employee Benefits Security 

Administration (EBSA), U.S. 

Department of Labor, (202) 693–8523, 

for questions relating to the Form 5500, 

and its Schedules A, C, D, G, H, and I, 

and lines 1 through 11 of the Form 

5500–SF (Short Form 5500), as well as 

the general reporting requirements 

under Title I of ERISA; Lisa MojiriAzad, Internal Revenue Service (IRS), 

Office of Chief Counsel, (202) 622–6060, 

or Ann Junkins, IRS, (202) 283–0722, for 

questions relating to Schedules SB, MB, 

and R of the Form 5500, lines 12 and 13 

of the Short Form 5500, and the filing 

of Short Form 5500 instead of the Form 

5500–EZ for plans that are not subject 

to Title I of ERISA, as well as questions 

relating to the general reporting 

requirements under the Internal 

Revenue Code; and Michael Packard, 

Pension Benefit Guaranty Corporation 

(PBGC), (202) 326–4080, ext. 3429, for 

questions relating to Schedules SB and 

MB of the Form 5500, and lines 13 

through 19 of Schedule R, as well as 

questions relating to the general 

reporting requirements under Title IV of 

ERISA. For further information on an 

item not mentioned above, contact Mr. 

Baird. The telephone numbers 

referenced above are not toll-free 

numbers. 

SUPPLEMENTARY INFORMATION: 

A. Background 

Sections 101 and 104 of Title I and 

section 4065 of Title IV of the Employee 

Retirement Income Security Act of 1974, 

as amended (ERISA), sections 6058(a) 

and 6059(a) of the Internal Revenue 

Code of 1986, as amended (Code), and 

the regulations issued under those 

sections, impose certain annual 

reporting and filing obligations on 

pension and welfare benefit plans, as 

well as on certain other entities.1 Plan 

administrators, employers, and others 

generally satisfy these annual reporting 

obligations by the filing of the Form 

5500 Annual Return/Report of 

Employee Benefit Plan, including its 

schedules and attachments (Form 5500 

Annual Return/Report), in accordance 

with the instructions and related 

regulations. 

The Form 5500 Annual Return/Report 

is the principal source of information 

and data available to the Department of 

Labor (Department or Labor), the 

Internal Revenue Service (IRS), and the 

Pension Benefit Guaranty Corporation 

(PBGC) (collectively, Agencies) 

concerning the operations, funding, and 

investments of about 800,000 pension 

and welfare benefit plans. These plans 

cover an estimated 150 million 

participants and hold an estimated $4.3 

trillion in assets. Accordingly, the Form 

5500 Annual Return/Report constitutes 

an integral part of each Agency’s 

enforcement, research, and policy 

formulation programs, and is a source of 

information and data for use by other 

federal agencies, Congress, and the 

private sector in assessing employee 

benefit, tax, and economic trends and 

policies. The Form 5500 Annual Return/ 

Report also serves as a primary means 

by which plan operations can be 

monitored by participants and 

beneficiaries and by the general public. 

On July 21, 2006, the Department 

published a final rule requiring 

electronic filing of the Form 5500 

Annual Return/Report for reporting 

years beginning on or after January 1, 

2008 (Electronic Filing Rule). 71 FR 

41359. Simultaneously with the 

publication of the Electronic Filing 

Rule, the Agencies published a notice of 

proposed forms revisions (July 2006 

Proposal) proposing changes to the 

Form 5500 Annual Return/Report for 

the 2008 reporting year. 71 FR 41615. 

On December 11, 2006, the Agencies 

published a Notice of Supplemental 

Proposed Forms Revisions 

(Supplemental Notice). 71 FR 71562. 

The Supplemental Notice was necessary 

to make changes to the Form 5500 

Annual Return/Report required by the 

Pension Protection Act of 2006, Pub. L. 

109–280, 120 Stat. 780 (2006), enacted 

on August 17, 2006 (PPA). 

The Agencies received 38 comment 

letters on the July 2006 Proposal,2 and 

seven comments on the Supplemental 

Notice. Comments were submitted by 

various members of the regulated 

community, including representatives of 

employers, plans, and plan service 

providers. Copies of the comments are 


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64732 Federal Register / Vol. 72, No. 221 / Friday, November 16, 2007 / Notices 

3As set forth in the Department’s semi-annual 

regulatory agenda, 72 FR 22845, the rulemaking 

would amend the regulation at 29 CFR section 

2550.408b–2 setting forth the standards applicable 

to the exemption under ERISA section 408(b)(2) for 

contracting or making reasonable arrangements 

with a party in interest for office spaces or services. 

The proposed amendment is intended to ensure 

that plan fiduciaries are provided or have access to 

the information necessary to determine whether an 

arrangement for services is ‘‘reasonable’’ within the 

meaning of the statutory exemption, as well as 

within the meaning of the prudence requirements 

of ERISA section 404(a)(1)(B). 

posted on the Department’s Web site at 

http://www.dol.gov/ebsa/regs. 

After careful consideration of the 

issues raised by the written public 

comments, the Agencies decided to 

adopt the forms largely as proposed, 

but, in an attempt to strike a balance 

between ensuring adequate reporting 

and disclosure to participants, 

beneficiaries, and the Agencies, on the 

one hand, and the costs and 

administrative burdens attendant to the 

administration and maintenance of 

employee benefit plans on the other, the 

Agencies revised some of the annual 

reporting requirements in response to 

public comments. The Agencies now are 

publishing in this Notice the final forms 

revisions for the Form 5500 Annual 

Return/Report (including the Short 

Form 5500), generally effective for the 

2009 reporting year (with certain 

transition changes effective for the 2008 

reporting year). Set forth below is a 

general summary of the public 

comments received in response to the 

proposals, changes made in response to 

those comments, and an overview of the 

final forms revisions being adopted in 

this Notice. 

The Agencies are printing in this 

Notice information copies of the 2009 

Form 5500, 2009 Form 5500–SF, and 

2009 Schedules A, SB, MB, C, D, G, H, 

I, and R. This Notice also includes 

information copies of the related 

instructions, except for the instructions 

to the Schedule SB and MB and certain 

new questions on the Schedule R, 

which the Agencies will publish after 

the Treasury/IRS develop the 

underlying substantive guidance under 

the PPA, and certain instructions 

relating to electronic filing procedures 

under the EFAST2 system. Information 

copies of the forms and the instruction 

package will also be posted on the 

Department’s Web page at http:// 

www.dol.gov/ebsa. Because of the 

switch to EFAST2 and a wholly 

electronic filing requirement, the 

information copies of the 2009 annual 

return/report forms printed in this 

Notice are not acceptable for and cannot 

be used for filing an annual return/ 

report under the EFAST2 system. Once 

the EFAST2 contract is awarded to a 

firm to develop the new wholly 

electronic filing system for the 2009 

Form 5500 Annual Return/Report forms, 

including the Form 5500–SF, the 

contractor may as part of its 

development of the new system need to 

make technical reformatting changes to 

the forms that may affect the appearance 

of the forms. Details on any changes to 

the appearance of the forms and on the 

wholly electronic filing and processing 

system, including details on electronic 

signature requirements, will be available 

as the contract is awarded and the 

system development is finalized. 

Although the paper forms will not be 

used for filing under the EFAST2 

system, the final format of the forms and 

schedules will be the required format 

for satisfying disclosure obligations 

under ERISA, including the plan 

administrator’s obligation to furnish 

copies of the annual report to 

participants and beneficiaries on request 

pursuant to section 104(b) of ERISA. 

B. Discussion of the Public Comments 

1. Deferral of Forms Revisions and 

Electronic Filing Mandate to the 2009 

Plan Year 

A significant number of the 

commenters, including several large 

industry groups representing plan 

sponsors and service providers, asked 

for a delay in the effective date of the 

forms changes. A number of the 

commenters asked for additional time to 

comment due to work being done to 

implement new statutory requirements 

enacted as part of the PPA. Some 

commenters also suggested that the 

comment period should be extended to 

allow more time to address the 

Schedule C (Service Provider 

Information) changes due to the 

significance of the changes in plan fee 

and expense reporting, the attendant 

compliance costs, and a desire to 

evaluate the Schedule C changes in 

conjunction with proposed regulations 

the Department has announced it will 

be publishing under ERISA section 

408(b)(2).3 Three different commenters 

suggested that the effective date for the 

new reporting requirements for Code 

section 403(b) plans be delayed until 

after the IRS publishes its final 

regulation on Code section 403(b) plans. 

Some commenters urged that the 

effective date be extended for the Form 

5500 Annual Return/Report changes 

until 2009 or 2010 at the earliest to 

allow sufficient time to make necessary 

changes to comply with the new 

requirements. One commenter, who 

requested a delayed implementation 

date generally for the new forms and 

electronic filing requirement, suggested 

an earlier implementation date for the 

Short Form 5500 as a way of satisfying 

the PPA requirement of a simplified 

report for plans with fewer than 25 

participants. 

The proposed revisions to the Form 

5500 Annual Return/Report, which 

include both those set forth in the 

Agencies’ July 2006 Proposal and those 

in the Supplemental Notice to address 

changes required by the PPA, are part of 

the switch under the ERISA Filing 

Acceptance System (EFAST) to a wholly 

electronic filing and processing system 

(EFAST2) that would replace the 

existing largely paper-based filing 

system. As part of that e-filing initiative, 

and as noted above, the Department 

published the Electronic Filing Rule, 

establishing an electronic filing 

requirement for annual reports filed for 

plan years beginning on or after January 

1, 2008. In adopting the final Electronic 

Filing Rule, the Department responded 

to public comments seeking a delay in 

the wholly electronic filing system by 

agreeing to a one year deferral of the 

electronic filing mandate from the 2007 

plan year to the 2008 plan year. The 

Department agreed to the deferral in 

order to facilitate an orderly and costeffective migration to an electronic 

filing system by both the Department 

and the regulated community. Under 

the final Electronic Filing Rule 

published in July 2006, the vast majority 

of filers would have had until at least 

July 2009 to make any necessary 

adjustments to accommodate the 

electronic filing of their annual report 

because annual reports generally are not 

required to be filed until the end of the 

7th month following the end of the plan 

year. The timing also provided service 

providers, software developers, and the 

Department additional time to work 

through electronic filing and processing 

issues. 

In evaluating the public comments 

seeking a further deferral of the 

implementation of the revised forms 

and, as a consequence, the electronic 

filing requirement, the Agencies 

evaluated the benefits of giving the 

regulated community more time to 

transition to the new EFAST2 electronic 

filing system, keeping in mind the 

effective dates mandated by the PPA for 

certain of the annual reporting changes. 

The Agencies continue to believe it is 

important for plans, service providers, 

and the Agencies to have an orderly and 

cost-effective migration to the EFAST2 

electronic filing system. In light of the 

substantial number of comments 

expressing concern about needing more 

time to adjust recordkeeping and other 

annual reporting systems, the Agencies 

have decided to defer for an additional 


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Federal Register / Vol. 72, No. 221 / Friday, November 16, 2007 / Notices 64733 

4 It is significant to note that the implementation 

of the annual reporting form changes not mandated 

by the PPA has been deferred until after the 

publication of the IRS final regulations on Code 

section 403(b) plans. 

5The Supplemental Notice explained that the 

Department believed that the EFAST2 system 

would satisfy the PPA requirement that the 

Department make available electronically on its 

Web site certain actuarial information filed as part 

of the Form 5500 Annual Return/Report. See PPA 

§ 504, 29 U.S.C. § 104(b). The Department believes 

that the related provision in the PPA calling for 

actuarial information to be filed electronically was 

intended to facilitate the Department’s ability to 

meet its obligation to post the actuarial information 

on its Web site within 90 days after the information 

is filed as part of the plan’s annual report. The 

Department believes it can still satisfy the web 

posting requirement under the current EFAST 

system without imposing a special electronic filing 

requirement on defined benefit pension plans for 

the transition 2008 plan year. 

6The text of the question on the new line 7 has 

been revised from that in the July 2006 proposal to 

exactly match the language in the annual reporting 

requirement in the PPA. 

year the implementation of annual 

reporting forms changes not mandated 

by the PPA,4 except for a few Schedule 

R items that the PBGC had determined 

that it needs to enable it to properly 

monitor the plans it insures. Thus, the 

current EFAST filing system will be 

continued for the 2007 and 2008 plan 

year filings. This includes the 

requirements to file the Schedule E, the 

Schedule SSA, and the IRS Form 5500–

EZ, ‘‘Annual Return of One-Participant 

(Owners and Their Spouses) Retirement 

Plan’’ (Form 5500–EZ), under the 

current EFAST system with the 

Department for the 2007 and 2008 

reporting years. Also, as provided in the 

Electronic Filing Rule, delinquent or 

amended filings for prior plan years for 

which paper filing options were 

available also will be subject to the 

electronic filing requirement. The 

deferral of the electronic filing 

requirement applies to delinquent and 

amended filings. The Department will 

provide instructions prior to the 

inauguration of the system on how those 

filings are to be made under the 

electronic filing system. 

Under the final regulations, the 

electronic filing requirement and all of 

the forms changes, except for those 

mandated by the PPA and the PBGC’s 

new Schedule R items discussed below, 

will become effective for all annual 

report filings made under Part 1 of 

Subtitle B of Title I of ERISA for plan 

years (or reporting years for non-plan 

filings) beginning on or after January 1, 

2009.5

To effectuate the postponement of the 

electronic filing requirement, the 

Department, in the final rule being 

published contemporaneously with this 

Notice amending its annual reporting 

regulations, is including an amendment 

to the Electronic Filing Rule. 

Specifically, that final rule amends the 

Department’s regulation at 29 CFR 

2520.104a–2 to provide that the 

electronic filing requirement is 

applicable for plan years beginning on 

or after January 1, 2009. The vast 

majority of filers will now have until at 

least July 2010 to make any necessary 

adjustments to accommodate the nonPPA required changes (other than the 

PBGC Schedule R changes) to the form 

and those required for electronic filing 

of their annual report because, as noted 

above, annual reports generally are not 

required to be filed until the end of the 

7th month following the end of the plan 

year. 

Short plan year filings for 2009 plan 

years and filings for DFEs for 2009 

reporting years will be subject to a 

special transition rule. The instructions 

to the Form 5500 Annual Return/Report 

advise filers that the due date for their 

Form 5500 for a plan year of less than 

12 months (short plan year) is the last 

day of the 7th month after the short plan 

year ends. For purposes of determining 

the filing deadline, the instructions state 

that a short plan year ends on the date 

of the change in accounting period or 

upon the complete distribution of assets 

of the plan in the case of terminated or 

merged plans. For DFE filings, the 

instructions provide that DFEs (other 

than GIAs) must file 2009 return/reports 

no later than nine and one half months 

after the end of the DFE year that ended 

in 2009, and the 2009 Form 5500 must 

report information for the DFE year (not 

to exceed 12 months in length). The 

Agencies historically have permitted 

short plan year filers and DFEs to use 

the prior year’s forms if the current year 

forms are not available by the plan’s or 

DFE’s filing due date. The Agencies 

expect that, in some cases, filings for 

2009 short plan years and DFE filings 

for 2009 reporting years (e.g., if the DFE 

year differs from the 2009 calendar year) 

may be due during 2009 and before the 

January 1, 2010, date on which the new 

EFAST2 wholly electronic filing system 

is expected to become operational for 

return/report filing purposes. Plans 

filing for 2009 short plan years and 

DFEs filing for 2009 reporting years will 

have the option of using the 2008 Form 

5500 Annual Return/Report forms and 

filing for 2009 under the current EFAST 

filing system if they file before the date 

the new EFAST2 electronic filing 

system becomes operational. 

Alternatively, plans whose due date for 

their 2009 short plan year filing and 

DFEs whose due date for their 2009 

reporting year filing falls before the new 

EFAST2 system becomes operational 

but who want to file electronically 

under the new EFAST2 system will be 

granted an automatic extension until 

after the EFAST2 system becomes 

operational in which to file. The 

Agencies intend to describe the terms 

and conditions for the automatic 

extension in the instructions for the 

2008 Form 5500 Return/Report. 

a. PPA-Required Actuarial Schedules, 

Multiemployer Plan Reporting, and 

Asset Allocation Information 

The PPA-required changes in the 

Form 5500 Annual Return/Report (other 

than the simplified reporting 

requirement) are the new actuarial 

information schedules (Schedules SB 

and MB), lines 13a and 13b of the 

Schedule R (identifying information on 

significant contributors to 

multiemployer defined benefit plans), 

lines 14–17 of the Schedule R 

(additional information related to 

multiemployer defined benefit pension 

plans), line 18 of the Schedule R 

(certain liabilities to participants and 

beneficiaries under two or more pension 

plans), and, for multiemployer defined 

benefit plans only, the new line 7 of the 

Form 5500 (number of employers with 

an obligation to contribute to the 

multiemployer plan).6 To comply with 

the PPA, these reporting changes are 

being implemented under the current 

EFAST system for 2008 plan year 

annual reports. 

The Agencies concluded that it would 

not be cost-effective or practical to 

create computer scannable versions of 

the Form 5500 and these schedules to be 

compatible with the outdated EFAST 

computer scannable form technology 

because these forms would have a 

limited one year useful life under the 

EFAST system during the transition 

period before implementation of the 

EFAST2 electronic filing system. 

Effective for the 2008 transition year, 

plans required to file actuarial 

information must check the box on the 

Form 5500 to indicate that they are 

filing a Schedule B, but instead of filing 

the current Schedule B, they will file 

Schedule SB or MB (whichever is 

applicable). The Schedule B will no 

longer be a valid schedule for 2008 plan 

year filings. Plan year 2008 Form 5500 

Annual Return/Reports filed by pension 

plans subject to the minimum funding 

rules must include a Schedule SB or MB 

and not a Schedule B for 2008 plan 

years. Filings that include a Schedule B 

instead of a Schedule SB or MB will be 

rejected. As to the other PPA-required 

items (lines 13a, 13b, and 14–18 of 

Schedule R and line 7 of Form 5500), for 


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64734 Federal Register / Vol. 72, No. 221 / Friday, November 16, 2007 / Notices 

the transition year, filers will be 

directed in the instructions to include 

answers to those questions as an 

attachment to the current Schedule R. 

Similarly, lines 13c–e (for 

multiemployer defined benefit plans) 

and line 19 (asset allocation questions 

for large defined benefit plans) of the 

Schedule R also are being implemented 

on a transition basis for 2008 plan year 

annual reports. Filers will also be 

directed in the instructions to include 

answers to these lines as an attachment 

to the Schedule R. 

The Agencies also changed the 2007 

Form 5500 Annual Return/Report 

instructions for short plan year filings 

(filings for years of less than 12 months) 

to accommodate these PPA changes. 

Specifically, the instructions to the 

Form 5500 Annual Return/Report 

historically have advised filers that the 

due date for their Form 5500 for a plan 

year of less than 12 months (short plan 

year) is the last day of the 7th month 

after the short plan year ends. For 

purposes of determining the filing 

deadline, the instructions state that a 

short plan year ends on the date of the 

change in accounting period or upon the 

complete distribution of assets of the 

plan in the case of terminated or merged 

plans. The Agencies have permitted 

short plan year filers to use the prior 

year’s forms if the current year forms for 

the short plan year are not available by 

the plan’s filing due date. The Agencies 

expect that, in some cases, filings for 

2008 short plan years may be due 

during 2008 and before the final 

regulations and instructions for the 

Schedule SB or MB are available. Since 

the Schedule B will not be a valid 

schedule for plan year 2008 filings, 

filers will not have the option of using 

the 2007 Schedule B with a 2008 short 

plan year filing, but will be required to 

wait until the 2008 Forms are available 

for filing. The Agencies have indicated 

in the instructions for the 2007 Form 

5500 Annual Return/Report that an 

automatic extension that will be 

available for 2008 short plan year filings 

required to include a Schedule SB or 

Schedule MB and/or a supplemental 

attachment to Schedule R. 

b. PPA-Required Simplified Reporting 

for Plans With Fewer Than 25 

Participants 

As noted in the Supplemental Notice, 

section 1103(b) of the PPA requires a 

simplified report for plans with fewer 

than 25 participants at the beginning of 

the plan year to be available for 2007 

plan year filings, i.e., filings for plan 

years beginning after December 31, 

2006. The Supplemental Notice 

proposed to satisfy the simplified report 

requirement for 2008 plan years, i.e., 

those beginning after December 31, 

2007, by implementing the Short Form 

for 2008 plan year reports under the 

new EFAST2 system. The Supplemental 

Notice explained the Agencies’

intention for the interim 2007 reporting 

year to give plans covering fewer than 

25 participants that met the conditions 

for being eligible to file the Short Form 

5500 the option of filing an abbreviated 

version of the current Form 5500 

Annual Return/Report for small plan 

filers. The Supplemental Notice 

explained that the abbreviated version 

would largely replicate, within the 

context of the existing Form 5500 

Annual Return/Report structure, the 

information that would be required to 

be reported on the proposed Short Form 

5500 by allowing certain schedules to be 

excluded from the filing and requiring 

only certain line items to be completed 

on some of the required schedules. With 

the additional deferral of the electronic 

filing requirement, this simplified 

reporting option for plans with fewer 

than 25 participants will be available for 

both the 2007 and 2008 plan year 

filings. 

For the 2007 and 2008 plan years, 

plans with fewer than 25 participants at 

the beginning of the plan year that meet 

the eligibility requirements for the Short 

Form 5500, treating those conditions as 

if they applied for 2007 and 2008 plan 

year filings, may file the following as 

their annual return/report: (1) The entire 

Form 5500; (2) a Schedule A for any 

insurance contract for which a Schedule 

A is required under current rules, 

completing lines A, B, C, D and the 

insurance fee and commission 

information in Part I; (3) if the reporting 

of actuarial information is required, the 

entire Schedule B for the 2007 plan 

year, and the entire Schedule SB or MB 

(whichever is applicable) for the 2008 

plan year; (4) the entire Schedule I; (5) 

Schedule R identifying information and 

Part II; and (6) the entire Schedule SSA. 

The instructions to the 2007 Form 5500 

Annual Return/Report explain and 2008 

Form 5500 Annual Return/Report will 

explain, respectively, this simplified 

reporting option. 

Some eligible small plan filers may 

want to wait until the implementation 

of the Short Form 5500 for the 2009 

plan year in order to avoid having to 

make changes to their annual reporting 

systems and procedures for 2007 and 

2008 plan year filings and then having 

to adjust them again to start filing the 

Short Form 5500 electronically for the 

2009 plan year. The above simplified 

reporting alternative, accordingly, is 

available for plans that voluntarily 

choose to take advantage of the option. 

Plans with fewer than 25 participants 

may continue to file in accordance with 

the otherwise applicable small plan 

filing rules for the 2007 and 2008 plan 

years. Small plans with 25 or more 

participants that meet the eligibility 

requirements must wait until the 2009 

plan year to take advantage of the Short 

Form’s simplified reporting. 

2. Short Form 5500 

The Short Form 5500 was proposed as 

a new two-page form for small plans 

(generally, plans with fewer than 100 

participants) with secure and easy to 

value investment portfolios. As set forth 

in greater detail in the July 2006 

Proposal, a plan would be eligible to file 

the Short Form if the plan: (1) Covers 

fewer than 100 participants or would be 

eligible to file as a small plan under the 

rule in 29 CFR 2520.103–1(d); (2) is 

eligible for the small plan audit waiver 

under 29 CFR 2520.104–46 (but not by 

virtue of enhanced bonding); (3) holds 

no employer securities; (4) has 100% of 

its assets in investments that have a 

readily determinable fair market value; 

and (5) is not a multiemployer plan. 

Commenters on the July 2006 

Proposal generally supported the 

proposed Short Form 5500 as a way to 

simplify the annual reporting 

requirements and reduce annual 

reporting burdens for small plans. The 

Agencies, accordingly, have decided to 

adopt the Short Form 5500 largely as 

proposed with only minor technical 

revisions to the form and the 

accompanying instructions. 

Two commenters suggested that the 

Agencies relax the conditions for plans 

to be eligible to file the Short Form 

5500. The commenters noted the 

requirement in the PPA (enacted after 

the July 2006 Proposal was published) 

that Labor and the Department of the 

Treasury (Treasury) jointly develop a 

simplified report for plans that cover 

fewer than 25 employees. One of the 

commenters suggested that Labor and 

Treasury use the Short Form 5500 to 

meet this requirement by eliminating 

any other eligibility conditions for plans 

covering fewer than 25 participants. 

That commenter also suggested that the 

Short Form 5500 eligibility 

requirement—that the plan hold 100% 

of its assets in secure, easy to value 

investments—be modified so that it 

tracked the 95% ‘‘qualifying plan asset’’

threshold that currently applies under 

the Department’s regulation at 29 CFR 

2520.104–46 for small pension plans to 

be eligible for the waiver of the general 

Title I requirement for employee benefit 

plans to be audited annually by an 

independent qualified public 

accountant (IQPA). Two other 


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Federal Register / Vol. 72, No. 221 / Friday, November 16, 2007 / Notices 64735 

commenters objected to the Short Form 

5500 and reduced annual reporting for 

small plans, asserting that small plans, 

especially those with fewer than 25 

participants, are more likely than plans 

of larger companies to suffer from 

mismanagement of funds and improper 

administration. Notwithstanding the 

PPA mandate to develop a simplified 

annual report, the commenters urged 

requiring more detailed reporting for 

small plans as a way of protecting 

against such abuses. 

The Department of Labor and the 

Department of Treasury continue to 

believe, as set forth in the Supplemental 

Notice, that the requirement in the PPA 

to provide ‘‘simplified’’ reporting for 

plans with fewer than 25 participants is 

satisfied by the simplified reporting 

scheme in the July 2006 Proposal. In 

addition, the Department of Labor does 

not view the PPA provision as a 

direction from Congress that was 

intended to preclude the Department 

from determining that plans with fewer 

than 25 participants should meet 

conditions consistent with the purposes 

of Title I and the PPA to be eligible to 

file the new simplified report. To the 

contrary, the Department believes the 

PPA provision should be read 

consistently with the authority granted 

the Department in ERISA section 

104(a)(2) and 104(a)(3) to create 

simplified reports for pension and 

welfare plans, both of which provisions 

acknowledge that the Department has 

such discretion. The Short Form 5500, 

as proposed, was targeted to provide a 

simplified report for plans with fewer 

than 25 participants. Approximately 

75% of all plans eligible to file the Short 

Form 5500 cover fewer than 25 

participants and approximately 95% of 

plans with fewer than 25 participants 

are estimated to be eligible to file the 

Short Form 5500. The decision to 

prohibit multiemployer plans and plans 

that invest in employer securities from 

being eligible to use the Short Form 

5500 is consistent with the PPA’s 

emphasis on expanding the annual 

reporting requirements for 

multiemployer plans and increasing 

transparency and participant control 

over employer securities in individual 

account plans. As under the July 2006 

Proposal, even those small plans not 

eligible to use the Short Form 5500 still 

would be able to avail themselves of the 

other simplified reporting options 

available to small plans under the Form 

5500 Annual Return/Report. The 

commenter’s suggestion to eliminate all 

of the Short Form 5500 eligibility 

conditions for plans covering fewer than 

25 employees therefore has not been 

adopted. 

The suggestion to modify the 

condition that 100% of the plan’s assets 

are held in investments that have a 

readily determinable fair market value 

also is not being adopted. As noted 

above, the Short Form 5500 conditions 

already require plans to satisfy the audit 

waiver conditions in 29 CFR 2520.104–

46 to be eligible to file the Short Form. 

The condition in the audit waiver 

regulation that 95% of the plans assets 

be ‘‘qualifying plan assets,’’ focuses on 

whether the assets are held by a 

regulated financial institution, The 

Short Form 5500 condition regarding 

types of plan investments, in contrast, is 

based on a premise that certain small 

plans, by virtue of all of their assets 

being held by regulated financial 

institutions and having a readily 

determinable fair market value, present 

reduced risks for their participants and 

beneficiaries. Using any percentage 

measure for assets with a readily 

determinable fair market value would 

create a risk that hard to value assets 

would be materially undervalued in 

order to meet the percentage threshold 

and result in plans with substantial 

holdings in hard to value assets being 

eligible to file the Short Form 5500. The 

Agencies continue to believe that the 

separate financial information regarding 

hard to value investments on the 

Schedule I is important for regulatory, 

enforcement, and disclosure purposes. 

The Agencies are not changing this 

provision because of their concerns that 

allowing plans with any hard to value 

assets to use abbreviated annual report 

filing (i.e., the Short Form 5500) could 

compromise enforcement and research 

needs of the Agencies and disclosure 

needs of participants and beneficiaries 

in such plans. 

3. Code Section 403(b) Plan Reporting 

Under the July 2006 Proposal, the 

limited annual reporting options 

currently available to Code section 

403(b) plans would have been 

eliminated so that Code section 403(b) 

plans would be subject to the same 

annual reporting rules that apply to 

other ERISA-covered pension plans. 

Two commenters representing employee 

benefit plan auditors and administrative 

service providers were supportive of the 

Department’s proposal and agreed that 

requiring Code section 403(b) plans to 

comply with the same annual reporting 

rules that applied to other ERISA 

covered pension plans would improve 

transparency and accountability. Other 

commenters representing 403(b) plan 

sponsors and insurance and investment 

companies opposed the proposal. Those 

opposing the expanded reporting 

requirement argued that compliance 

with the reporting requirement would 

be both burdensome and costly given 

the fact that most 403(b) plans are a 

composite of individual contracts issued 

to employees by different 403(b) 

vendors without a central point for 

administration and recordkeeping. The 

commenters claimed that there is no 

record of abuse in the 403(b) plan area 

that supported the proposed changes. 

Certain commenters also suggested that 

different annual reporting rules for Code 

section 403(b) plans are justified by the 

fact that the tax exempt employers that 

sponsor Code section 403(b) plans do 

not have a tax incentive for sponsoring 

pension plans for their employees and 

might be more likely to terminate plans 

or refuse to sponsor plans based on 

concerns about administrative costs and 

burdens. 

After evaluating the comments, the 

Department continues to believe that 

subjecting Code section 403(b) plans to 

the same annual reporting rules that 

apply to other ERISA covered pension 

plans is consistent with the purposes of 

Title I of ERISA and the interests of 

covered participants and beneficiaries. 

The approach to annual reporting by tax 

sheltered annuity programs was 

premised historically on the conclusion 

that they differed from ordinary pension 

or deferred compensation plans. Code 

section 403(b) plans, which date back to 

1958, were originally less in the nature 

of a plan than of an arrangement under 

which an employer purchased from an 

insurance company on behalf of an 

employee an individual annuity 

contract that could be tailored to the 

desires and financial means of the 

individual employee. Because 

contributions were required to be 

invested only in annuity contracts or in 

certain mutual fund custodial accounts, 

the Department had believed that the 

regulatory supervision of insured 

annuity contracts and of regulated 

investment companies provided much 

of the disclosure, fiduciary and funding 

protection afforded by Title I of the Act. 

The Department also had concluded 

that because section 403(b) programs 

may be individually tailored, the 

reporting and disclosure provisions of 

Title I could present substantial 

administrative difficulties for the 

employer and for the Department. 

Finally, the Department viewed section 

403(b) programs as similar to individual 

retirement account (IRA) based plans 

that were granted an exemption from 

the annual reporting requirements 

under Title I provided they met certain 

conditions. 


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7One commenter expressed concern that some 

Code section 403(b) investments might not meet the 

Short Form 5500 eligibility requirement that 100% 

of the plan’s assets be held in investments that have 

a readily determinable fair market value. The 

instructions published with the July 2006 Proposal 

specifically provided that investments in mutual 

fund shares and insurance contracts for which 

valuation information is provided by the insurer at 

least annually were assets that had a ‘‘readily 

determinable fair market value’’ for purposes of the 

Short Form 5500 eligibility conditions. Those 

instructions are carried over into the instructions to 

the final Short Form 5500. 

8One commenter argued that Code section 403(b) 

plans covered by ERISA have no ERISA section 107 

recordkeeping obligations under Title I because 

they file under an alternative method of compliance 

under section 110 of ERISA, not under a simplified 

report or exemption under section 104 of ERISA, 

and ERISA section 107 only requires administrators 

to keep records necessary to verify the information 

actually filed on the Form 5500 when it is filed as 

an alternative method of compliance. ERISA section 

107 provides that ‘‘[e]very person subject to a 

simplified requirement to file any report or to 

certify any information therefor under this title or 

who would be subject to such a requirement but for 

an exemption or simplified reporting requirement 

under section 104(a)(2) or (3) of this title, shall 

maintain records on the matters of which disclosure 

is required which will provide in sufficient detail 

the necessary basic information and data from 

which the documents thus required may be 

verified, explained, or clarified, and checked for 

accuracy and completeness. . . .’’ Accepting the 

commenter’s argument would lead to the 

anomalous result that large Code section 403(b) 

plans would have very limited recordkeeping 

obligations under ERISA section 107, but plans 

exempt from any Form 5500 filing requirement 

would be required to keep records necessary to 

verify the information that would be required to be 

As the IRS indicated in the preamble 

to the recently published final 

regulations on Code section 403(b) plans 

(72 FR 41128, Jul. 26, 2007), various 

amendments to section 403(b) over the 

past 40 years have diminished the 

extent to which the rules governing 

Code section 403(b) plans differ from 

the rules governing other employerbased plans, such as arrangements that 

include salary reduction contributions, 

i.e., Code section 401(k) plans. The 

IRS’s final Code section 403(b) 

regulations would impose requirements 

involving the establishment of a more 

centralized system of recordkeeping for 

all Code section 403(b) plans. The 

establishment and growth since 1978 of 

401(k) plans has made the ‘‘individually 

tailored’’ character of Code section 

403(b) plans less distinctive. Section 

401(k) plans are often structured as 

participant directed with multiple 

investment options offered by separate 

investment providers, and many plans 

include brokerage accounts as a way of 

allowing employees to further tailor the 

plan to their individual investment 

objectives and financial means. 

Developments in the Code section 

403(b) plan market have also raised 

questions about whether regulatory 

supervision of Code section 403(b) plan 

vendors under insurance and securities 

laws provides much of the disclosure, 

fiduciary, and funding protections 

afforded by Title I of the Act. In the 

fiscal years 2002 through 2006, the 

Department found violations in 78 

percent of its investigations of Code 

section 403(b) plans. Although the 

predominant issue in these 

investigations was delinquent employee 

salary contributions, investigations of 

Code section 403(b) plans also revealed 

delinquent employer contributions, 

imprudence, prohibited uses of assets, 

and reporting and disclosure violations. 

The high incidence of improper 

handling of employee contributions 

suggests a potentially broader laxity in 

fiduciary oversight. There are also 

reports that governmental entities that 

sponsor Code section 403(b) plans 

(which generally would be excluded 

from ERISA as governmental plans) are 

concerned about undisclosed fees, 

penalties, and restrictions in their Code 

section 403(b) plans and are making 

demands for additional disclosures. See, 

e.g., California Assembly Bill 2506, 

signed Sept. 29, 2002 (codified at Cal. 

Education Code secs. 25100–25115). 

The Department believes that the 

annual report requirements, including 

an audit by an IQPA, provide important 

oversight of the Code section 403(b) 

plan’s internal control structure and 

overall operations. The Department 

believes that preparing the financial 

statements and schedules as part of the 

annual report in compliance with the 

Department’s requirements for reporting 

and disclosure under ERISA provides 

participants with greater assurance that 

the plan administrator or other 

authorized parties have properly 

monitored the financial condition and 

operation of the plan. The impact of 

having to meet the same annual 

reporting requirements applicable to 

other ERISA-covered plans would be 

substantially less burdensome for small 

tax-exempt employers, which generally 

should be eligible for the small plan 

audit waiver and for filing the Short 

Form 5500. 

While the new annual report 

requirements may result in additional 

costs to a Code section 403(b) plan, 

these reporting requirements would 

only apply to Code section 403(b) plans 

that are subject to Title I of ERISA and 

would subject those plans only to the 

same annual reporting requirements that 

apply to other ERISA-covered pension 

plans. In such cases, the administration 

and management of the Code section 

403(b) plan have already been subject to 

ERISA’s general fiduciary obligations. 

Such plans should, therefore, already 

have an administrative structure in 

place to ensure compliance with various 

Title I requirements, such as having a 

written plan document, furnishing 

summary plan descriptions and other 

ERISA required disclosures to 

participants and beneficiaries, and 

maintaining an adequate recordkeeping 

system so that the plan fiduciaries can 

prudently manage the plan and monitor 

plan service providers. In the 

Department’s view, the process of 

preparing an annual report reinforces a 

recordkeeping and monitoring 

discipline on plan officials that 

facilitates better fiduciary compliance. 

In that regard, the Department does not 

believe that it would be helpful to adopt 

the suggestion by one commenter to 

have Code section 403(b) plans answer 

only a single or limited number of 

questions focused just on timely 

transmission of employee salary 

reduction contributions to the plan. The 

Department does not believe that 

continuing a general exemption from 

the audit requirement for Code section 

403(b) plans subject to Title I annual 

reporting requirements is appropriate. 

As noted in the preamble to the July 

2006 Proposal, small Code section 

403(b) plans (generally covering fewer 

than 100 participants) should be able to 

meet the conditions for being exempt 

from the audit requirement and be 

eligible to file the proposed Short Form 

5500.7 Thus, relative to the current 

requirements, the final rule provides 

significant annual reporting and audit 

relief for small tax exempt employers. In 

that regard, in the Department’s view, 

Code section 403(b) plans that were 

eligible to file as a small plan under 29 

CFR 2520.103–1(d) in the previous year 

and that have participant counts of less 

than 121 at the beginning of the 2009 

plan year can file as small plans under 

the new filing rules. 

One commenter that supported the 

proposal to apply generally applicable 

annual reporting rules to Code section 

403(b) plans suggested that interim 

relief may be needed because auditors 

may refuse to take on initial 

engagements because records from prior 

years may not be adequate for current 

year audit purposes. Although Code 

section 403(b) plans have not yet been 

subject to an audit requirement as part 

of the annual reporting process, as noted 

above, fiduciaries of such plans must 

keep records under ERISA section 107 

to verify that they are in fact eligible to 

file as Code section 403(b) plans and 

have a general fiduciary obligation to 

keep adequate records to monitor the 

plan and ensure compliance with the 

fiduciary and other substantive 

requirements of Title I of ERISA.8


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filed under section 103 of ERISA. In any event, all 

Code section 403(b) plans filing a Form 5500 under 

the limited reporting provisions available to Code 

section 403(b) plans would have to keep records 

under ERISA section 107 to verify that they are in 

fact a pension plan or arrangement using a tax 

deferred annuity arrangement under Code section 

403(b)(1) and/or a custodial account for regulated 

investment company stock under Code section 

403(b)(7) as the sole funding vehicle for providing 

pension benefits and would have a general 

fiduciary obligation to keep records adequate to 

ensure compliance with the fiduciary and other 

substantive requirements in Title I of ERISA. 

Further, Code section 403(b) plans are 

required to maintain various records in 

order to comply with Code requirements 

including, for example, discrimination 

testing, required distributions and 

compliance with maximum contribution 

limitations. Despite the existing 

recordkeeping requirements, the 

Department recognizes that auditors 

may face difficulties in providing an 

unqualified opinion in their initial 

audits of Code section 403(b) plans. In 

that regard, the final forms changes 

defer the reporting year to which this 

requirement applies for an additional 

year from that in the proposal. This 

Notice is thus being published over a 

year before the first plan year for which 

plan audits would be required, and over 

two years before the plan audits 

themselves would likely be commenced. 

In light of the extended lead time the 

publication date gives plans to make 

changes to their recordkeeping practices 

and make certain they have access to the 

necessary records in anticipation of the 

audit for the 2009 plan year, in the 

Department’s view, it would be 

premature at this point to announce 

general transitional relief from the audit 

requirement. The Department will, 

however, remain open to reconsidering 

the issue to the extent developments 

suggest that a transitional enforcement 

policy or other transitional relief would 

be appropriate to address problems 

caused by lack of familiarity with the 

audit process or is needed to facilitate 

a smoother transition to the new annual 

reporting regime by Code section 403(b) 

plans. 

A few commenters contended that the 

‘‘universal availability’’ requirement 

applicable to Code section 403(b) plans 

under the Internal Revenue Code and 

Treasury Department regulations will 

unfairly result in Code section 403(b) 

plans with only a small number of 

active participants being subject to the 

large plan audit requirement because all 

eligible employees are counted as 

covered participants. The Department 

notes that Code section 401(k) plans are 

currently subject to a similar rule where 

all employees who are eligible to make 

salary reduction contributions are 

required to be counted as participants 

regardless of whether they in fact make 

any contributions. The Department also 

expects that, like Code section 401(k) 

plans, a substantial percentage of large 

Code section 403(b) plans should be 

eligible for limited relief from the full 

audit requirement by taking advantage 

of the limited scope audit option 

available under the Department’s 

regulation at 29 CFR 2520.103–8. 

Some additional technical changes 

were made to the final forms to make it 

clear that certain annual reporting 

options available to Code section 401(k) 

plans are also available to Code section 

403(b) plans. Specifically, the Schedule 

H instructions have been modified to 

provide for aggregate reporting on Lines 

4i (Schedule of Assets Held for 

Investment Purposes) and Line 4j 

(Schedule of Reportable Transactions) 

for individual annuity contracts and 

custodial accounts in Code section 

403(b) plans as is currently permitted 

for participant-directed accounts in 

Code section 401(k) plans. In addition, 

the Schedule A instructions have been 

expanded to make clear that the current 

rule allowing filers to report a group of 

individual policies issued by the same 

insurer on a single Schedule A would 

apply for Code section 403(b) individual 

annuity contracts. At the request of one 

commenter, Line 9 of the Form 5500 has 

been changed to make clear that Code 

section 403(b) plans that are funded 

with and pay benefits through Code 

section 403(b)(7) ‘‘custodial accounts’’

should check ‘‘trust’’ for both funding 

and benefit arrangement. 

Finally, in light of the additional 

annual reporting obligations associated 

with maintaining a Code section 403(b) 

plan that is covered by Title I, several 

commenters stated that more guidance 

was necessary on the Department’s safe 

harbor regulation at 29 CFR 2510.3–2(f) 

to assist plans in determining whether 

they were covered by Title I of ERISA. 

The commenters stated that this 

guidance was especially important in 

light of Treasury’s then anticipated 

issuance of final regulations at 72 FR 

41128, TD 9340 reflecting legislative 

changes made to Code section 403(b) 

since the existing regulations were 

adopted in 1964 and incorporating 

interpretive positions that Treasury has 

taken in other guidance on Code section 

403(b). The Department’s safe harbor at 

29 CFR 2510.3–2(f) states that a program 

for the purchase of an annuity contract 

or the establishment of a custodial 

account in accordance with provisions 

set forth in Code section 403(b) and 

funded solely through salary reduction 

agreements or agreements to forego an 

increase in salary, are not ‘‘established 

or maintained’’ by an employer under 

section 3(2) of ERISA, and, therefore, are 

not employee pension benefit plans 

subject to Title I, provided that certain 

factors are present. The Department 

agrees that it is important for Code 

section 403(b) plans to be able to 

determine whether they are covered by 

Title I for annual reporting and other 

ERISA compliance purposes. Thus, the 

Department issued guidance 

contemporaneously with Treasury’s 

issuance of its revised regulations under 

Code section 403(b) on the continued 

availability of the safe harbor at 29 CFR 

2510.3–2(f) and the interaction of the 

Department’s safe harbor and the 

provisions of the Treasury regulations 

addressing employer tax compliance 

obligations in the ongoing operation of 

a Code section 403(b) arrangement. See 

FAB 2007–02 (July 24, 2007) (available 

on the Internet at http://www.dol.gov/ 

ebsa/regs/fabmain.html). 

4. Schedules SB and MB (Pension Plan 

Actuarial Information) 

Draft Schedules SB and MB were 

posted on the Department’s Web site in 

conjunction with the Supplemental 

Notice. Instructions for these draft 

Schedules were not posted nor are they 

included in this Notice because their 

development hinges on guidance to be 

issued by the IRS and/or the PBGC 

implementing the PPA requirements 

underlying the Form 5500 Annual 

Return/Report data elements. Specific 

guidance regarding the details required 

in Schedule SB and Schedule MB will 

be provided in future guidance and will 

be included in the instructions. 

The Agencies received no comments 

related to the new Schedule MB and 

multiple comments from one 

commenter on Schedule SB. That 

commenter suggested that Line 4a be 

eliminated because it is identical to the 

entry in the second column of Line 3d. 

The Agencies note that the amount 

reported on Line 4a will not be the same 

as the amount reported in Line 3d and 

that this will be made clear in the 

instructions. 

This commenter also suggested that 

item 6 be expanded to have one line for 

reporting regular target normal cost and 

another line for reporting at-risk target 

normal cost. The Agencies acknowledge 

that some plans will need to calculate 

both amounts in order to determine 

target normal cost, but conclude that it 

is not necessary to require that these 

interim calculations be reported. 

Guidance regarding the details of this 

calculation will be included in the 

instructions. 

This commenter suggested that the 

words ‘‘not less than zero’’ be added to 


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the end of the parenthetical definition 

for Line 30 on the Schedule SB. The 

Agencies concluded that this change is 

not necessary. Guidance regarding Line 

30 will be included in the instructions. 

This commenter noted that the 

definitions for Lines 7 and 8 refer to 

Lines 13 and 35 from the prior year, but 

that these definitions will not be valid 

for 2008 unless the 2007 Schedule B is 

changed to include Lines 13 and 35 as 

defined in the 2008 Schedule SB. The 

Agencies note that Lines 13 and 35 will 

not be included on the 2007 Schedule 

B. The Schedule SB was designed to 

reflect various PPA reporting and 

disclosure provisions (generally 

effective for 2008 and subsequent years). 

Information on ‘‘look back’’ rules 

applicable for completing the questions 

on the Schedule SB will be included in 

the instructions. 

5. Schedule C (Service Provider 

Information) 

The Department believes that an 

annual review of plan fees and expenses 

as part of the annual reporting process 

is part of a plan fiduciary’s on-going 

obligation to monitor service provider 

arrangements with the plan. 

Commenters generally supported the 

goals of the proposed changes to the 

Schedule C, as stated in the proposal, of 

increasing transparency regarding fees 

and expenses paid by employee benefit 

plans and ensuring that plan officials 

obtain the information they need to 

assess the compensation paid for 

services rendered to the plan, taking 

into account revenue-sharing 

arrangements among plan service 

providers and potential conflicts of 

interests. 

Commenters representing insurance 

companies, banks, and other financial 

institutions, however, while generally 

supporting fee transparency and 

applauding the Department’s initiatives 

in this area, raised concerns that the 

proposed Schedule C reporting scheme 

for indirect compensation was more 

extensive than necessary. They asserted 

that the proposed changes could result 

in duplicative, misleading, and 

confusing reporting. The commenters 

also argued that the proposed changes, 

if not narrowed, would impose 

significant administrative costs on 

service providers to track and disclose 

information on indirect compensation, 

which costs they likely would pass on 

to their employee benefit plan clients. 

These commenters suggested that 

reporting of indirect compensation, as 

proposed, should be narrowed in 

various ways: (1) Eliminate or narrow 

reporting of ‘‘float’’ income; (2) 

postpone any requirement to report 

‘‘soft dollars’’ until after the Securities 

and Exchange Commission (SEC), as the 

primary regulator of soft dollar 

compensation, addresses the subject as 

it applies to investors generally; (3) 

except from reporting revenue sharing 

payments among affiliates and by other 

bundled service providers to entities 

that the bundled provider engages to 

provide services; (4) retain the current 

rules under which brokerage 

commissions are not required to be 

reported unless the broker is granted 

some discretion; (5) define ‘‘service 

providers’’ required to be listed in the 

Schedule C as limited to persons with 

direct service relationships with the 

plan and exclude from Schedule C 

reporting payments to ‘‘subcontractors’’

based on the premise that 

subcontractors are merely assisting the 

direct service provider in fulfilling its 

contractual obligations and are not 

providing services to the plan; (6) 

confirm that insurers and investment 

providers are not required to be listed as 

service providers on Schedule C solely 

as a result of the plan’s purchase of the 

insurance contract or investment with 

the investment provider; and (7) 

integrate the annual reporting 

requirement into other regulatory 

disclosure requirements regarding fee 

and expense disclosure to avoid 

duplicative and confusing disclosure 

requirements. 

Two individual commenters 

suggested that the Schedule C should be 

completed by small plans as well as 

large plans and that the $5,000 reporting 

threshold for listing a service provider 

on the Schedule C should be lowered or 

eliminated. Another commenter 

suggested that, if full Schedule C 

reporting was not expanded to small 

plans, investment-related fees and 

expenses should be reported separately 

in a similar manner as administrative 

service provider expenses under the 

July 2006 Proposal which called for 

administrative service provider 

expenses paid by the plan to be reported 

as an aggregate line item on Schedule I 

and the Short Form. 

As noted in the July 2006 Proposal, 

issues relating to the appropriate 

manner and scope of the reporting of 

service provider compensation on the 

Schedule C have been raised by the 

ERISA Advisory Council and the 

Government Accountability Office, as 

well as by Form 5500 Annual Return/ 

Report filers and plan service providers. 

The Department is working on a 

separate regulation setting forth the 

standards applicable to the exemption 

under ERISA section 408(b)(2) for 

contracting or making reasonable 

arrangements with a party in interest for 

services. See 72 FR 22845. That 

regulation is intended to eliminate the 

current uncertainty as to the 

information relating to services and fees 

that plan fiduciaries must obtain and 

service providers must furnish for 

purposes of determining whether a 

contract for services to be rendered to a 

plan is reasonable. Another rulemaking 

initiative on the Department’s regulatory 

agenda involves review of participantlevel disclosure, including the 

regulation governing ERISA section 

404(c) plans (29 CFR 2550.404c–1), to 

ensure that participants and 

beneficiaries in individual account 

plans are provided the information they 

need, including information about fees 

and expenses, to make informed 

investment decisions. Id. Other federal 

agencies, for example the SEC, are also 

focusing on efforts to give investors, 

including employee benefit plans, better 

information about the actual amount 

they have paid investment fund 

managers during a given period. 

Against this backdrop, and inasmuch 

as plan administrative costs are being 

passed on to plan participants with 

increasing frequency, it is critical to 

ensure that the benefits of any new 

annual reporting requirement outweigh 

the attendant compliance costs—costs 

that may ultimately reduce retirement 

savings. The Schedule C requirements 

historically have been limited to large 

plans that are required to file the Form 

5500 Annual Return/Report and have 

not covered the broader class of plans 

covered by the Department’s other fee 

transparency initiatives. Considered in 

context with other fee disclosure 

initiatives at the Department and 

elsewhere that are more tailored to the 

concerns expressed by GAO and the 

ERISA Advisory Council on changes 

needed to provide 401(k) plan 

participants better information on fees, 

particularly investment fees indirectly 

incurred by participants directing the 

investment of assets in their individual 

401(k) plan accounts, the Department 

does not believe expanding the 

Schedule C annual reporting 

requirements to small pension plans 

would be consistent with the direction 

from Congress in the PPA for the 

Department to simplify the annual 

report for plans sponsored by small 

businesses. 

The Department continues to believe 

that it is appropriate to modify the 

Schedule C reporting requirements for 

large plans in an effort both to clarify 

the reporting requirements and to 

ensure that the Form 5500 Annual 

Return/Report serves a role in helping 

plan officials obtain the information 

they need to assess the reasonableness 


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of the compensation paid for services 

rendered to the plan, taking into 

account revenue sharing and other 

financial relationships or arrangements 

and potential conflicts of interest that 

might affect the quality of those 

services. After having carefully 

reviewed the public comments on the 

Schedule C proposal, the Schedule C is 

being adopted largely as proposed, but 

some revisions are being made to the 

proposed requirements. The changes are 

intended to reduce the administrative 

burdens on plans and plan service 

providers and clarify the reporting 

requirements without compromising the 

proposal’s overall objectives. 

a. Indirect Compensation Reporting on 

Schedule C 

Reportable compensation under the 

final Schedule C revisions continues to 

be defined to include money and any 

other thing of value (for example, gifts, 

awards, trips) received directly or 

indirectly from the plan (including fees 

charged as a percentage of assets and 

deducted from investment returns) for 

services rendered to the plan. The 

Department does not agree with the 

commenters who argued that only those 

persons with ‘‘direct service 

relationships’’ with the plan should be 

treated as providing services to the plan 

for Schedule C reporting purposes. The 

Department believes that such a 

conclusion would be inconsistent even 

with the current reporting requirements 

in the Schedule C. Under current 

reporting rules, reportable indirect 

compensation expressly includes 

‘‘among other things, payment of 

‘finder’s fees’ or other fees and 

commissions by a service provider to an 

independent agent or employee for a 

transaction or service involving the 

plan.’’ Nothing in the proposal was 

intended to restrict or diminish the 

existing requirement to report such 

finders’ fees or commissions. Rather, the 

proposal was designed to expand 

indirect compensation reporting 

requirements. The Department also 

believes that adopting the commenters’

suggestion would undermine the 

objective of improving disclosure of fee 

and compensation information because 

it is not consistent with the reality of the 

employee benefit plan marketplace 

where the nature and complexity of the 

business and investment environment 

in which plans operate has changed the 

ways in which plans obtain and pay for 

administrative, investment, and other 

services. Although the Department 

agrees that an investment of plan assets 

or the purchase of insurance is not, in 

and of itself, reportable service provider 

compensation for purposes of the 

Schedule C, in the Department’s view, 

persons that provide investment 

management, recordkeeping, participant 

communication, and other services to 

the plan as part of a transaction with the 

plan should be treated as providing 

services to the plan or its participants 

for purposes of Schedule C reporting. 

Thus, under the final Schedule C 

revisions, and subject to the alternative 

reporting option described below, such 

persons would be required to be 

identified in Part I if they received, 

directly or indirectly, $5000 or more in 

reportable compensation for a 

transaction or service involving the 

plan. 

Several commenters suggested that a 

payment be reportable on Schedule C 

only if either the service provider’s 

eligibility for the payment or the 

amount of the payment is based on a 

transaction directly involving assets of 

the plan. The commenters argued that 

such a test would be consistent with 

conflict of interest rule in ERISA section 

406(b)(3), which prohibits receipts by 

plan fiduciaries of consideration for 

their own personal account from any 

party dealing with a plan ‘‘in 

connection with’’ transactions involving 

plan assets. The Department does not 

agree that the standard for Schedule C 

reporting should be narrowed to parallel 

the prohibited transaction standard in 

ERISA section 406(b)(3). Unlike the 

prohibited transaction provision in 

406(b)(3), the Schedule C revisions were 

not intended to be limited to receipts by 

plan fiduciaries or to identifying 

impermissible conflicts of interest. The 

Schedule C reporting of indirect 

compensation also is not limited to only 

those circumstances where a plan 

fiduciary affirmatively chooses the 

indirect service providers. Rather, one 

of the goals of the Schedule C changes 

is to improve fee disclosure to plan 

fiduciaries, especially where they do not 

have a role in determining the 

compensation paid to parties that are 

receiving fees for a transaction or 

service involving the plan. Schedule C 

reporting arises in part from ERISA 

section 103(c)(3), which requires 

information in the annual report 

regarding ‘‘each person’’ (not limited to 

just fiduciaries) who rendered services 

to the plan or who had transactions with 

the plan who received, directly or 

indirectly, compensation from the plan 

during the year for services rendered to 

the plan or its participants. Further, 

ERISA section 103(c)(5) expressly 

provides that the administrator shall 

furnish as part of the annual report 

‘‘[s]uch financial and actuarial 

information’’ as the ‘‘Secretary may find 

necessary or appropriate.’’ In the 

Department’s view, the prohibited 

transaction standard in ERISA section 

406(a)(1)(C)—transactions that 

constitute a ‘‘direct or indirect’’

furnishing of goods, services, or 

facilities to the plan—is generally a 

more suitable analog for Schedule C 

reporting. Thus, in the Department’s 

view, the Schedule C reporting 

requirement should generally capture 

both persons who receive direct or 

indirect compensation and persons who 

provide services directly or indirectly to 

the plan. 

The Department nonetheless agrees 

that additional guidance on certain 

areas of concern raised by commenters 

would establish useful compliance 

guides for plan administrators and plan 

service providers. 

As was noted in the July 2006 

Proposal, Schedule C was intended to 

capture information on compensation 

received by persons providing services, 

and not information on benefit 

payments to participants and 

beneficiaries. Where fully insured group 

health benefits, or similarly fully 

insured benefits under a plan, are 

purchased from and guaranteed by a 

licensed insurance company, insurance 

service, or other similar organization, 

and where information regarding that 

contract is reported on the Schedule A, 

compensation paid by the insurance 

company from its general assets to 

affiliates or third parties for 

administrative activities necessary for 

the insurer to satisfy its contractual 

obligation to provide benefits is not 

required to be treated as reportable 

service provider compensation for 

purposes of the Schedule C. Insurance 

investment contracts are not eligible for 

this exception. As described below in 

the discussion of the Schedule A 

(Insurance Information), a similar 

exclusion is being adopted in defining 

the scope of insurance fees and 

commissions that must be separately 

reported on the Schedule A. In 

determining whether such 

compensation is excludable from the 

Schedule C, the Department would look 

to whether the administrative services 

are necessary for the insurer to satisfy 

its contractual obligation to provide 

benefits under the plan and are not 

services incidental to the sale or 

renewal of a policy, whether payments 

by the insurer are out of its general 

assets to third parties without any other 

direct or indirect charge to the plan 

other than the policy premium, are 

made pursuant to a contract or written 

understanding to provide the services, 

and whether the amount of the 

compensation paid by the insurer is 


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9Financial service providers (e.g., banks and trust 

companies) sometimes place ERISA plan assets in 

a general account for short periods of time in order 

to facilitate certain transactions, such as while 

waiting for investment instructions from the plan’s 

fiduciaries or in order to make a distribution or 

other disbursement. The period that begins when 

the plan money is deposited in the general account, 

and ends when the investment instructions are 

executed or the disbursement check clears, is 

known as the ‘‘float.’’ During this float period, the 

money often is invested in conservative, short-term 

investments. In some cases, the ERISA plan is 

credited with the earnings on these investments. In 

others, the financial service provider keeps the 

earnings as part of its compensation. 

10Soft dollars include research or other products 

or services, other than execution, received from a 

broker-dealer or other third party in connection 

with securities transactions. 

reasonable in light of the value of the 

services provided. 

Under the proposal, Schedule C 

reportable compensation included 

brokerage commissions and fees directly 

or indirectly charged to the plan on 

purchase, sale, and exchange 

transactions regardless of whether the 

broker is granted discretion. 

Commenters urged retaining the current 

limitation under which such 

compensation is reported on the 

Schedule C only for brokers granted 

discretion. The Department continues to 

believe that brokerage fees and 

commissions may constitute a 

significant part of a plan’s annual 

expenses and that continuing the 

current exemption from the Schedule C 

reporting for such expenses is not 

appropriate. A review of expenses as 

part of the annual reporting process is 

part of a plan fiduciary’s on-going 

obligation to monitor service provider 

arrangements with the plan. Requiring 

the reporting of such brokerage 

commissions and fees should emphasize 

and reinforce that monitoring 

obligation. The Department understands 

that information on brokerage fees and 

commissions may be provided to the 

plan by parties other than the broker 

receiving the fee or commission. For 

example, a number of commenters 

indicated that in many cases the broker 

will not know the party on whose behalf 

a brokerage transaction is being 

executed because the instructions to 

execute trades are often provided by 

investment managers who control 

investment portfolios for multiple 

ERISA plans, non-ERISA plans, and 

non-plan clients. The commenters 

asserted that it may be very difficult for 

the broker to identify fees and 

commissions it receives from ERISA 

plan transactions, much less identify 

fees and commissions it receives on 

transactions involving a particular 

ERISA plan. The Department notes that 

the plan administrator is the party with 

the obligation to complete the Schedule 

C. Further, the Schedule C does not 

require that information on reportable 

fees and commissions necessarily be 

furnished to the administrator by the 

party receiving the fee or commission. 

Rather, in the situation described by the 

commenters, the investment manager 

should have information on which 

transactions are being executed for 

which clients and should have 

information on the fees and 

commissions it is being charged for 

those transactions. In such a case, the 

investment manager, rather than the 

broker, may be the appropriate party to 

provide the plan administrator with 

information on those service provider 

fees and commissions. 

Many of the comments raising 

concerns about the difficulties and 

burdens of reporting indirect 

compensation focused on ‘‘float’’

revenue; 9 securities brokerage 

commissions (including soft dollar 

commissions10); and service fees 

charged against plan investments and 

reflected in the net value of the plan’s 

investment in mutual funds, bank 

investment funds, and insurance 

company investment contracts. 

According to the GAO, see, e.g., ‘‘Private 

Pensions: Changes Needed To Provide 

401(k) Plan Participants and the 

Department of Labor Better Information 

on Fees’’ (GAO 07–21, Nov. 2006), these 

investment-related fees indirectly paid 

by plans and plan participants account 

for the largest portion of total plan fees 

regardless of plan size. Services 

provided for these fees can include 

investment management (e.g., selecting 

and managing the securities included in 

a mutual fund); consulting and 

providing financial advice 

(recommending vendors for investment 

options or other services); custodial or 

trustee services for plan assets; and 

shareholder services (such as telephone 

or web-based customer services for 

participants). Record-keeping fees were 

identified as generally constituting the 

second-largest portion of these indirect 

fees. Record-keeping fees are usually 

paid to a service provider to set up and 

maintain the plan. These fees cover 

activities such as enrolling plan 

participants, processing participant 

investment selections, preparing and 

mailing account statements, and other 

related administrative activities. 

The commenters indicated that the 

burden and complexity of reporting 

investment-related fees is due in large 

part to the fact that a substantial 

majority of retirement plan service 

providers maintain plan records and 

investment information at an omnibus 

account level. Certain commenters 

described omnibus accounting as ‘‘best 

practice’’ in the industry. They 

suggested that efficiencies in data 

exchanges and settlement transactions 

between funds and retirement plan 

record keepers generated by omnibus 

accounting are used to reduce plan 

service costs. These savings were 

described as based in part upon the 

service provider maintaining omnibus 

trading accounts with investmentrelated service compensation based 

upon a percentage of the total assets in 

an investment fund. A commenter 

representing the mutual fund industry 

asserted that it would be extremely 

difficult to parse out by plan (in dollars) 

specific components of a fund’s 

expenses for purposes of Form 5500 

reporting. The commenter suggested 

that the data systems overhaul that 

would be needed to track this 

information would be prohibitively 

expensive. Other commenters suggested 

that, although it may be possible with 

current data systems to generate an 

estimate of the amount of investmentrelated fees reflected in the periodic net 

asset valuation of a plan’s investment on 

a case-by-case basis, systematically 

performing such a task each year for 

each investing plan would be difficult 

given the variation in omnibus account 

investment fees and the pervasiveness 

of their use as a means of compensating 

service providers for an array of 

investment-related services. 

In a similar vein, several commenters 

expressed concern about the Schedule C 

reporting requirements in the case of 

revenue sharing among members of a 

bundled service arrangement (including, 

in particular, revenue sharing among 

affiliates from investment-related fees 

charged at the omnibus account level). 

The commenters explained that bundled 

service arrangements include 

arrangements where the plan hires one 

company to provide, either directly or 

through affiliated entities or unaffiliated 

subcontractors, an array of services 

rather than purchasing the services on 

an individual basis. In some typical 

arrangements, a bundle of services is 

included as part of an investment 

transaction and the service providers are 

paid out of investment management and 

other charges levied on an investment 

fund comprised of many ERISA plans, 

other plans, and, in some cases, nonplan investors. Several commenters 

asked that the final Schedule C 

revisions confirm that payments 

received in such a bundled arrangement 

by a service provider from an affiliate 

not be separately reportable on 

Schedule C. The commenters argued 


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that separate reporting was not 

necessary to identify possible conflicts 

of interest because the self-interest such 

a service provider has in its affiliate 

should be readily apparent to the plan 

fiduciary evaluating an investment in 

the bundled arrangement or any advice 

or recommendation by that service 

provider relating to its affiliate. The 

commenters also argued that separate 

disclosures on revenue sharing among 

affiliates are not necessary where the 

total compensation received by the 

affiliated group is to be reported. The 

commenters argued that allocation of 

revenues among affiliates may not be 

based on the value of services provided 

by the respective affiliates to investing 

plans, but instead may be driven by tax 

accounting, cash flow or other internal 

business purposes of the affiliate group. 

They also argued that, although they 

could attempt to allocate a cost to each 

service in the bundled, the annual 

report does not in other cases require 

service providers to report their cost, as 

opposed to the charges paid by the plan. 

The commenters also argued that 

reporting revenue sharing among 

affiliates would create a confusing 

distinction between entities that provide 

services using employees in multiple 

divisions of one company and entities 

that use several separate subsidiaries to 

provide the services. One of the 

commenters suggested that if multiple 

affiliates within an organizational group 

provided services to a plan, it should be 

sufficient to identify in Part I of 

Schedule C the organization together 

with its participating affiliates and 

report compensation on an aggregate 

basis. 

Other commenters representing 

‘‘unbundled’’ or ‘‘open architecture’’

investment providers asserted that 

allowing aggregate reporting for 

bundled/affiliated providers, without 

having a parallel rule for unbundled 

providers would generate misleading 

information for plan administrators. The 

commenters represented that unbundled 

investment service arrangements use the 

same basic omnibus accounting and 

omnibus account fee arrangements as 

bundled providers. In the unbundled 

context, revenue sharing is used to 

compensate unaffiliated entities 

providing the same recordkeeping and 

shareholder services provided by 

affiliates in a bundled provider 

arrangement. They pointed out that 

technological improvements in 

information management systems and 

data exchange between investment 

funds and retirement plan record 

keepers have given unbundled 

providers the ability to offer cost and fee 

structures competitive to those of 

bundled providers. They also argue that 

unbundled arrangements give plans 

access to a wider range of unaffiliated 

investment vehicles than is typically 

offered by bundled providers. 

Representatives of the ‘‘unbundled’’

service providers claim that, just like 

the bundled providers, the parties 

providing sales, recordkeeping, 

participant communication, and other 

services are often paid indirectly from 

charges levied against the investment 

funds in which the plan accounts are 

invested. They read the Schedule C 

proposal as requiring, in the case of 

bundled providers, reporting of a single 

sum equal to the total compensation, 

including investment management and 

other asset-based fees, paid by the plan 

without reporting the allocation of those 

charges to affiliated service providers in 

the bundle. In comparison, they read the 

proposal to require that the plan report, 

in the ‘‘unbundled’’ structure, both the 

total investment management and other 

asset-based fees as well as report 

allocations from those fees to the 

unaffiliated service providers. The 

commenters suggested, therefore, that, 

although an unbundled arrangement 

may provide the same services as a 

bundled arrangement and the various 

service providers may be paid out of the 

same investment management and 

omnibus asset-based charges as in a 

bundled arrangement, the Schedule C 

reporting could make it appear as if the 

unbundled arrangement included more 

fees. 

The Department has decided to revise 

the Schedule C reporting requirement in 

an effort to address both the concerns 

regarding the burden and expense of 

reporting plan specific components of 

omnibus asset-based charges and 

concerns over disparate reporting 

treatment of affiliated service provider 

groups and unaffiliated providers using 

essentially the same indirect 

compensation arrangements. In that 

regard, the Department notes that even 

commenters generally supporting the 

Schedule C proposal urged the 

Department to provide flexibility, 

consistent with the spirit of the 

proposed Schedule C changes, in 

defining acceptable methods of 

reporting fee and expense information 

and allocating the fees and expenses for 

specific service provider compensation 

to individual plans. 

Thus, the final Schedule C revisions 

include a new definition of what would 

constitute a bundled arrangement for 

Schedule C reporting purposes. In the 

case of such bundled arrangements, 

although revenue sharing within the 

bundled group generally does not need 

to be separately reported, the person or 

persons in the bundle receiving separate 

fees charged against the plan’s 

investment (e.g., investment 

management fees, float revenue, and 

other asset-based fees such as 

shareholder servicing fees, 12b–1 fees, 

and wrap fees if charged in addition to 

the investment management fee) must, 

subject to the alternative reporting 

option described below, be treated as 

receiving separate reportable 

compensation for Schedule C purposes. 

Also, and subject to the alternative 

reporting option described below, any 

person in the bundle who is a fiduciary 

to the plan or provides one or more of 

the following services to the plan

contract administrator, consulting, 

investment advisory (plan or 

participants), investment management, 

securities brokerage, or recordkeeping—

receiving amounts as commissions 

(including finders’ fees), soft dollars or 

other nonmonetary compensation, float 

revenue, or transaction-based charges 

(e.g., brokerage commissions) must be 

separately reported on the Schedule C if 

their total reportable compensation 

equals or exceeds $5,000. The 

Department believes that having to 

disclose the receipt of separate fees 

actually charged against the plan’s 

investment would not require service 

providers to disclose information 

legitimately classified as proprietary or 

confidential. Further, in the case of 

commissions, soft dollars, finders’ fees, 

float revenue, and transaction-based 

charges paid to affiliates, the 

Department believes such charges are 

just as likely for both affiliate groups 

and unaffiliated providers to be relevant 

to the plan fiduciary in evaluating 

possible conflicts of interest. 

Except as described above, the 

Department continues to believe that it 

is generally sufficient for Schedule C 

reporting purposes to treat an affiliate 

group as a single person and identify 

that affiliate group in Part I of the 

Schedule C as the party receiving 

compensation from the plan for 

rendering services to the plan. The 

Department emphasizes, however, that 

if one or more of the affiliates or a 

member of a bundled arrangement 

received compensation from sources 

outside the affiliate group or bundled 

arrangement in connection with the 

investment transaction with the plan or 

services provided to the plan, that 

compensation also would have to be 

included as part of the reportable 

compensation received in determining 

Schedule C reporting requirements. 

For purposes of this Schedule C 

reporting rule, an ‘‘affiliate’’ of a person 

includes any person, directly or 


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indirectly, through one or more 

intermediaries, controlling, controlled 

by, or under common control with the 

person. The instructions for the 

Schedule C have been revised to 

provide that ‘‘control,’’ with respect to 

a person other than an individual, 

means the ability to exercise a 

controlling influence over the 

management or policies of such person. 

In attempting to strike a balance 

between the costs and benefits of 

improved disclosure of investmentrelated fees and expenses, the 

Department believes some of the 

concerns regarding the burden and 

complexity of allocating fees charged in 

an omnibus account structure can be 

addressed by further modifying the 

Schedule C requirements so they rely on 

disclosures regarding those fees 

resulting from other regulations or 

business practices to the extent those 

disclosures meet the objectives 

underlying the Department’s Schedule C 

proposal. The final Schedule C revisions 

thus include an alternative reporting 

option for ‘‘eligible indirect 

compensation.’’ To constitute eligible 

indirect compensation for this purpose, 

the compensation has to be of a certain 

type and the plan must have received 

certain disclosures. The eligible 

compensation types are compensation 

not paid directly by the plan or plan 

sponsor but received by plan service 

providers from omnibus level fees 

charged to investment funds in which 

the plan invests where the charges are 

reflected in the value of the investment 

or return on investment of the 

participating plan or its participants and 

for: distribution, investment 

management, recordkeeping or 

shareholder services; commissions and 

finder’s fees paid to persons providing 

direct or indirect services to the 

participating plans; float revenue; 

securities brokerage commissions and 

other transaction-based fees (whether or 

not they are capitalized as investment 

costs); and ‘‘soft dollar’’ revenue. For 

the alternative reporting option to be 

available, in addition to being within 

that class of investment fees, the plan 

administrator must also be furnished 

written materials, including in 

electronic form, that disclose the 

existence of the indirect compensation; 

the services provided for the indirect 

compensation or the purpose or 

purposes for the payment of the indirect 

compensation; the amount (or estimate) 

of the compensation or a description of 

the formula used to calculate or 

determine the compensation; and the 

identity of the party or parties paying 

and receiving the compensation. The 

Department believes that any written 

disclosure, whether regulatory, 

contractual, or voluntary, could be 

relied upon so long as all of the 

elements of the disclosure were 

provided to the plan administrator. 

Further, the necessary information 

could be provided to the plan 

administrator in separate disclosures 

from multiple parties. 

In the case of service providers who 

received only eligible indirect 

compensation, the plan administrator 

would be able to check a box on the 

Schedule C to indicate that there were 

such service providers and that the plan 

had received the appropriate 

disclosures, and then identify on the 

Schedule C each person from whom the 

plan administrator received the 

necessary disclosures regarding the 

eligible indirect compensation. For 

example, 12b–1 fees received by a party 

providing recordkeeping services to a 

plan would not have to be separately 

reported on the Schedule C if the 

disclosures in the mutual fund 

prospectus together with disclosures in 

the service contract advised the plan 

administrator of the fact that the 12b–1 

fees were being received, what the fees 

were paid for, the amount or estimate of 

the fees received or the formula used to 

calculate the amount of the fees 

received, and the party from whom the 

recordkeeper was receiving the fees. 

Similarly, ‘‘soft dollars’’ received by an 

investment manager in the form of 

research or other permissible services in 

connection with securities trades on 

behalf of plan clients need not be 

separately reported on the Schedule C if 

disclosures in the SEC Form ADV, 

together with disclosures in the 

investment management contract, 

advised the plan administrator that the 

manager is receiving ‘‘soft dollars,’’ the 

reason the person was receiving the 

‘‘soft dollar’’ payment, the amount of 

‘‘soft dollars’’ or the formula used to 

determine the amount of ‘‘soft dollars’’

that the manager receives in connection 

with each securities transaction, and the 

party or parties from whom the 

investment manager is receiving the 

‘‘soft dollars.’’ The Department 

recognizes that it may not be practicable 

to provide a formula or estimate to 

calculate the value of certain types of 

‘‘soft dollar’’ non-monetary 

compensation at the plan level, 

particularly so-called ‘‘proprietary’’ soft 

dollar arrangements, such as access to 

information from certain research 

specialists. In such circumstances, a 

description of the eligibility conditions 

sufficient to allow a plan fiduciary to 

evaluate them for reasonableness and 

potential conflicts of interests would 

satisfy the ‘‘amount of compensation’’

prong of the disclosure alternative for 

Schedule C reporting. When reporting 

service providers who received eligible 

indirect compensation and other 

compensation, the service provider 

would be required to be separately 

listed on the Schedule C if the total 

compensation equaled or exceeded the 

$5,000 threshold. The plan 

administrator would check a box to 

indicate that some of the compensation 

was eligible indirect compensation and 

complete the other elements of the 

Schedule C to report information on the 

balance of the direct and indirect 

compensation received by the service 

provider. Since the identity of the 

service provider would be included on 

the Schedule C in such cases, separately 

listing the person from whom the plan 

received the required disclosures 

regarding the eligible indirect 

compensation would not be necessary. 

The Department has previously 

expressed its opinion that in hiring and 

retaining service providers plan 

fiduciaries must engage in an objective 

process designed to elicit information 

necessary to assess the qualifications of 

the provider, the quality of services 

offered, and the reasonableness of the 

fees charged in light of the services 

provided. In addition, the process 

should be designed to avoid selfdealing, conflicts of interest, or other 

improper influence. The alternative 

reporting option being adopted as part 

of the Schedule C revisions for eligible 

indirect compensation is intended to 

emphasize and reinforce the obligation 

to review of plan expenses as part of a 

plan fiduciary’s on-going obligation to 

monitor service provider arrangements. 

It also provides the Department with 

adequate reporting to engage in effective 

oversight activities while addressing 

concerns about annual reporting 

burdens and costs, which are 

increasingly being passed on to plan 

participants and beneficiaries. A party 

seeking to avail itself of the alternative 

reporting option would also bear the 

burden of maintaining records sufficient 

to demonstrate compliance with the 

conditions of the alternative reporting 

option. 

Several commenters asked that the 

Department modify the proposed 

Schedule C requirement applicable to 

plan fiduciaries and certain enumerated 

service providers who received, directly 

or indirectly, $5,000 or more in total 

compensation, and also received more 

than $1,000 in reportable compensation 

from a person other than the plan or 

plan sponsor. Under the proposal, the 

Schedule C would have had to provide 


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information identifying the payor of 

such indirect compensation, the payor’s 

relationship with the plan or services 

provided to the plan by the payor, the 

amount paid, and the nature of the 

compensation. The enumerated service 

providers were contract administrator, 

securities brokerage (stock, bonds, 

commodities), insurance brokerage or 

agent, custodial, consulting, investment 

advisory (plan or participants), 

investment or money management, 

recordkeeping, trustee, appraisal, or 

investment evaluation. The commenters 

expressed concern that the list of 

enumerated service providers was 

overbroad because it included most 

types of plan service providers, 

including those where compensation 

arrangements did not present any real 

conflict of interest concerns. The 

commenters also objected because the 

reporting requirement substantially 

reduced the costs savings and burden 

reductions of the aggregate reporting of 

compensation by affiliates and bundled 

service providers. In light of the other 

revisions being made to the reporting 

requirements for bundled service 

arrangements described above, the 

Department is revising the Schedule C 

instructions to limit the enumerated 

service provider list to types of 

providers where compensation 

arrangements presenting conflict of 

interest concerns are most likely to 

exist. 

Modifications were also suggested to 

the aspect of the Schedule C proposal 

that required reporting business meals, 

gifts, promotional items, and other 

similar non-monetary forms of 

compensation. Commenters complained 

that the proposal would require costly 

tracking and reporting by plan service 

providers of typical business expenses 

only remotely connected to the plans. 

One commenter cited, as an example, 

the need to track and report when an 

employee of a plan service provider is 

treated to a business lunch by another 

service vendor to discuss the services 

the vendor provides to the service 

provider’s plan clients. The commenter 

questioned whether the cost of such 

tracking and potential reporting, which 

ultimately could be passed on to the 

plan or the plan sponsor, is justified 

based on value to plan fiduciaries 

evaluating the reasonableness of service 

provider fees. The Department 

recognizes that providing meals, 

entertainment, free travel, or other 

gratuities may serve an ordinary 

business purpose, such as cultivating 

goodwill or securing or maintaining a 

commercial relationship, but continues 

to believe that non-monetary 

compensation should be subject to 

Schedule C reporting rules. Access to 

this information should help plan 

fiduciaries gauge whether the service 

provider’s business decisions with 

regard to the plan may be influenced by 

any such personal benefits. At the same 

time, excepting from reporting 

occasional and insubstantial free meals, 

gifts, and promotional items will help to 

ensure that service providers are not 

burdened with reporting routine 

business gratuities that should be of 

little interest to plan fiduciaries. 

The Department thus has modified 

the Schedule C reporting requirements 

to exclude ordinary business gifts that 

are both occasional and of insubstantial 

value, for example, widely distributed 

items such as pens with a company 

name permanently imprinted or 

ordinary business lunches, where the 

cost of the gift or meal would be tax 

deductible for federal income tax 

purposes for the person providing the 

gift or meal and the gift or meal would 

not be taxable income to the recipient. 

For this exemption to apply, the gift 

must be valued at less than $50, and the 

aggregate value of gifts from one source 

in a calendar year must be less than 

$100, but gifts with a value of less than 

$10 do not need to be counted toward 

the $100 annual limit. If the $100 

aggregate value limit is exceeded, the 

aggregate value of all the gifts will be 

reportable. Gifts from multiple 

employees of one service provider 

should be treated as originating from a 

single source when calculating whether 

the $100 threshold applies. On the other 

hand, in applying the threshold to an 

occasional gift received from one source 

by multiple employees of a single 

service provider, the amount received 

by each employee should be separately 

determined in applying the $50 and 

$100 thresholds. For example, if six 

employees of a company providing 

administrative services to employee 

benefit plans attend a business 

conference put on by a broker designed 

to educate and explain the broker’s 

employee benefit business services, 

where refreshments valued at $20 per 

individual are provided at no cost to the 

employees, the gratuities would not be 

reportable on the Schedule C even 

though the total cost of the refreshments 

would be $120. The Schedule C 

instructions have also been revised to 

emphasize that these thresholds are for 

purposes of Schedule C reporting only 

and to caution filers that the payment or 

receipt of gifts and gratuities of any 

amount by plan fiduciaries may violate 

ERISA and give rise to civil liabilities 

and criminal penalties. 

Commenters also expressed concern 

that the Schedule C reporting rule 

allowing any reasonable method of 

allocating indirect compensation among 

multiple plans as long as the method is 

disclosed to the plan administrator 

would result in confusion for plan 

officials because service providers will 

not necessarily be using consistent 

methods in allocating indirect 

compensation. The diversity in the form 

and manner of payment of indirect 

compensation described in the 

comments, however, defied applying a 

single allocation method for such 

compensation among multiple plans. 

Thus, in circumstances where the 

amount of indirect compensation 

received by a person is attributable to 

more than one plan, allowing any 

reasonable allocation method but also 

requiring the method of allocation to be 

disclosed to the plan administrator 

provides the parties with appropriate 

flexibility in meeting the annual 

reporting requirement while ensuring 

the plan administrator is properly 

informed. 

Several commenters raised concerns 

about the proposed indirect 

compensation reporting requirements as 

possibly leading to confusion among 

plan officials over ‘‘double reporting’’ of 

service provider compensation. They 

cited as an example of such ‘‘double 

reporting’’ situations where an 

investment advisor is paid an 

investment management fee from a 

mutual fund, and the investment 

advisor uses some of that revenue to pay 

fees to brokers, pension consultants, and 

others for marketing and distribution 

expenses. The commenters were 

concerned that if the investment 

management fee received by the 

investment manager and the fee 

received by a broker, for example, are 

both required to be reported as indirect 

compensation on the Schedule C, plan 

officials could incorrectly conclude that 

the plan paid the broker’s fee in 

addition to the investment management 

fee. The Department believes that the 

modifications to the form and 

instructions described above, including 

the alternative reporting option for 

eligible indirect compensation, should 

address this concern by giving service 

providers flexibility that will allow 

them to provide plans with disclosures 

that can be used to satisfy the Schedule 

C reporting requirements while also 

clearly explaining the indirect 

compensation in a way that will enable 

the service providers to avoid creating 

confusion about the indirect fees and 

compensation they receive. 

The Schedule C is also being modified 

so that service providers required to be 


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listed would separately report direct 

compensation paid by the plan and 

indirect compensation received from 

sources other than the plan or the plan 

sponsor, for example, compensation 

charged against investment assets. In 

addition, in light of the fact that 

particular service providers may receive 

direct and indirect compensation of 

various types from various sources, in 

order to provide more informative 

disclosures about the types of fees being 

paid to or received by plan service 

providers, the final forms revisions 

expand the service codes currently 

required on the Schedule C, which 

identify the types of services provided, 

to include fee codes designed to better 

identify the types of direct and indirect 

compensation received. For example, 

codes were added for direct payments 

by the plan out of a plan account, 

including charges to plan forfeiture 

accounts and fee recapture accounts, 

charges to a plan’s trust account before 

allocations are made to individual 

participant accounts, and direct charges 

to plan participant individual accounts 

(e.g., loan charges, brokerage account 

service fee, distribution service charge). 

Codes for types of indirect 

compensation include common 

investment fees indirectly paid by plans 

and participants, such as sales loads 

(including charges on purchases and 

deferred sales charge); redemption fees; 

purchase fees paid to the fund (not to a 

broker); exchange fees charged to an 

investor when they exchange (transfer) 

to another fund within the same fund 

group; account maintenance fees; 

investment management fees paid out of 

fund assets to the fund’s investment 

adviser for investment portfolio 

management; distribution and service 

(12b–1) fees; shareholder service fees; 

custodial fees; legal expenses; 

accounting fees; and transfer agent 

expenses. The fee codes should provide 

plan sponsors, participants and 

beneficiaries, and the Department with 

better information on the types of 

compensation being paid directly or 

indirectly by the plan. 

The Department believes that this 

revised framework for the Schedule C 

continues to accomplish the objectives 

of improving Schedule C reporting of 

fee and compensation information, 

while addressing many of the concerns 

of the commenters relating to annual 

reporting burdens, costs, and potentially 

duplicative and confusing disclosures to 

plan officials. It also provides sufficient 

flexibility so that plans and service 

providers can use other current or future 

regulatory disclosure regimes, such as 

soft dollar disclosure requirements 

developed by the SEC, as part of 

satisfying ERISA’s annual reporting 

requirements. 

b. Miscellaneous Schedule C Issues 

One commenter asked the Department 

to confirm that revenue sharing 

payments, such as sales loads and 

12b–1 fees received from the mutual 

funds and other revenue sharing 

payments from distributors and/or 

advisors of the mutual fund for subtransfer agency services and shareholder 

services, are not necessarily ‘‘plan 

assets’’ for purposes of the fiduciary 

responsibility provisions of Title I of 

ERISA solely by virtue of being required 

to be listed on the Schedule C. The 

commenter pointed out that some 

revenue sharing payments to plan 

service providers are calculated based 

on the amount of assets a plan or a 

group of plans have invested in a 

particular investment vehicle or family 

of vehicles at a given time. Other 

revenue sharing payments are not assetbased, but may involve a flat fee. In the 

Department’s view, the Schedule C 

reporting requirements are not restricted 

to plan asset payments. In general, in 

evaluating plan investments, 

identification of plan assets is governed 

either by the ‘‘plan asset’’ regulation (29 

CFR 2510.3–101), or, in situations 

beyond the regulations, the assets of an 

employee benefit plan are identified on 

the basis of ordinary notions of property 

rights. See, e.g., Advisory Opinion 

2005–22A. In the context of a plan’s 

investment in a mutual fund or other 

investment vehicle, the plan’s beneficial 

interest generally is its ownership of 

shares, units, or an undivided interest in 

the underlying assets of the vehicle. The 

fact that revenue sharing payments 

charged against the assets in an 

investment vehicle are required to be 

reported on Schedule C or disclosed 

under the alternative reporting option 

would not, by virtue of the reporting 

requirement alone, make those revenue 

sharing payments plan assets under the 

plan asset regulation or under ordinary 

notions of property rights. 

One commenter suggested that 

revising the instructions to Schedule C 

to clarify that health and welfare plans 

exempt from the financial reporting and 

audit requirements by reason of meeting 

the conditions in the Department’s 

limited exemption in 29 CFR 2520.104–

44, including plans that rely on the 

enforcement policy guidance in the 

Department’s Technical Release 92–01, 

are not required to file a Schedule C. 

The Department has modified the 

instructions for the Schedule C to make 

it clear that, although neither the 

limited exemption at 2520.104–44 nor 

Technical Release 92–01 expressly 

address Schedule C reporting 

requirements, plans that meet the 

conditions of the exemption or the 

enforcement policy guidance are not 

required to complete and file a Schedule 

C to report information on service 

provider compensation. Another 

commenter requested confirmation that 

where the plan sponsor pays expenses 

of the plan, the amounts paid by the 

plan sponsor, and not reimbursed by the 

plan, would not have to be reported on 

Schedule C. The Schedule C and its 

instructions continue to provide that 

reporting is only required for amounts 

directly or indirectly paid by or received 

from the plan. 

Several commenters expressed 

concern with the statement in the July 

2006 Proposal that if reportable 

compensation is due to a person’s 

position with or services rendered to 

more than one plan, the total amount of 

compensation received should be 

reported on the Schedule C of each plan 

if the compensation could not 

reasonably be allocated among the 

various separate plans. The 

commenters’ concern focused on an 

example in the preamble to the July 

2006 Proposal involving a $1,000 gift 

from a securities broker to an 

investment adviser given because of the 

investment adviser’s relationship with 

ERISA plans as potential clients for the 

securities broker. The preamble 

assumed the $1,000 gift could not be 

reasonably allocated among the ERISA 

plans and indicated that in such a case 

the $1,000 should be reported on the 

Schedule C of all plans for which the 

investment advisor performed services. 

The commenters urged clarifying in the 

instructions that, as long as a reasonable 

allocation can be made in such 

circumstances, the total value of the gift 

or other consideration is not required to 

be reported on the Schedule C of each 

plan. The Department agrees that in the 

case of gifts or other consideration 

attributable to multiple plans, only an 

allocable share of value of the gift or 

other consideration needs to be 

included on each plan’s Schedule C as 

long as the value of the gift or other 

consideration can be reasonably 

allocated among the multiple plans. 

Commenters also expressed concerns, 

similar to those submitted by insurers 

on the Schedule A described below, 

regarding the requirement to identify 

service providers that fail or refuse to 

provide the administrator with the 

information needed to complete the 

Schedule C. The Department continues 

to believe that identifying service 

providers that fail to provide 

information needed to complete the 


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Schedule C is important information 

that will allow the Department to better 

carry out its responsibilities to 

administer and enforce the provisions of 

Title I of ERISA. As noted below in 

connection with the similar question 

being added to the Schedule A, the 

instructions for the Schedule C have 

been changed to remind plan 

administrators that they have an 

obligation to take reasonable and 

prudent steps to secure the necessary 

Schedule C information and that 

administrators generally should contact 

the service providers and make a 

request for Schedule C information 

before identifying a service provider on 

the Schedule C as having failed or 

refused to provide necessary 

information. 

One commenter requested 

confirmation that the proposed changes 

regarding reporting of indirect 

compensation did not require service 

provider compensation reported on a 

Schedule C filed for a master trust 

investment account (MTIA) or 29 CFR 

2520.103–12 investment entity (103–

12IE) also to be reported on the 

participating plans’ Schedule Cs. The 

indirect compensation reporting 

requirements were not intended to 

change the rule in the current 

instructions to the Schedule C, which 

emphasizes that compensation to a 

service provider should not be reported 

both on the Schedule C for the plan and 

on the Schedule C for the MTIA or 103–

12IE in which the plan participates. 

Rather, plan filers must include the 

plan’s share of compensation paid 

during the year to an MTIA trustee or 

other person providing services to the 

MTIA or 103–12IE only if such 

compensation is not subtracted from the 

total income of the MTIA or 103–12IE 

in determining the net income (loss) 

reported on the MTIA or 103–12IE’s 

Schedule H, Line 2k, or is not reported 

on the MTIA’s or 103–12IE’s Schedule 

C. 

Two commenters urged the 

Department not to eliminate the 

provision in the current Schedule C 

under which only the ‘‘top 40’’ highest 

compensated service providers are 

required to be listed on the Schedule C 

reporting, as proposed. The commenters 

suggested that the ‘‘top 40’’ limit be 

retained or replaced with some other 

limit based on a larger number of 

service providers or requiring service 

providers to be listed when their 

compensation exceeded a specified 

percentage of total plan expenses. The 

commenters suggested that, for a very 

large plan, requiring all service 

providers that received $5,000 or more 

in direct or indirect compensation could 

require the plan to list hundreds of 

service providers and substantially 

complicate their Form 5500 Annual 

Return/Reports. A review of Form 5500 

Annual Return/Report data for reports 

filed before the ‘‘top 40’’ limit was 

adopted in the 1999 Form 5500 Annual 

Return/Report indicates that only a few 

very large plans reported 40 or more 

service providers on the Schedule C. A 

review of more recent Schedule C data 

also reflects that the 40th highest paid 

service provider generally was paid as 

much or nearly as much as the 15th or 

20th highest paid service provider even 

though the Schedule C requires service 

providers to be reported in descending 

order of amount of compensation. Based 

on these data, the Department does not 

believe continuing the ‘‘top 40’’ limit is 

appropriate. 

One commenter suggested that 

clarifying the reporting year in which 

termination of an accountant or an 

enrolled actuary must be reported on 

Schedule C. Although not expressing a 

preference for either result, the 

commenter indicated that it was not 

clear whether the termination should be 

reported on the form filed for the year 

in which the accountant was terminated 

or on the form filed for the year in 

which a new accountant performed the 

plan audit. The instructions have been 

revised in response to the comment to 

state more explicitly the existing rule 

that the termination of an accountant or 

an enrolled actuary must be reported in 

the Form 5500 Annual Return/Report 

for the plan year in which the 

accountant or enrolled actuary was 

terminated. 

6. Schedule A (Insurance Information) 

The Agencies received a number of 

comments in response to the proposed 

addition of a new section to the 

Schedule A to identify insurance 

providers that fail to give plan 

administrators the information 

necessary to complete the Schedule A. 

A commenter representing plan 

auditors, which supported the change 

based on the auditors’ experience of 

having difficulty getting information 

needed to complete plan audits, also 

requested an expansion of the 

requirement to cover insurance carriers 

that did not provide the requisite 

information in a timely fashion. In 

contrast, insurance industry 

commenters expressed concern that the 

reporting requirement may create 

unnecessary administrative burdens 

when plan administrators wrongly 

identify insurers as having failed to 

provide required information. One 

insurance industry commenter, 

describing testimony before the ERISA 

Advisory Council on this issue as 

‘‘unsubstantiated anecdotal reports,’’

objected to the Department’s reliance on 

a report of the ERISA Advisory Council 

(see 71 FR at 41620), as support for 

adding the new section. Two insurance 

industry commenters suggested that, if 

the reporting requirement was retained, 

plan administrators should be required 

to advise insurers before identifying the 

insurer on the Schedule A as having 

failed to provide required information. 

Section 103(a)(2) of ERISA provides 

that, if some or all of the information 

necessary to enable the administrator to 

comply with the requirements of Title I 

of ERISA is maintained by an insurance 

carrier or other organization that 

provides some or all of the benefits 

under a plan or holds assets of the plan 

in a separate account, such carrier or 

other organization is required to 

transmit and certify the accuracy of 

such information to the administrator 

within 120 days after the end of the plan 

year. Given the importance of plan 

administrators receiving timely 

information necessary to complete 

Schedule A, especially fee and 

commission information, the recurring 

reports of difficulties in this area, and 

the recommendation by the ERISA 

Advisory Council that such a question 

be included on the Schedule A to assist 

plan administrators and the Department 

in enforcing the insurance carriers’

obligations in this regard, the 

Department continues to believe that 

insurance providers that fail to provide 

the necessary information should be 

identified on Schedule A. 

The Department nonetheless agrees 

that, in addition to the insurer’s 

obligation to provide information, plan 

administrators have an obligation to 

take reasonable and prudent steps to 

secure the necessary Schedule A 

information. The Department also 

accepts that there may be instances 

where plan administrators and insurers 

disagree over what information is 

required and other instances where 

administrators may identify an insurer 

on the Schedule A based the 

administrator’s erroneous conclusion 

that the insurer failed to provide 

required information. The current 

instructions for the Schedule A that 

remind filers of the insurer’s obligation 

to provide information needed to 

complete the Schedule A, accordingly, 

are being expanded to remind plan 

administrators that they have an 

obligation to take reasonable and 

prudent steps to secure the necessary 

Schedule A information and that they 

generally should contact the insurer and 

make a request for any missing 


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11Although the proposal eliminated the Schedule 

A filing requirement for plans eligible to file the 

Short Form 5500, the Short Form 5500, consistent 

with the overall objective of improving fee 

transparency, the Short Form 5500 adopted from 

the Schedule A requirement to report aggregate 

insurance fees and commissions, in the form of a 

compliance question. 

12 If commissions and finders’ fees are imbedded 

in insurance company payments to agents, brokers 

or others for services that are part of the insurer 

satisfying its contractual obligation to provide 

benefits under the plan, such as payments for 

claims processing or recordkeeping, such 

commission and finders’ fees would still be 

reportable on the Schedule A. 

information before identifying an 

insurance provider on the Schedule A. 

Another commenter requested 

confirmation that electronic 

transmission of the required Schedule A 

information would satisfy the insurer’s 

obligation under ERISA section 

103(a)(2). The commenter noted that 

some plan administrators may believe 

that insurers are required under ERISA 

to provide plan administrators with a 

completed copy of the Schedule A that 

the administrator could file as part of 

the plan’s annual report. The 

commenter noted that some insurers 

had developed such a practice as part of 

the services they provided to 

policyholders, but indicated that such 

practices could be difficult to continue 

in a wholly electronic filing 

environment. In the Department’s view, 

nothing in ERISA precludes insurers 

and plan administrators from agreeing 

to the insurer’s electronic transmission 

of Schedule A information to the 

administrator. The Department also 

anticipates that some software providers 

will have EFAST2 compatible systems 

that will enable multiple parties, 

including insurers, to include 

information as part of the development 

of the plan’s annual report. The 

Department also agrees that while 

insurers are required to provide the 

information necessary for the plan 

administrator to complete the Schedule 

A, insurers are not required by ERISA to 

provide the information on a completed 

Schedule A itself. 

One commenter suggested that the 

requirement to report fees, 

commissions, and other compensation 

paid to agents, brokers, and other 

persons in connection with an 

insurance contract placed with or 

retained by the plan should be reported 

on Schedule C instead of on Schedule 

A. The commenter suggested that such 

a change would facilitate a ‘‘level 

playing field’’ in the annual reporting 

area between insurers and banks, 

investment companies, and other 

investment product providers. Another 

commenter suggested that there should 

be a de minimis reporting exception on 

the Schedule A under which persons 

receiving monetary or non-monetary 

commissions and fees totaling less than 

$500 would not be required to be listed 

on the Schedule A. One insurance 

company commenter complained that 

the Schedule A approach to the 

reporting of fees and commissions was 

unduly burdensome on insurers and 

service providers and lacked a clearly 

articulated purpose. The commenter 

asked that the Agencies limit or clarify 

Schedule A reporting in several ways: 

Limit Schedule A fee and commission 

reporting to ‘‘sales-related’’

compensation; exempt from Schedule A 

reporting payments to a ‘‘general agent 

or manager’’ even if the amounts are 

paid in connection with a policy placed 

with or retained by an employee benefit 

plan; address whether compensation 

can be reported on a Schedule A for the 

year in which the compensation was 

paid rather than for the year in which 

the right to the payment accrued; 

confirm that payments are not required 

to be reported if they are made after the 

year in which an insurance contract or 

policy is terminated; and establish safe 

harbor methods for allocation of 

compensation attributable to multiple 

policies. 

The July 2006 Proposal did not 

include any proposed changes to the fee 

and commission reporting requirements 

on the Schedule A.11 The Department 

issued Advisory Opinion 2005–02A in 

February 2005 to address a reported 

pattern and practice among some in the 

insurance industry of underreporting 

commission and fee payments to 

brokers, agents, and other persons. This 

pattern and practice was reported to be 

based on incorrect interpretations of the 

Schedule A, the Schedule A 

instructions, and other guidance issued 

by the Department regarding the 

Schedule A reporting requirements. The 

Advisory Opinion was intended to 

explain clearly the Department’s views 

regarding the current Schedule A 

reporting requirements. After carefully 

considering the public comments on the 

Schedule A, the Department does not 

believe that the comments provide a 

basis for making major substantive 

changes to the Schedule A reporting 

requirements at this time. The 

Department, however, agrees that two 

changes adopted as part of the final 

Schedule C reporting requirements 

should also be adopted as part of the 

Schedule A reporting requirements on 

insurance fees and commissions. 

Specifically, the Department 

previously clarified, as part of an update 

of the instructions following the 

publication of Advisory Opinion 2005–

02A, that compensation paid by the 

insurer to third parties for 

recordkeeping and claims processing 

services provided to the insurer as part 

of the insurer’s administration of the 

insurance policy is not required to be 

reported as fees and commissions on 

Line 2 of the Schedule A.12 One 

commenter complained that the 

instructions should have been expanded 

to include other similar types of 

administrative functions. One insurance 

organization gave as an example its 

national accounts programs under 

which its regional group health 

insurance programs are able to offer 

ERISA plans access to medical 

providers in all fifty states pursuant to 

agreements with its other regional 

programs that operate in those states. 

The Department agrees that where 

benefits have been purchased from and 

guaranteed by a licensed insurance 

company, insurance service, or other 

similar organization, payments by the 

insurer from its general assets to 

affiliates or third parties for performing 

administrative activities as part of the 

insurer satisfying its contractual 

obligation to provide the fully insured 

benefits under the plan (such as 

recordkeeping and claims processing 

services) and where there is no direct or 

indirect charge to the plan for the 

administrative services other than the 

insurance premium, the payments by 

the insurer to the affiliates or third 

parties do not need to be reported on 

Line 2 of Schedule A as ‘‘fees and other 

commissions.’’ In determining whether 

such compensation is excludable from 

fee and commission reporting on the 

Schedule A, the Department would look 

to whether the services is necessary for 

the insurer to satisfy its contractual 

obligation to provide benefits, not 

services for the insurer incidental to the 

sale, placement, retention or renewal of 

a policy, whether payments to third 

parties are made pursuant to a contract 

or written understanding to provide the 

services, and whether the amount of the 

compensation paid by the insurer is 

reasonable in light of the value of the 

services provided. The instructions for 

the Schedule A have been revised 

accordingly. 

The other Schedule C change that the 

Department is also adopting as part of 

the Schedule A fee and commission 

reporting requirements is the provision 

excluding occasional and insubstantial 

non-monetary compensation paid by an 

insurance company to agents, brokers 

and other persons from the fees and 

commissions that would otherwise be 

required to be reported on the Schedule 

A. The same restrictions governing this 


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exception under the Schedule C will 

apply to the Schedule A. The 

instructions for the Schedule A have 

been revised accordingly. 

7. Removal of IRS-Only Schedules 

Generally commenters were 

supportive of the removal of IRS-only 

schedules. One commenter suggested, 

however, that the IRS should provide 

guidance on the method and format of 

reporting information formerly on the 

Schedule SSA. The IRS is reviewing 

alternatives for simplifying the filing of 

the data formerly on the Schedule SSA 

and working with stakeholders in 

exploring and evaluating simplification 

and other changes while ensuring that 

this data remains a source of 

information for the Social Security 

Administration. The Agencies note that 

due to the additional one-year deferral 

in implementing the annual reporting 

form changes not mandated by the PPA 

(except for a few Schedule R items), the 

removal of IRS-only forms and 

schedules as a result of the electronic 

filing mandate will also be delayed until 

the electronic filing system is in place. 

Therefore, Form 5500-EZ, Schedule E, 

and Schedule SSA will continue to be 

filed under the current EFAST 

processing system for the 2007 and 2008 

plan years. 

8. Compliance Questions (Schedule H, 

Schedule I, Short Form 5500) 

a. Delinquent Participant Contributions 

and Loan Repayments on Schedule H, 

Line 4a 

The comments submitted on this 

issue generally supported the 

Department’s inclusion in the 

instructions of a format for a 

supplemental schedule to be used by 

the plan’s accountant for purposes of 

rendering an opinion on whether 

delinquent participant contributions 

information on Line 4a of Schedule H is 

presented fairly, and is in all material 

respects the information required to be 

reported. Commenters also supported 

the proposal to revise the instructions to 

expressly confirm that delinquent 

participant loan payments can be 

included on Line 4a as opposed to being 

reported in response to the general 

prohibited transaction question on Line 

4d. Accordingly, the revised 

instructions for line 4a are being 

adopted as proposed. 

One commenter thought that it would 

be easier to report delinquent 

contribution information if the items on 

the proposed standardized schedule 

were incorporated into Line 4a itself 

and the requirement to attach a 

supplemental schedule were eliminated. 

A commenter representing accountants 

stated that including a standard 

schedule for reporting delinquent 

contributions in the Form 5500 Annual 

Return/Report instructions was helpful, 

but suggested that it be revised to be 

identical to the prohibited transaction 

schedule included in Schedule G. 

The revisions to the 2002 Form 5500 

Annual Return/Report eliminated the 

need for plan administrators to double 

report delinquent participant 

contributions on Line 4a (which 

specifically asked about delinquent 

transmittal of participant contributions) 

and Line 4d (which asked about 

prohibited transactions with parties in 

interest). Rather, the instructions for 

Line 4a expressly state that the amounts 

paid by a participant or beneficiary to 

an employer and/or withheld by an 

employer for contribution to the plan 

become plan assets as of the earliest 

date on which such contributions can 

reasonably be segregated from the 

employer’s general assets (see 29 CFR 

2510.3–102) and caution that an 

employer holding these assets after that 

date commingled with its general assets 

will have engaged in a prohibited use of 

plan assets (see ERISA section 406). A 

delinquent participant contribution 

reported on Line 4a is, by definition, a 

prohibited transaction. Reporting that 

transaction again on Line 4d was 

unnecessary and made it difficult for the 

Agencies to use effectively the 

information reported on Line 4d in 

cases where the plan was reporting 

other prohibited transactions on Line 

4d. 

Likewise, having the Line 4a 

supplemental schedule format match 

the prohibited transaction format on 

Schedule G also would result in 

unnecessary reporting. By definition the 

party-in-interest involved is the 

employer and the prohibited transaction 

is the delinquent transmittal of 

participant contribution or delinquent 

transmittal of participant loan 

repayments. The Schedule G 

requirements to identify the parties 

involved and describe the nature of the 

prohibited transaction are therefore 

unnecessary. Further, the Schedule G is 

structured so that it can be used to 

report a diverse variety of prohibited 

transactions, whereas the additional 

elements on the proposed format for the 

Line 4a supplemental schedule are 

tailored for the specific prohibited 

transaction involved. Finally, line 4a 

requires reporting delinquent 

contributions regardless of whether the 

prohibited transaction has been fully 

corrected under the Department’s 

Voluntary Fiduciary Correction Program 

(VFCP) and the conditions of Prohibited 

Transaction Class Exemption 2002–51 

have been satisfied, but Schedule G only 

requires reporting if an exemption does 

not apply. 

The Department had posted a series of 

frequently asked questions (FAQs) on its 

Web site at http://www.dol.gov to 

provide guidance to plan administrators 

and accountants on complying with the 

requirements of the Form 5500 Annual 

Return/Report for reporting delinquent 

participant contributions. The format of 

the supplemental schedule included in 

the July 2006 Proposal was taken in 

large part from similar formats included 

in those FAQs. The July 2006 Proposal 

was intended to incorporate the 

guidance in those FAQs into the 

instructions to the Form 5500 in order 

to make that guidance more generally 

available to plan administrators and to 

assist accountants in satisfying their 

obligations under ERISA section 103 to 

treat the information on Line 4a as 

subject to the audit requirement and as 

part of the supplemental schedules for 

purposes of the IQPA report and 

opinion. 

b. Reporting Blackouts and Blackout 

Notices 

One commenter expressed concern 

about the structure of the compliance 

questions proposed for Schedule H, 

Schedule I, and the Short Form 5500 on 

whether there was a ‘‘blackout period’’

subject to the notice requirements in 

section 101(i) of ERISA and the 

Department’s regulation at 29 CFR 

2520.101–3. Specifically, the 

commenter noted that the proposal 

would require a plan administrator 

whose plan had experienced a 

‘‘blackout period’’ during the reporting 

year to answer that a blackout notice 

was not provided even in cases where 

an exception from the notice 

requirement applied. Although the 

proposed instructions expressly 

directed filers to indicate that they had 

not provided a notice even in cases 

where an exception from the notice 

requirement applied, the blackout 

notice questions have been modified to 

address the commenter’s concern. The 

first question asking whether there was 

a blackout remains unchanged. The 

second question has been modified to 

have filers check ‘‘yes’’ if they either 

provided the required notice or one of 

the exceptions to providing the notice 

applied or ‘‘no’’ if they did not provide 

notice and no exception applied. 

c. Reporting ‘‘Deemed’’ Distributions 

One commenter suggested moving 

line items regarding defaulted 

participant loans as ‘‘deemed’’

distributions on the Short Form 5500, 


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Schedule H, and Schedule I from the 

financial section to the compliance 

section. The commenter argued that 

loans that are deemed distributed for tax 

purposes generally continue to be plan 

assets for plan qualification and 

financial reporting such that traditional 

recordkeeping and financial reporting 

systems do not ‘‘write off’’ the deemed 

distribution amount from the books. The 

Agencies established the current regime 

for reporting deemed distributions 

during the last major revision of the 

forms in connection with the 1999 Form 

5500 Annual Return/Report. The 

Agencies considered off-balance sheet 

reporting for deemed distributions, but 

that approach failed to address various 

reporting questions such as: what is the 

appropriate value for carrying loans that 

have been deemed distributed where 

there is no reasonable expectation that 

the loan would be repaid until offset 

against an account value at the time of 

an actual distribution; should the value 

include continued accrual of interest 

payments as they become due even after 

the loan is deemed distributed and, if 

so, would that practice inappropriately 

inflate the apparent value of plan assets; 

and if the loan is required to be carried 

as a plan asset, with or without interest 

accruals, should an offsetting increase 

in a reserve for bad debts be included 

in the financial statements to avoid an 

inflated figure for total plan assets. The 

treatment of deemed distributions 

currently set forth in the instructions 

dealt with these questions as a financial 

reporting matter within the context of 

treating the loans as deemed, not actual, 

distributions. While the requirements 

relating to participant loans (including 

defaulted participant loans) are a 

compliance matter and information 

relating to these loans must be 

maintained as part of the plan’s records, 

the Agencies have determined not to 

make the change suggested by the 

commenter. The IRS, however, is 

considering whether to further clarify 

the reporting of defaulted participant 

loans in the instructions. 

d. Reporting ‘‘Incurred But Not 

Reported’’

Funded health and welfare plans may 

be exposed to a financial obligation for 

claims that have been incurred, for 

example, by a participant who obtained 

covered health care treatment from a 

doctor or hospital, but that have not yet 

been reported to the plan in the form of 

a claim for benefits. Many funded plans 

thus establish an ‘‘Incurred But Not 

Reported’’ (IBNR) accounting reserve for 

such claims that have been incurred but 

not yet been submitted for payment. The 

financial accounting for these 

obligations is required under the 

American Institute of Certified Public 

Accountant’s Statement of Position 01–

2, but that accounting treatment is not 

consistent with Form 5500 Annual 

Return/Report reporting requirements, 

which allow funded welfare plans to 

report IBNR on the Schedule H financial 

statements as a plan liability. A 

commenter representing the accounting 

industry suggested modifying the 

instructions for Schedule H to shift 

reporting of IBNR for welfare plans from 

the financial statements on the Schedule 

H to the general compliance questions 

on the Schedule H, presumably in order 

to avoid the need for the accountant’s 

report to include a reconciling note 

reflecting the difference between the 

Schedule H financial statements and 

any separate financial statements 

prepared by the accountant for purposes 

of rendering the required accountant’s 

opinion under section 103 of ERISA. 

The reason that IBNR was permitted to 

be included in the Schedule H financial 

statements was due to comments from 

representatives of large funded welfare 

benefit plans that maintained their 

financial records on a cash basis and 

claimed that their IBNR reserve can 

often amount to a fairly significant 

liability for plans such that failing to 

include the liability on the Schedule H 

for a cash basis filer created the false 

impression that the plan was 

substantially overfunded at the end of 

the plan year. There was nothing in the 

accounting industry comment that 

suggested the above described problem 

was no longer a concern for large 

funded welfare plans or that explained 

how the proposed change would 

substantially benefit employee benefit 

plans, their participants and 

beneficiaries, or the Agencies, and, 

accordingly the option to include IBNR 

as part of the plan’s liabilities is not 

being converted into a mandatory 

compliance question for all welfare 

plans that file the Schedule H at this 

time. 

e. Assets Without Readily Determinable 

Current Value 

Line 4g of the Schedule H is a 

compliance question that asks whether 

the plan held any assets whose current 

value was neither readily determinable 

on an established market nor set by an 

independent third party appraiser. If the 

answer to Line 4g is ‘‘yes,’’ the filer is 

required to report the value of those 

assets. Line 4g currently gives examples 

of assets that may not have a readily 

determinable value on an established 

market (e.g., NYSE, AMEX, over the 

counter, etc.) including real estate, 

nonpublicly traded securities, shares in 

a limited partnership, and collectibles. 

An accounting industry commenter 

suggested that the instructions be 

revised to include expressly ‘‘hedge 

funds, certain [common and collective 

trusts], and stable value funds’’ as 

examples of assets required to be 

reported on Line 4g. The Agencies did 

not adopt this suggestion. Rather than 

there being a generally accepted 

definition of what constitutes a ‘‘hedge 

fund’’ or ‘‘stable value fund,’’ the class 

of investments that might fit within 

those terms is quite diverse. More 

importantly, regardless of the label used 

to describe an investment, the standard 

for Line 4g remains the same—assets 

should be listed if they do not have a 

readily determinable value on an 

established market and were not valued 

by an independent third-party appraiser 

during the plan year. 

The comment did, however, lead the 

Agencies to evaluate the instructions 

and conclude that a strict reading of 

Line 4g might lead filers to conclude 

that certain types of common plan 

investments are required to be reported 

on Line 4g, such as insurance 

investment contracts and mutual fund 

shares. The Agencies, therefore, are 

modifying the instructions to Line 4g to 

make clear that insurance investment 

contracts for which the plan received 

valuation information at least annually 

and mutual fund shares are not 

reportable on Line 4g. 

f. Reporting Mutual Fund Dividends 

A commenter suggested that Line 2b of 

Schedule H (dividends) should be 

expanded to add an entry for dividend 

payments on mutual fund shares. The 

Schedule H currently has entries for 

dividend payments on common and 

preferred stock and for income gain/loss 

for mutual fund (Investment Company) 

shares, but no entry for dividend 

payments on mutual fund shares. The 

Agencies believe separately identifying 

mutual fund share dividends would 

provide useful information and would 

eliminate possible confusion on where 

to report such income. Accordingly, the 

Agencies are adding a new Line 2b(2)(C) 

to report mutual fund dividend 

payments. 

g. Reporting ‘‘Total Fees Paid’’

A commenter asked for clarification 

as to whether the lines on Schedule H 

and Schedule I for ‘‘total fees paid’’

include indirect compensation. The 

commenter correctly noted that the 

proposed instructions for these 

Schedules did not expressly include 

indirect compensation and that the 

balance sheet structure of the financial 

statements on these Schedules was 


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consistent with a conclusion that only 

compensation paid directly by the plan 

would be reported. The Department 

agrees that indirect compensation 

received from parties other than the 

plan, although it may be a reportable fee 

or expense on the Schedule C or 

Schedule A, is not reportable on the 

balance sheet structured asset/liability 

and income/expense statements in the 

Schedule H, the Schedule I, or the Short 

Form 5500. 

9. Schedule R (Retirement Plan 

Information) 

a. Minimum Funding 

One commenter suggested simplifying 

line items on the Short Form 5500 and 

the Schedule R concerning minimum 

funding. The Agencies have determined 

that the minimum funding reporting 

requirements are necessary and 

consistent with the PPA’s additional 

reporting requirements relating to plan 

funding and to ensuring transparency 

and accountability. The Agencies, 

however, have determined to make 

certain revisions to the minimum 

funding information on Schedule R and 

the Short Form 5500 to avoid any 

discrepancies in the data being reported. 

Therefore, the Short Form 5500 and 

Schedule R minimum funding questions 

are being revised to provide adequate 

information on minimum funding to the 

Agencies, participants, and other 

interested persons. 

b. Asset Allocation Information for Very 

Large Defined Benefit Pension Plans 

Twelve commenters addressed the 

PBGC’s efforts to gather information on 

the allocation of assets by large defined 

benefit pension plans. (Two of these 

commenters reiterated their concerns 

when commenting on the Supplemental 

Notice.) Four commenters asserted that 

most of the information is already 

included as a part of the Schedule H 

and that collecting this data is 

unnecessary. Six commenters said it 

would be difficult or costly to obtain the 

requested asset allocation breakdowns 

for assets invested in commingled 

funds. Two asked that the effective date 

of the additional information be 

delayed. The commenters 

acknowledged that such information is 

required on the SEC Form 10–K. Two 

pointed out that the 10–K data are 

aggregated from all of the sponsor’s 

defined benefit plans and do not 

include the detailed debt breakout 

requested in the proposal. Four noted 

that the data on the SEC Form 10–K may 

be as of a date that is different from the 

plan reporting date for the Form 5500 

Annual Return/Report. Three also noted 

that non-publicly traded companies are 

not required to file the SEC Form 10–

K and, therefore, do not necessarily 

collect this information. One suggested 

that the new funding requirements of 

the recently enacted PPA diminish the 

value of this information. One 

commenter supported the proposal to 

move the asset allocation information 

from Schedule B to Schedule R (as 

noted in the Supplemental Notice). 

Two commenters noted that providing 

the Macaulay duration would be time 

consuming and costly. Four suggested 

that the Macaulay duration is not a good 

measure of risk and does not address the 

callability of some bonds. Others 

suggested that the effective duration is 

a more commonly used measure than 

the Macaulay duration. Three 

commented that the debt holdings of 

some plans are split among several 

different bond managers and providing 

a single duration measure for all of the 

plan’s debt holdings could be difficult. 

In an effort to address the comments 

citing the burden of complying with the 

data collection, the questions were 

modified to reduce the number of 

calculations. Specifically, instead of 

asking for the distribution by four 

categories (stocks, debt, real estate, and 

other) and then asking for a separate 

breakdown of the debt, the questions 

have been restructured to ask for data on 

five categories of assets (stocks, 

investment-grade debt, high-yield debt, 

real estate, and other) that should sum 

to 100 percent. Holdings of government 

bonds would be included in the 

appropriate debt group which should 

generally be investment-grade debt. 

In response to comments on the 

appropriateness of reporting the average 

duration determined using the 

Macaulay measure, two changes have 

been made. First, ranges are provided so 

that, in most cases, an estimate will 

suffice (0–3 years, 3–6 years, 6–9 years, 

9–12 years, 12–15 years, etc.). Guidance 

regarding how to determine the average 

duration when there are multiple bond 

portfolios will be included in the 

instructions to the 2008 Form 5500 

Annual Return/Report. It is anticipated 

that the instructions will provide that 

the weighted average of the individual 

portfolio average durations (where the 

weights are the values of the bond 

portfolios) be reported for plans with 

several bond portfolios. 

Second, any generally accepted 

measure of duration may be used 

(effective duration, modified duration, 

Macaulay duration, etc.). An item has 

been added to report the measurement 

basis that was used to determine the 

average duration. 

As redesigned, the allocation of assets 

questions will provide the PBGC with 

important data necessary to enable it to 

monitor properly the plans it insures. 

The data will be particularly useful for 

the PBGC’s Early Warning program, 

which is designed to identify plans 

whose risk to the PBGC is increasing. 

For many plans the PBGC is unable to 

derive this information from the current 

Schedule H data. Knowing not only the 

level of plan assets relative to its 

liabilities but also how well a plan’s 

assets match these liabilities is integral 

information the PBGC needs to properly 

assess the risks and exposures the 

Agency faces. 

The difficulty in obtaining asset 

allocation information for assets 

invested in commingled funds is 

appreciated, and, in fact, is the reason 

the PBGC needs to collect these data on 

the Form 5500 Annual Return/Report. 

For publicly traded companies, the 

allocation of these assets is reported on 

companies’ Form 10–K. Even in cases 

where aggregated data are reported on 

the Form 10–K or where data are 

determined as of a different date, the 

disaggregated information should be 

accessible without undue burden. Also, 

most financial information is available 

on a daily basis and the incremental 

costs for obtaining this data for the 

valuation date should not be significant. 

The cost of obtaining the data may be 

somewhat higher for non-publicly 

traded companies that may need to 

institute new procedures to obtain this 

information; however, the PBGC’s need 

for this data for plans of non-publicly 

traded companies is also great. The 

PBGC believes ample notice has been 

given to allow companies to make 

whatever data gathering arrangements 

are necessary because notification of 

these questions was given at least three 

years prior to the first date they would 

be due (July 31, 2009 for calendar year 

plans) and because similar information 

is already required to be provided on 

the Form 10–K. 

The bond portfolio duration 

information will help the PBGC 

properly monitor the plans it insures in 

several ways. First, as an insurer, the 

PBGC needs to know not only what 

proportion of a plan’s liabilities is 

covered by its assets, but also how well 

those assets immunize the liabilities. 

Second, it will assist the PBGC in its 

monitoring activities and indicate 

which plans are moving to more risky 

asset investments that could increase 

the PBGC’s exposure or the likelihood 

that the PBGC will receive a claim from 

that plan. Third, it will inform the PBGC 

of how to negotiate better protections for 

the plan’s participants should such 

negotiations become necessary. Finally, 

it would assist the PBGC’s modeling 


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efforts for informing policy makers if 

additional legislative or regulatory 

changes are needed to protect plan 

participants and the insurance 

programs. 

One commenter suggested that the 

strengthened funding rules under the 

PPA negate the need for the additional 

asset allocation information. The new 

funding rules do not guarantee that the 

plans that the PBGC insures will 

become and remain fully funded in the 

future. Even if they do become fully 

funded, the PBGC’s risk is highly 

dependent on how well plans’ assets 

immunize their liabilities. A decrease in 

the price of stocks generally or a 

decrease in interest rates can quickly 

move a plan from being fully-funded to 

being only 80 percent funded, or worse. 

c. Information on Major Contributors to 

Multiemployer Defined Benefit Pension 

Plans 

One comment was submitted about 

the PBGC’s efforts to obtain data on 

major contributors to multiemployer 

pension plans. The commenter 

questioned how information should be 

reported in situations where a 

contributing employer has multiple 

contribution rates, contribution base 

units, or bargaining agreement 

expiration dates with respect to 

different groups of participants under 

the plan. In response to this comment, 

question 13 has been slightly modified. 

In this situation, in lieu of reporting this 

information directly on the form, plan 

administrators will check a box to 

indicate that the employer contributes 

under two or more collective bargaining 

agreements or at different rates for 

different classes of participants and 

include, as an attachment, a summary of 

the date each collective bargaining 

agreement expires and/or information 

about each contribution rate. 

d. Number of Participants on Whose 

Behalf No Contributions Were Made by 

an Employer and Ratio of Participants 

on Whose Behalf No Employer Had an 

Obligation To Make Contributions 

One commenter suggested that the 

definition of ‘‘participant’’ for this 

purpose needs to be clearly defined. 

Although no comments were submitted 

with respect to the question on the ratio 

of participants on whose behalf no 

employer had an obligation to make 

contributions, the wording on the 

Schedule R has been revised to conform 

more closely to the wording in section 

503(a) of the PPA. Terms will be defined 

in the instructions for the Schedule R. 

e. Information on the Number of 

Employers Who Withdrew From the 

Plan During the Preceding Year and the 

Amount of Their Withdrawal Liability 

One commenter questioned whether 

the definition of ‘‘withdrew’’ is the 

definition contained in the 

Multiemployer Pension Plan 

Amendments Act of 1980, Pub. L. No. 

96–364, 94 Stat. 1208, which includes 

special rules for plans in the 

construction, entertainment, and other 

industries. See ERISA section 4203. 

Guidance regarding the definition of 

‘‘withdrew’’ for this purpose will be 

included in the instructions to the 2008 

Form 5500 Annual Return/Report. 

10. Streamlining Form 

a. Reducing the Number of 

Supplemental Attachments 

A commenter who was focused 

particularly on the Short Form 5500 

suggested that it would further 

streamline the filing process for small 

plans if the Agencies eliminated 

supplemental attachments for Line D of 

the Form 5500 Annual Return/Report 

and Line C of the Short Form 5500 

regarding filing under extension or 

under the Delinquent Filer Voluntary 

Correction Program (DFVC Program). 

The Agencies agree that eliminating 

those supplemental attachments would 

facilitate electronic filing, especially for 

small plans. Accordingly, for those 

filing on extension or under the DFVC 

Program, filers would now simply check 

a box as to the type of extension (IRS 

Form 5558, Corporate tax extension, 

special extension) or the DFVC Program. 

A new space is being added to this line 

for filers using a special extension, i.e. 

disaster relief or combat extension, to 

provide a brief description of the 

extension. Filers would no longer have 

to attach a copy of the request for 

extension filed with the IRS or create a 

special supplemental attachment to 

describe the filing under a special 

extension or the DFVC Program, 

although they would continue to be 

required to maintain a copy of any 

request for an extension filed with the 

IRS as part of their records. 

That commenter also suggested that 

the supplemental schedules should not 

be required to be attached if information 

on Schedule H, Line 4i (assets held for 

investment) and Line 4j (5% reportable 

transactions), are in the IQPA report. 

Past experience with the supplemental 

schedule for Line 4a strongly suggests 

that making this change could give rise 

to confusion among accountants 

regarding their obligations to render 

opinions on the supplemental schedules 

required to be part of the annual report. 

See ERISA section 103(a)(3)(A). 

Accordingly, and although 

acknowledging that many IQPA reports 

include information on Schedule H, 

Line 4i (assets held for investment) and 

Line 4j (5% reportable transactions), the 

change is not being made at this time. 

b. Welfare Plan Reporting 

Two commenters suggested that 

welfare plans have separate reporting 

forms and instructions. This comment 

appears to be based on the premise that 

the Form 5500 Annual Return/Report is 

primarily designed to collect 

information about the activity of 

retirement plans and that creating a 

separate form for welfare plans would 

be more appropriate than having the 

welfare plan fit itself into a retirement 

plan-oriented filing. As noted in the 

preamble to the proposal, the 

Department believes that generally 

retaining the current reporting 

requirements is important for disclosure 

purposes for both the Department and 

for participants and beneficiaries in the 

welfare plans that currently report. 

Rather than being designed for pension 

plans versus welfare plans, the Form 

5500 Annual Return/Report is primarily 

focused on collecting financial 

information about funded plans and 

plans that use insurance products to 

provide benefits. The Department 

already exempts most small welfare 

plans from the requirement to file a 

Form 5500 Annual Return/Report and 

exempts most large welfare plans from 

the financial reporting and audit 

requirements in its regulations at 29 

CFR 2520.104–20 and 2520.104–44. The 

structure of the Form 5500 Annual 

Return/Report was modified in 1999 

further to remove pension related 

information from the welfare plan 

annual report by structuring the Form 

5500 Annual Return/Report as a main 

Form 5500, which includes basic 

identifying information, and separate 

schedules that focus on particular 

subject matter or filing requirements. 

The Department also believes that 

considerations for having a separate 

form for welfare plans will be less 

significant in a system where all filing 

is electronic. Under any type of 

electronic system, we anticipate that 

filers would need to access the 

instructions relevant only to their type 

of plan, eliminating any potential 

confusion from determining in a unified 

form package which instructions are 

relevant to the filer. 

The commenters also suggested that 

the Department reconsider the ERISA 

Advisory Council Working Group’s 

recommendation to eliminate the audit 

requirement for large, funded welfare 


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13The instruction language published here is 

based on that for the 2007 plan year. The Agencies 

may make changes for the 2008 and/or 2009 plan 

years not requiring notice and comment that will 

be made publicly available in time for filing, which 

will be incorporated into the final 2009 Instructions 

to the extent appropriate. In addition, the Agencies 

have eliminated the Schedule B (Actuarial 

Information) and replaced it with the Schedule SB 

(Single-Employer Defined Benefit Plan Actuarial 

Information) and Schedule MB (Multiemployer 

Defined Benefit Plan and Certain Money Purchase 

Plan Actuarial Information) for plan years 

beginning after December 31, 2007. Instructions for 

those Schedules are dependent on substantive 

rulemaking under the PPA and will be published 

separately in advance of the time for filing the Form 

5500 Annual Return/Report for plan years 

beginning after December 31, 2007. 

plans that do not accumulate assets, but 

maintain it for multiemployer welfare 

plans and for single-employer welfare 

plans that accumulate assets. As noted 

in the preamble to the July 2006 

Proposal, the Department believes that 

retaining the current requirements as 

they relate to funded welfare plans (i.e., 

those with assets held in trust) and large 

fully insured plans, without imposing 

new reporting burdens on all welfare 

plans best serves to balance the needs of 

the Department and participants and 

beneficiaries and the burden associated 

with the reporting requirements. 

11. Electronic Filing and Manual 

Signature Requirements 

A commenter noted that instructions 

to Forms 5500 and 5500–SF under the 

section entitled ‘‘How to File—

Electronic Filing Requirement’’ contain 

the following statement: ‘‘Even though 

the Forms 5500 and 5500–SF must be 

filed electronically, the administrator 

must keep a copy of the Forms 5500 and 

5500–SF, including schedules and 

attachments, with all required manual 

signatures on file as part of the plan’s 

records * * *.’’ The commenter asked 

for confirmation that plan sponsors may 

satisfy the Department’s record 

retention rule by maintaining an 

electronic version (as permitted under 

ERISA section 107) and, therefore, are 

not required to keep a paper signature 

copy of the filing. The Department notes 

that its electronic filing regulations 

require that plan administrators and 

direct filing entities maintain an original 

copy of the Form 5500 Annual Return/ 

Report, with all required signatures, as 

part of their records. See 29 CFR 

2520.103–1, 2520.103–2, 2520.103–9, 

2520.103–12. The Department’s 

regulations under ERISA section 107 

permit filers to use electronic media for 

record maintenance and retention, so 

long as they meet the requirements of 29 

CFR 2520.107–1. 

Commenters also asked how manual 

signatures on schedules filed with the 

Form 5500 will be handled under the 

EFAST2 electronic filing system. 

Enrolled actuaries will continue to have 

the obligation to sign a copy of the 

plan’s Schedule SB or MB (whichever is 

applicable) and an electronic copy of 

the manually signed schedule must be 

filed as part of the plan’s electronic 

filing under the EFAST2 system. To 

meet this obligation, the plan or the 

enrolled actuary must use EFASTapproved software capable of generating 

a printed version of the Schedule SB or 

MB (whichever is applicable). The 

completed version of the schedule must 

be printed, manually signed by the 

enrolled actuary, and converted into an 

electronic image (such as a pdf 

document) of the schedule showing the 

manual signature, and that electronic 

image file must be attached to the Form 

5500 Annual Return/Report e-filing. A 

signed copy of the schedule must also 

be kept on file as part of the plan’s 

records pursuant to the above noted 

requirements in the Department’s 

annual reporting regulations. It is 

expected that the Form 5500 Annual 

Returns/Reports filed by plans subject to 

the IQPA audit requirement will follow 

a similar procedure in attaching a copy 

of the signed IQPA report to the plan’s 

electronically filed annual report. 

One commenter noted that the Form 

5500 signature section contains a 

declaration that the signatories have 

‘‘examined this return/report, including 

accompanying schedules, statements 

and attachments, as well as the 

electronic version of this return/report,’’

and noted that it is unclear what action 

must be taken by the plan sponsor and 

plan administrator to satisfy the 

requirement to examine the electronic 

version. The declaration on the Form 

5500, as well as on the Short Form 5500, 

continues to provide that the person 

signing the Form must examine a copy 

of the electronic version of the annual 

return/report. The Agencies expect that 

EFAST2 will be designed in a manner 

so that all required signatures will 

satisfy the applicable statutory and 

regulatory provisions. 

C. Overview of the Forms Revisions 

The revisions to the annual return/ 

report forms involve the following major 

categories of changes, along with other 

technical revisions and updates, to the 

current structure and content of the 

Form 5500 Annual Return/Report: 

• Establishment of the Short Form 

5500 as a new simplified report for 

certain small plans effective for 2009 

plan year; 

• Removal of the IRS-only schedules 

from the Form 5500 Annual Return/ 

Report as a result of the move to a 

wholly electronic filing system effective 

for 2009 plan year; 

• Elimination of the special limited 

financial reporting rules for Code 

section 403(b) plans effective for 2009 

plan year; 

• Revision of the Schedule C (Service 

Provider Information) to clarify the 

reporting requirements and improve the 

information plan officials receive 

regarding amounts being received by 

plan service providers effective for 2009 

plan year; 

• Replacement of Schedule B with 

Schedule SB and Schedule MB to reflect 

the changes in reporting and funding 

requirements for single and 

multiemployer defined benefit pension 

plans under the PPA effective for 2008 

plan year; 

• Modification of the Schedule R to 

add questions required by the PPA to 

gather information on pension plan 

funding and compliance with minimum 

funding requirements effective for 2008 

plan year but filed as an attachment 

rather than as actual schedules. These 

modifications will be effective in 

standard format for 2009 plan year; 

• Modification of the Schedule R to 

collect data PBGC needs to properly 

monitor the plans it insures effective for 

2008 plan year but filed as an 

attachment rather than as an actual 

schedule. These modifications will be 

effective in standard format for 2009 

plan year; and 

• Miscellaneous changes to the 

schedules and instructions to improve 

and clarify reporting effective for 2009 

plan year. 

In addition to the description of the 

form changes contained in this Notice, 

the Agencies have included the 

following appendices: (1) Appendix A—

a facsimile of the Short Form 5500; (2) 

Appendix B—Instructions to the Short 

Form 5500; (3) Appendix C—facsimiles 

of the Form 5500 Annual Return/Report, 

Schedule A, Schedule SB, Schedule 

MB, Schedule C, Schedule D, Schedule 

G, Schedule H, Schedule I, and 

Schedule R; and (4) Appendix D—the 

instructions for the 2009 Form 5500 

Annual Return/Report.13

1. Short Form 5500 as New Simplified 

Report for Certain Small Plans 

The Agencies are adopting the new 

two page form—the Short Form 5500—

to be filed by certain small plans 

(generally, plans with fewer than 100 

participants) with secure and easy to 

value investment portfolios—as 

proposed, except that the instructions 

for the line item for ‘‘administrative 

expenses’’ has been modified slightly to 

make it consistent with parallel line 

items on Schedules H and I. 


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14Short Form 5500 filers will not be required to 

file Schedule D, but DFEs in which such plans 

invest will still be required to list the plan name 

and Employer Identification Number (EIN) on Part 

II of the DFE’s Schedule D. 

15Small defined benefit plans to which the SAR 

no longer applies under the PPA for plan years after 

December 31, 2007, will have to provide the 

enhanced information in the new Defined Benefit 

Plan Funding Notice. The Department anticipates 

publishing a model notice, along with revisions to 

29 CFR 2520.104–46, with regard to this change. 

16Schedule P (Annual Return of Fiduciary of 

Employee Benefit Trust) was removed from Form 

5500 filings beginning with the 2006 plan year 

(2005 plan year for Form 5500–EZ), in anticipation 

of the move to electronic filing. See, Announcement 

2007–63, 2007–30 I.R.B. 65. In addition, Schedule 

T (Qualified Pension Plan Coverage Information) 

was removed from Form 5500 filings beginning 

with the 2005 plan year. The IRS notes that this 

change was not intended to effect the applicable 

required or optional non-discrimination testing 

(including the testing options described in Revenue 

Procedure 93–42), 1993–2 C.B. 540. 

17The Schedule E is being removed effective for 

the 2009 Form 5500 in anticipation of the move to 

electronic filing. 

A pension or welfare plan will be 

eligible to file the Short Form 5500 if 

the plan: (1) Covers fewer than 100 

participants or would be eligible to file 

as a small plan under the 80 to 120 rule 

in 29 CFR 2520.103–1(d); (2) is eligible 

for the small plan audit waiver under 29 

CFR 2520.104–46 (but not by virtue of 

enhanced bonding); (3) holds no 

employer securities at any time during 

the plan year; (4) at all times during the 

plan year, has 100% of its assets in 

investments that have a readily 

determinable fair market value; and (5) 

is not a multiemployer plan. For this 

purpose, participant loans meeting the 

requirements of ERISA section 

408(b)(1), whether or not they have been 

deemed distributed, and investment 

products issued by banks and licensed 

insurance companies that provide 

valuation information at least annually 

to the plan administrator will be treated 

as having a readily determinable fair 

market value. 

Most Short Form 5500 filers will not 

be required to file any schedules, 

although defined benefit pension plans 

and money purchase plans currently 

amortizing funding waivers will be 

required to file Schedule SB or MB.14

Small plans that are not eligible to file 

the Short Form 5500 will continue to be 

able to file simplified reports as under 

the current system. Specifically, small 

plan Form 5500 Annual Return/Report 

filers will file the Form 5500 and 

Schedules A, SB or MB, D, I, and R, 

where applicable. The conditions for the 

small pension plan audit waiver in 29 

CFR 2520.104–46 remain unchanged. 

Small pension plans will still be able to 

claim the audit waiver even if they are 

not eligible to file the Short Form 5500. 

Conversely, small pension plans filing 

the Short Form 5500 will continue to be 

required to meet all applicable 

requirements for the audit waiver, 

including the enhanced Summary 

Annual Report (SAR) and other 

disclosure requirements of that 

regulation.15 Similarly, all welfare plans 

that file the Form 5500 Annual Return/ 

Report and have fewer than 100 

participants are currently exempt from 

the audit requirement without regard to 

how their assets are invested. See 29 

CFR 2520.104–46(b)(2). The Short Form 

5500 will not change the welfare plan 

audit waiver conditions. For a funded 

welfare plan to be eligible to file the 

Short Form 5500, however, the plan will 

have to meet that form’s requirements 

regarding investment assets. 

2. Removal of IRS-Only Components 

From the Form 5500 Annual Return/ 

Report 

As described in detail in the July 2006 

Proposal, in order to effectuate the 

electronic filing requirement that will be 

effective for the 2009 Form 5500 Annual 

Return/Report, the portions of the Form 

5500 Annual Return/Report required to 

satisfy filing obligations imposed by the 

Code, but not required under ERISA, 

had to be removed because the Code 

and regulations thereunder do not 

permit the IRS to mandate electronic 

filing of the Form 5500 Annual Return/ 

Report. Therefore, effective for the 2009 

plan year (when mandatory electronic 

filing is implemented), the following 

form and schedules will not be filed 

with the Form 5500 Annual Return/ 

Report to the Department, but will be 

filed to the IRS: Form 5500–EZ Annual 

Return of One-Participant (Owners and 

Their Spouses) Retirement Plan and the 

Schedule SSA (Annual Registration 

Statement Identifying Separated 

Participants With Deferred Vested 

Benefits).16 In addition, the Schedule E 

(ESOP Annual Information) will no 

longer be required to be part of the Form 

5500 Annual Return/Report. 17 Three 

questions on employee stock ownership 

plan (ESOP) information on the 

Schedule E will be moved to the 

Schedule R effective for the 2009 Form 

5500 Annual Return/Report. The IRS, 

however, has advised the Department 

that it intends that plan administrators, 

employers, and certain other entities 

that are subject to filing and reporting 

requirements under the Code must 

continue to satisfy any applicable 

requirements in accordance with IRS 

revenue procedures, regulations, 

publications, forms, and instructions 

and that the IRS will advise filers of 

how to provide the information on the 

Form 5500–EZ and the information 

formerly required on the Schedule SSA 

in advance of the time for filing of the 

2009 Form 5500 Annual Return/Report. 

In addition, as described in detail in the 

July 2006 proposal and to ease the 

burdens on these filers, the IRS has also 

advised the Department that certain 

Form 5500–EZ filers will be permitted 

to satisfy the requirement to file the 

Form 5500–EZ with the IRS by filing the 

proposed Short Form 5500 

electronically through the EFAST 

processing system. Information 

regarding the Form 5500–EZ filers who 

would be eligible for this proposed 

electronic filing option is included in 

the proposed instruction for the Short 

Form 5500 under ‘‘Specific Instructions 

for One-Participant Plans.’’

3. Elimination of Limited Reporting 

Option for Code Section 403(b) Pension 

Plans 

Code section 403(b) plans that are 

subject to Title I of ERISA now will be 

subject to the annual reporting rules that 

apply to other ERISA-covered pension 

plans, including eligibility for the Short 

Form 5500. 

4. Addition of New Questions to 

Schedules on Title I Compliance, 

Service Provider Compensation, and 

Pension Plan Funding 

a. Schedule A: Identify Insurers That 

Fail To Supply Information 

As proposed, a new check box is 

being adopted on the Schedule A to 

permit plans to identify situations in 

which the insurance company or other 

organization that provides some or all of 

the benefits under a plan has failed to 

provide Schedule A information. Space 

also is provided for the administrator to 

indicate the type of information that 

was not provided. As a separate 

Schedule A is required for each 

insurance contract, the identity of the 

insurance company or organization will 

be self-evident. This would give the 

Department more usable data on 

insurers that fail to satisfy their 

disclosure obligations under section 

103(a)(2) of ERISA and the Department’s 

regulations. A reminder is being added 

to the Schedule A instructions to advise 

plan administrators that they should 

contact the insurer to request the 

required information and to advise the 

insurer that the plan administrator 

intends to identify the insurer on the 

Schedule A as not having provided the 

information needed. 

b. Actuarial Schedules—New Schedules 

SB and MB 

The Agencies have adopted their 

proposal to eliminate the existing 


sroberts on PROD1PC70 with NOTICES
Federal Register / Vol. 72, No. 221 / Friday, November 16, 2007 / Notices 64753 

18Unike multiemployer plans within the meaning 

of ERISA sections 3(37) and 4001(a)(3) to which 

more than one employer is required to contribute, 

which must be maintained pursuant to one or more 

collective barganing agreements between one or 

more employee organization and more than one 

employer, and which must satisfy other 

requirements prescribed in regulations issued by 

the Department at 29 CFR 2510.3–37, multipleemployer plans are plans that cover the employees 

of two or more employers but are treated as singleemployer plans for various purposes under ERISA. 

Schedule B and create two new 

Schedules—the Schedule SB, ‘‘Singleemployer Defined Benefit Plan Actuarial 

Information,’’ and the Schedule MB, 

‘‘Multiemployer Defined Benefit Plan 

and Certain Money Purchase Plan 

Actuarial Information.’’ This is 

necessary because the PPA significantly 

changed the funding requirements 

applicable to defined benefit pension 

plans. These changes render the existing 

Schedule B largely obsolete, especially 

for single-employer defined benefit 

pension plans. While the PPA changes 

for multiemployer defined benefit 

pension plans allow for continued use 

of a reporting scheme similar to the 

existing Schedule B, a number of 

Schedule B changes are needed for 

multiemployer plans. 

i. New Schedule SB ‘‘Single-employer 

Defined Benefit Plan Actuarial 

Information’’ 

The Schedule SB is to be filed for all 

single-employer defined benefit plans 

(including multiple-employer defined 

benefit plans).18 The Schedule SB will 

capture identifying information about 

the plan and plan sponsor, the type of 

plan, and prior year plan size. It 

includes basic information about plan 

assets, number of participants, funding 

target information, and a statement by 

an enrolled actuary. It consists of basic 

actuarial worksheets designed to allow 

the Agencies to evaluate the plan’s 

compliance with the funding 

requirements as amended by sections 

101, 102, 111, and 112 of the PPA, and 

to ensure that the reporting 

requirements under ERISA, as amended 

by section 503 of the PPA, are included 

on the schedule. The material is divided 

into sections consisting of ‘‘Basic 

information,’’ ‘‘Beginning of year 

carryover and prefunding balances,’’

‘‘Funding percentages,’’ ‘‘Contributions 

and liquidity shortfalls,’’ ‘‘Assumptions 

used to determine funding target and 

target normal cost,’’ ‘‘Miscellaneous 

items,’’ ‘‘Reconciliation of unpaid 

minimum required contributions for 

prior years,’’ and ‘‘Minimum required 

contribution for current year.’’ Airlines 

that have frozen pension plans electing 

the alternate funding schedule and 

plans for which the effective date of the 

new PPA funding rules is delayed 

(PBGC settlement plans, certain defense 

contractors, certain rural electrical 

cooperatives, etc.) will not be required 

to fill out all of these sections. Instead, 

additional information related to the 

applicable funding rules for such plans 

will be provided as an attachment. 

ii. New Schedule MB, ‘‘Multiemployer 

Defined Benefit Plan and Certain Money 

Purchase Plan Actuarial Information’’ 

Schedule MB is to be filed for 

multiemployer defined benefit plans 

and for money purchase plans 

(including target benefit plans) that are 

currently amortizing funding waivers. 

Schedule MB is very similar to the 

existing Schedule B. 

New items that have been added 

include (1) accrued liability determined 

using the unit credit cost method, (2) 

information about whether the plan is in 

endangered, seriously endangered, or 

critical status, and, if so, whether the 

plan is complying with the applicable 

requirements for its funding 

improvement or rehabilitation plan, and 

(3) information required by PPA section 

503. Information that was applicable 

solely to single-employer plans has been 

eliminated. 

5. Schedule C: Compensation Received 

by Plan Service Providers 

As in the proposal, the Schedule C 

will consist of three parts. Part I of the 

Schedule C will require the 

identification of each person who 

received, directly or indirectly, $5,000 

or more in total compensation (i.e., 

money or anything else of value) in 

connection with services rendered to 

the plan or their position with the plan 

during the plan year. Direct 

compensation would be reported on a 

separate line item from compensation 

received from sources other than the 

plan or plan sponsor in connection with 

the service provider’s position with the 

plan or services provided to the plan. 

The final revisions also provide an 

alternative disclosure option for 

reporting certain eligible indirect 

compensation provided that certain 

disclosures are made to the plan 

administrator regarding the 

compensation and the party or parties 

paying and receiving the indirect 

compensation. With respect to such 

compensation for which those 

disclosures were not provided, and 

other indirect compensation received 

from sources other than the plan or plan 

sponsor, filer would report a total 

amount. They would also provide 

identifying information regarding the 

payor and the nature of compensation 

received by certain key service 

providers where the amount was $1,000 

or more and where the amount was an 

estimate rather than an actual amount. 

A new Part II for Schedule C provides 

a place for plan administrators to 

identify each fiduciary or service 

provider that failed or refused to 

provide the information necessary to 

complete Part I of the Schedule C. 

The third part of the Schedule C (Part 

III) will be the current Part II of the 

Schedule C, used for reporting 

termination information on accountants 

and enrolled actuaries. The proposal 

would not alter these current 

requirements. 

6. Schedules H and I: Compliance With 

Blackout Notice Requirements 

Plan administrators now will report 

on Schedule H or I, or the Short Form 

5500, as appropriate, whether there has 

been a temporary suspension, 

limitation, or restriction lasting more 

than three consecutive business days of 

any ability of participants or 

beneficiaries to direct or diversify assets 

credited to their accounts, to obtain 

loans from the plan, or to obtain plan 

distributions. If there was a blackout, 

plan administrators will have to state if 

participants either were provided the 

required notice of this suspension 

period or one of the exceptions to 

providing the blackout notice applies. 

7. Schedules H and I: Failure To Pay 

Benefits When Due 

As in the July 2006 Proposal, a 

compliance question that would require 

plan administrators to answer whether 

the plan has failed to pay any benefits 

when due during the plan year is added 

to the Schedule H and Schedule I, and 

is also included on the new Short Form 

5500. 

8. Schedule I: Separate Disclosure of 

Fees Paid to Administrative Service 

Providers 

The disclosure requirements for direct 

compensation paid by small plans for 

administrative expenses, i.e., 

professional and administrative salary, 

fee, and commission payments, were 

expanded in the proposal and are 

modified here in response to comments 

suggesting that the requirements for 

Short Form 5500, Schedule I, and 

Schedule H filers be more uniform. As 

with the proposal, the Short Form 5500 

and Schedule I have a separate line item 

for direct payments to professional and 

administrative service providers, which 

will promote better awareness among 

plan fiduciaries regarding these fee 

payments and will provide participants, 

beneficiaries, and government 

regulatory agencies with improved 


sroberts on PROD1PC70 with NOTICES
64754 Federal Register / Vol. 72, No. 221 / Friday, November 16, 2007 / Notices 

19The addition of the supplemental schedule to 

provide a format for describing the delinquent 

participant contributions does not alter the IQPA’s 

duty to treat Line 4a itself as one of the 

supplemental schedules for purposes of its audit 

duties both under ERISA and under GAAS. 

20A similar addition would be made to the 

instructions for Line 4a of the Schedule I applicable 

to small plans filers who are not eligible for the 

audit waiver. 

disclosure of these plan expenses. The 

instructions have been modified, 

however, to make more explicit that the 

information included in the 

administrative expense line on the Short 

Form 5500 and Schedule I more directly 

correlates to those line items on the 

Schedule H that ask for a more detailed 

breakout of such information. 

9. Schedule R 

As proposed, Schedule R has been 

modified for 2009 to include additional 

questions required by section 503 of the 

PPA and to collect information on how 

assets are invested. Certain ESOP 

questions previously on the Schedule E 

also have been moved to the Schedule 

R. 

The new Part V collects PPA-required 

information on multiemployer defined 

benefit plans and additional information 

related to major contributing employers. 

Asset allocation questions for large 

defined benefit plans (1,000 or more 

participants) are included in Part VI. 

Such plans must provide a breakdown 

of plan assets by type of investment 

(stock, investment-grade debt, highyield debt, real estate, and other). 

Information on the average duration of 

combined investment-grade and highyield debt is also required. For this 

purpose, duration may be determined 

using any generally accepted 

methodology. 

Schedule R has been modified, as 

proposed, to ask the following questions 

regarding the operations and 

investments of the ESOP: (1) Whether 

any unallocated employer securities or 

proceeds from the sale of unallocated 

securities were used to repay any 

exempt loan; (2) whether the ESOP 

holds any preferred stock, and if so, 

whether the ESOP has an exempt loan 

with the employer as lender that is part 

of a ‘‘back-to-back’’ loan—the 

repayment terms of the employer loan to 

the ESOP are substantially similar to the 

repayment terms of a loan to the 

employer from a commercial lender; 

and (3) whether the ESOP holds any 

stock that is not readily tradable on an 

established securities market. 

The new PPA-related questions and 

the asset allocation questions on the 

2009 Schedule R, but not the ESOP 

questions, will be required to be 

submitted as a non-standard attachment 

to the 2008 Schedule R under the 

original EFAST system. 

10. Other Improvements and 

Clarifications of Form 5500 Reporting 

Requirements 

The last category of revisions involves 

technical amendments to the Form 

5500, individual schedules, and 

instructions to clarify and improve 

existing reporting requirements that 

either were set forth in the proposal or 

are being made in response to public 

comments. 

a. Form 5500 

A question asking for the number of 

contributing employers in a 

multiemployer plan is added to the 

Form 5500. The instructions for the 

funding and benefit checklists have 

been expanded to clarify that Code 

section 403(b) plans invested in annuity 

contracts should check ‘‘insurance’’ and 

plans using Code section 403(b)(7) 

custodial accounts should check 

‘‘trust.’’ The Form 5500 includes a 

checklist of the various schedules that 

may be required to be attached. In 

addition to revising the checklist to 

eliminate the IRS-only Schedules, and 

replacing the Schedule B with the 

Schedules SB and MB, the Agencies 

have also kept the other proposed 

cosmetic changes to the presentation of 

the schedule checklist. Under the 

current filing requirements, plans must 

include on the Form 5500 all of the plan 

characteristics that apply to the plan 

from a list of codes included in the 

instructions. These ‘‘feature’’ codes 

allow the Agencies to identify and 

classify the universe of filers by their 

major characteristics. New plan feature 

codes for defined contribution pension 

plans with automatic enrollment 

features and default investment 

provisions have been added. The 

Agencies also have eliminated the 

feature codes for certain types of plans 

that are not subject to Title I of ERISA 

because they will not be filing the Form 

5500 with EFAST under the proposed 

electronic filing system. The optional 

line for identifying the principal 

preparer of the Form 5500 is deleted. 

b. Schedules H and I: New 

Supplemental Schedule for Line 4a of 

the Schedule H for Reporting 

Delinquent Participant Contributions 

The instructions continue to state that 

delinquent participant contributions 

reported on Schedule H, Line 4a, should 

be treated as part of the supplemental 

schedules for purposes of the required 

IQPA audit and opinion. The 

instructions separately also provide 

that, if the information contained on 

Schedule H, Line 4a, is not presented in 

accordance with the Department’s 

regulatory requirements, the IQPA 

report must make the appropriate 

disclosures in accordance with 

Generally Accepted Auditing Standards 

(GAAS). The instructions to Schedule 

H, Line 4a, are modified to require 

delinquent participant contributions to 

be presented on a standardized 

supplemental schedule where 

delinquent participant contributions are 

identified on Line 4a and are expanded 

to include the guidance contained in the 

previously released ‘‘FAQs on Reporting 

Delinquent Participant Contributions on 

the Form 5500,’’ available on the 

Department’s Web site at http:// 

www.dol.gov, that make explicit the 

IQPA’s separate opinion obligations 

under ERISA and GAAS.19 The new 

Schedule H, ‘‘Line 4a ‘‘Schedule of 

Delinquent Participant Contributions’’

will identify the total participant 

contributions transferred late to the 

plan, the total that are nonexempt 

prohibited transactions, and the total 

contributions fully corrected under the 

VFCP. See 71 FR 20262 (Apr. 19, 2006). 

Those that constitute nonexempt 

prohibited transactions would be broken 

down into contributions not corrected, 

contributions corrected outside of the 

VFCP, and contributions pending 

correction in the VFCP.20

In addition, as proposed, the 

Schedule H and I instructions for Line 

4a now permit inclusion of delinquent 

forwarding of participant loan 

repayments on Line 4a of the Schedule 

H or Schedule I, and Line 10a of the 

Short Form 5500, provided that filers 

that choose to include such participant 

loan repayments on Line 4a use the 

same supplemental schedule and IQPA 

disclosure requirements for the loan 

repayments as for delinquent 

transmittals of participant contributions. 

At the suggestion of one commenter, a 

checkbox has been added to the new 

line 4a Schedule to identify whether 

loan repayments are included. 

c. Schedule R: New Minimum Funding 

Question 

Schedule R currently contains 

questions regarding minimum required 

contributions for certain defined 

contribution plans. An additional 

question now asks whether the 

minimum funding amount reported will 

be met by the funding deadline and the 

minimum funding questions have been 

revised to avoid any discrepancies in 

the date being reported. 


sroberts on PROD1PC70 with NOTICES
Federal Register / Vol. 72, No. 221 / Friday, November 16, 2007 / Notices 64755 

21On August 29, 2006, OMB issued a notice 

indicating that it would continue its approval of the 

information collections approved under Control No. 

1210–0110 as currently in effect, but would not 

approve the Department’s request for approval of 

revisions to the ICR until after consideration of 

public comment on the July 2006 Proposal and 

promulgation of a final rule, describing any 

changes. 

22The Agencies have designed the instruction 

package for the 5500 Forms so that filers generally 

will be able to complete the Form 5500 Annual 

Return/Report or the Short Form 5500 by reading 

the instructions without needing to refer to the 

statutes or regulations themselves. 

d. Miscellaneous Technical 

Adjustments 

Various commenters submitted 

technical suggestions on how to further 

improve and clarify various portions of 

the proposals which focused principally 

on technical corrections and 

improvements in the instructions as 

opposed to changes on the forms. The 

Agencies have reviewed the comments 

and made various technical corrections/ 

clarifications in response to those 

comments. 

D. Regulations Relating to the Proposed 

Form 

As noted above, certain amendments 

to the annual reporting regulations 

under ERISA are necessary to 

accommodate some of the revisions to 

the forms. The Department is publishing 

separately today in the Federal Register 

amendments to the Department’s annual 

reporting regulations. That document 

includes a discussion of the findings 

required under sections 104 and 110 of 

ERISA that are necessary for the 

Department to adopt the Form 5500 

Annual Return/Report, as revised 

herein, and the new Short Form 5500, 

as an alternative method of compliance, 

limited exemption, and/or simplified 

report under the reporting and 

disclosure requirements of Part 1 of 

Subtitle B of Title I of ERISA. 

Paperwork Reduction Act Statement 

In accordance with the requirements 

of the Paperwork Reduction Act of 1995 

(PRA) (44 U.S.C. 3506(c)(2)), the July 

2006 Proposal solicited comments on 

the information collections included in 

the proposed revision of the Form 5500 

Annual Return/Report pursuant to Part 

1 of Subtitle B of Title I and Title IV of 

ERISA and the Internal Revenue Code. 

The Department also submitted an 

information collection request (ICR) to 

OMB in accordance with 44 U.S.C. 

3507(d), contemporaneously with 

publication of the July 2006 Proposal, 

for OMB’s review of the Department’s 

information collections previously 

approved under OMB Control No. 1210–

0110.21 Public comment on the 

information collections contained in the 

Supplemental Notice was also solicited 

in connection with its publication in 

December, 2006. Although no public 

comments were received that 

specifically addressed to the paperwork 

burden analysis of the information 

collections, the comments that were 

submitted in response to the July 2006 

Proposal and the Supplemental Notice, 

which are described earlier in this 

preamble, contained information 

relevant to the costs and administrative 

burdens attendant to the proposals. The 

Agencies took into account such public 

comments in connection with making 

changes to the proposals, analyzing the 

economic impact of the proposals, and 

developing the revised paperwork 

burden analysis summarized below. 

In connection with the publication of 

this Notice, the Department and the 

PBGC submitted ICRs to OMB for its 

review and approval of the information 

collections contained in the Form 5500 

Annual Return/Report, as herein 

revised, and the new Short Form 5500. 

OMB has approved these ICRs. The IRS 

has not submitted an ICR to OMB, but 

will do so in advance of release of the 

Form 5500 Annual Return/Report and 

the Short Form 5500 for public use as 

agreed with OMB. The public is advised 

that an agency may not conduct or 

sponsor, and a person is not required to 

respond to, a collection of information 

unless it displays a currently valid OMB 

control number. The Department 

intends to publish a notice announcing 

OMB’s decision upon review of the 

Department’s ICR. 

A copy of the ICR for an Agency may 

be obtained by contacting the 

appropriate PRA addressee shown 

below or at www.RegInfo.gov. PRA 

Addressees: Department of Labor: 

Gerald B. Lindrew, Office of Policy and 

Research, U.S. Department of Labor, 

Employee Benefits Security 

Administration, 200 Constitution 

Avenue, NW., Room N–5718, 

Washington, DC 20210. Telephone: 

(202) 693–8410; Fax: (202) 219–4745. 

Pension Benefit Guaranty Corporation: 

Disclosure Division of the Office of the 

General Counsel, Pension Benefit 

Guaranty Corporation, 1200 K Street, 

NW., 11th Floor, Washington, DC 

20005–4026. Telephone: (202) 326–4040 

(TTY and TDD users may call the 

Federal relay service toll-free at 1–800–

877–8339 and asked to be connected to 

(202) 326–4040). Fax: (202) 326–4042. 

Except as otherwise indicated, these are 

not toll-free numbers. 

The following is a summary of the 

information collection and the 

Agencies’ estimates of the burden it 

imposes for plan year 2007: 

Type of Review: Revision of a 

currently approved collection. 

Agencies: Employee Benefits Security 

Administration (OMB No. 1210–0110); 

Internal Revenue Service (OMB No. 

1545–0710); Pension Benefit Guaranty 

Corporation (OMB No. 1212–0057). 

Title: Form 5500 Series. 

Affected Public: Business or other forprofit; Not-for-profit institutions. 

Form Number: DOL/IRS/PBGC Form 

5500, DOL/IRS/PBGC Form 5500–SF, 

and Schedules. 

Total Respondents: 780,000. 

Total Annual Responses: 780,000. 

Frequency of Response: Annually. 

Estimated Total Annual Burden 

Hours: 1.13 million (see below for 

break-out of annual burden hours by 

Agency). 

Total Annual Burden Cost (Operating 

and Maintenance): $333 million (see 

below for break-out of total annual 

burden cost by Agency). 

The Agencies’ burden estimation 

methodology excludes certain activities 

from the calculation of ‘‘burden.’’ If the 

activity is performed for any reason 

other than compliance with the 

applicable federal tax administration 

system or the Title I annual reporting 

requirements, it is not counted as part 

of the paperwork burden. For example, 

most businesses or financial entities 

maintain, in the ordinary course of 

business, detailed accounts of assets and 

liabilities, and income and expenses for 

the purposes of operating the business 

or entity. These recordkeeping activities 

were not included in the calculation of 

burden because prudent business or 

financial entities collect and maintain 

such information for ordinary and 

customary business reasons unrelated to 

annual return/reporting under ERISA. 

This analysis accounts only for time 

necessary for gathering and processing 

information associated with the annual 

return reporting, including learning 

about changes in the reporting 

requirements.22 In addition, an activity 

is counted as a burden only once if 

performed for both Code and Title I 

annual return/reporting purposes. The 

Agencies, therefore, have included in 

their PRA calculations a burden for 

reading the instructions, but no 

additional recordkeeping burden 

attributable to the Form 5500 Annual 

Return/Report or the Short Form 5500. 

Paperwork and Respondent Burden 

Estimated time needed to complete 

the forms listed below reflects the 

combined requirements of the IRS, the 

Department, and the PBGC. The time 

needed by a particular plan will vary 

depending on individual circumstances. 


sroberts on PROD1PC70 with NOTICES
64756 Federal Register / Vol. 72, No. 221 / Friday, November 16, 2007 / Notices 

23 In 2007 and 2008, certain eligible small plans 

have a simplified reporting alternative, as described 

above, which allows eligible filers to complete 

fewer schedules and line items on certain 

schedules. For eligible filers that choose to use the 

simplified reporting option, the burden of filing 

will be smaller than the tables indicate, because this 

option allows eligible plans to fill out fewer line 

items and schedules. 

The estimated average times are shown 

in Table 1 below. 

TABLE 1.—BURDEN BY SCHEDULE AND YEAR 23

Pension Welfare 

Large Small Large Small 

Plan Year 2007 Burden 

Form 5500 .................................... 1 hr., 43 min. ...................... 1 hr., 17 min. ...................... 1 hr., 45 min. ...................... 1 hr., 14 min. 

Sch A ..................................... 2 hr., 41 min. ...................... 2 hr., 44 min. ...................... 3 hr., 30 min. ...................... 2 hr., 36 min. 

Sch B ..................................... 7 hr., 56 min. ...................... 7 hr., 55 min. ...................... .............................................

Sch C ..................................... 2 hr., 22 min. ...................... ............................................. 3 hr., 8 min. ........................

Sch D ..................................... 1 hr., 39 min. ...................... 20 min. ................................ 1 hr., 52 min. ...................... 20 min. 

Sch E ..................................... 3 hr., 18 min. ...................... 3 hr., 18 min. ...................... .............................................

Sch G .................................... 11 hr., 29 min. .................... ............................................. 11 hr.

Sch H ..................................... 7 hr., 12 min. ...................... ............................................. 8 hr.

Sch I ...................................... ............................................. 1 hr., 57 min. ...................... ............................................. 1 hr., 48 min. 

Sch R ..................................... 1 hr., 36 min. ...................... 1 hr., 3 min. ........................ .............................................

Sch SSA ................................ 6 hr., 25 min. ...................... 1 hr., 42 min. ...................... .............................................

Plan Year 2008 Burden 

Form 5500 ............................. 1 hr., 43 min. ...................... 1 hr., 17 min. ...................... 1 hr., 45 min. ...................... 1 hr. 14 min. 

Sch A ..................................... 2 hr., 41 min. ...................... 2 hr., 44 min. ...................... 3 hr., 30 min. ...................... 2 hr., 36 min. 

Sch MB .................................. 9 hr., 12 min. ...................... 4 hr., 29 min. ...................... .............................................

Sch SB .................................. 9 hr., 8 min. ........................ 9 hr., 19 min. ...................... .............................................

Sch C ..................................... 2 hr., 22 min. ...................... ............................................. 3 hr., 8 min. ........................

Sch D ..................................... 1 hr., 39 min. ...................... 20 min. ................................ 1 hr., 52 min. ...................... 20 min. 

Sch E ..................................... 3 hr., 18 min. ...................... 3 hr., 18 min. ...................... .............................................

Sch G .................................... 11 hr., 29 min. .................... ............................................. 11 hr. ...................................

Sch H ..................................... 7 hr., 12 min. ...................... ............................................. 8 hr. .....................................

Sch I ...................................... ............................................. 1 hr., 57 min. ...................... ............................................. 1 hr., 48 min. 

Sch R ..................................... 1 hr., 55 min. ...................... 1 hr., 10 min. ...................... .............................................

Sch SSA ................................ 6 hr., 25 min. ...................... 1 hr., 42 min. ...................... .............................................

Simplified Filing Option for Certain 

Small Plans.

............................................. 2 hr., 34 min. ...................... ............................................. 2 hr., 32 min. 

Plan Year 2009 Burden 

Form 5500 ............................. 1 hr., 54 min. ...................... 1 hr., 19 min. ...................... 1 hr. 45 min. ....................... 1 hr., 14 min. 

Sch A ..................................... 2 hr., 52 min. ...................... 2 hr., 51 min. ...................... 3 hr., 39 hr., ........................ 2 hr., 43 min. 

Sch MB .................................. 7 hr., 52 min. ...................... 4 hr., 14 min. ...................... .............................................

Sch SB .................................. 6 hr., 38 min. ...................... 6 hr., 49 min. ...................... .............................................

Sch C ..................................... 3 hr., 4 min. ........................ ............................................. 3 hr., 38 min. ......................

Sch D ..................................... 1 hr., 39 min. ...................... 20 min. ................................ 1 hr. , 52 min. ..................... 20 min. 

Sch G .................................... 11 hr., 29 min. .................... ............................................. 11 hr. ...................................

Sch H ..................................... 7 hr., 42 min. ...................... ............................................. 8 hr., 35 min. ......................

Sch I ...................................... ............................................. 2 hr., 5 min. ........................ ............................................. 1 hr., 55 min. 

Sch R ..................................... 1 hr., 43 min. ...................... 1 hr., 5 min. ........................ .............................................

Short Form 5500 ................... ............................................. 2 hr., 32 min. ...................... ............................................. 2 hr., 32 min. 

The aggregate hour burden for the 

Form 5500 Annual Return/Report 

(including schedules and Short Form 

5500) is estimated to be 1.13 million for 

plan year 2007, 1.12 million for plan 

year 2008, and 854,000 hours for plan 

year 2009. The hour burden reflects 

annual filing activities carried out 

directly by filers. The cost burden is 

estimated to be $333 million for plan 

year 2007, $329 million for plan year 

2008, and $278 million for plan year 

2009. The cost burden reflects filing 

services purchased annually by filers. 

Presented below is a chart showing the 

total hour and cost burden of the revised 

Form 5500 Annual Return/Report and 

the new Short Form 5500, separately 

allocated across the Department and the 

IRS. There is no separate PBGC entry on 

the chart because, as explained below, 

its share of the paperwork burden is 

very small relative to that of the IRS and 

the Department. 


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24 Due to the removal of Schedules E and 

Schedule SSA, no burden is associated with SSA 

for plan year 2009. 

TABLE 2.—AGENCY BURDENS BY YEAR

Pension plans Welfare plans Total 

Total 

Large Small Large Small Large Small 

Agency Plan Year 2007 

DOL ........................................ Hours .. 219,000 213,000 102,000 3,000 321,000 216,000 536,000 

$MM .... $42 $87 $65 $1.3 $107 $88 $195 

IRS/SSA .................................. Hours .. 250,000 327,000 13,000 2,000 264,000 329,000 592,000 

$MM .... $33 $100 $1.7 $0.7 $35 $101 $136 

Agency Plan Year 2008 

DOL ........................................ Hours .. 219,000 197,000 102,000 3,000 321,000 200,000 521,000 

$MM .... $42 $81 $65 $1.3 $107 $83 $190 

IRS/SSA .................................. Hours .. 257,000 321,000 13,000 2,000 270,000 323,000 593,000 

$MM .... $36 $99 $1.7 $0.6 $38 $100 $138 

Agency Plan Year 2009 24

DOL ........................................ Hours .. 258,000 164,000 105,000 2,000 363,000 166,000 529,000 

$MM .... $49 $61 $67 $0.8 $117 $62 $178 

IRS .......................................... Hours .. 143,000 164,000 14,000 2,000 158,000 166,000 323,000 

$MM .... $26 $69 $2 $0.6 $28 $70 $98 

The paperwork burden allocated to 

the PBGC includes a portion of the 

general instructions, basic plan 

identification information, a portion of 

Schedules MB and SB, and a portion of 

Schedule R. The PBGC’s Estimated 

Share of Total Annual Burden is: 

• 1,800 hours and $1.6 million for 

plan year 2007, 

• 2,000 hours and $1.8 million for 

plan year 2008, and 

• 1,200 hours and $1.3 million for 

plan year 2009. 

Appendix A 

BILLING CODE 4510–29–P 


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BILLING CODE 4510–29–C 

Appendix B 

2009 Instructions for Form 5500–SF 

Short Form Annual Return/Report of 

Small Employee Benefit Plan 

ERISA refers to the Employee 

Retirement Income Security Act of 1974, 

and Code references are to the Internal 

Revenue Code, unless otherwise noted. 

EFAST Processing System 

Under the computerized ERISA Filing 

Acceptance System (EFAST), you must 

electronically file your 2009 Form 

5500–SF. You may file your 2009 Form 

5500–SF on-line, using EFAST’s webbased filing system or you may file 

through an EFAST-approved vendor. 

For more information, see the 

instructions for Electronic Filing 

Requirement. 

General Instructions 

The Form 5500–SF, Short Form 

Annual Return/Report of Small 

Employee Benefit Plan (Form 5500–SF), 

is a simplified annual reporting form for 

use by certain small pension and 

welfare benefit plans. To be eligible, the 

plan generally must have fewer than 100 

participants at the beginning of the plan 

year; it must be exempt from the 

requirement that the plan’s books and 

records be audited by an independent 

qualified public accountant; it must 

have 100% of its assets invested in 

certain secure investments with a 

readily determinable fair value; it must 

hold no employer securities; and it must 

not be a multiemployer plan. See Who 

May File Form 5500–SF for more 

detailed instructions on who may file 

the Form 5500–SF. Plans required to file 

an annual return/report that are not 

eligible to file the Form 5500–SF must 

file a Form 5500, Annual Return/Report 

of Employee Benefit Plan or Form 5500–

EZ Annual Return of One-Participant 

(Owners and Their Spouses) Retirement 

Plan (to the extent applicable), with all 

required schedules and attachments 

(Form 5500). 

To reduce the possibility of 

correspondence and penalties, we 

remind filers that the Internal Revenue 

Service (IRS), Department of Labor 

(DOL), and Pension Benefit Guaranty 

Corporation (PBGC) have consolidated 

their return/report forms to minimize 

the filing burden for employee benefit 

plans. Administrators and sponsors of 

employee benefit plans generally will 

satisfy their IRS and DOL annual 

reporting requirements for the plan 

under ERISA sections 104 and 4065 and 

Code section 6058 by filing either the 

Form 5500, Form 5500–SF, or Form 

5500–EZ, Annual Return of OneParticipant (Owners and Their Spouses) 

Retirement Plan (Form 5500–EZ),. 

Defined contribution and defined 

benefit pension plans may be required 

to file additional information with the 

IRS regarding their compliance with tax 

laws. See http://www.irs.gov for more 

information. Defined benefit pension 

plans covered by the PBGC may have 

special additional requirements, 

including filing the PBGC Form 1, 

Premium Package, and reporting certain 

transactions directly with that agency. 

See the PBGC’s Premium Payment 

Package (Form 1 Package), available at 

http://www.pbgc.gov. 

The Form 5500–SF must be filed 

electronically. See How to File—

Electronic Filing Requirement 

instructions. Your entries will be 

initially screened. Your entries must 

satisfy this screening in order to be 

filed. Once filed, your form may be 

subject to further detailed review, and 

your filing may be rejected based upon 

this further review. 

ERISA and the Code provide for the 

assessment or imposition of penalties 

for not submitting the required 

information when due. See Penalties. 

Annual reports filed under Title I of 

ERISA must be made available by plan 

administrators to plan participants and 

by the DOL to the public pursuant to 

ERISA sections 104 and 106. 

Note: The IRS Form 5500–EZ generally is 

used by one-participant plans (as defined 

below) that are not subject to the 

requirements of section 104(a) of ERISA to 

satisfy the annual reporting and filing 

obligations imposed by the Code. Certain 

one-participant plans who are eligible to file 

a Form 5500–EZ may file the Form 5500–SF 

to satisfy the filing obligations under the 

Code. One-participant plans that are eligible 

to file the Form 5500–SF electronically 

complete only certain questions on the Form 

5500–SF. (See Specific Instructions for OneParticipant Plans). Therefore, a plan that is 

required to file Form 5500–EZ may file the 

paper Form 5500–EZ with the IRS or the 

Form 5500–SF electronically. For more 

information on filing with the IRS go to 

http://www.irs.gov/ep or call 1–877–829–

5500. 

How To Get Assistance 

If you need help completing this form 

or have related questions, call the 

EFAST Help Line at [number to be 

provided] (toll free). The EFAST Help 

Line is available Monday through 

Friday from 8 a.m. to 8 p.m., Eastern 

Time. 

You can access the EFAST Web Site 

24 hours a day, 7 days a week at 

http://www.efast.dol.gov to: 

• View forms and related 

instructions. 

• Get information regarding EFAST, 

including approved software vendors. 

• See answers to frequently asked 

questions about the Form 5500–SF, the 

Form 5500 and its Schedules, and 

EFAST. 

• Access the main EBSA and DOL 

Web Sites for news, regulations, and 

publications. 

You can access the IRS Web Site 24 

hours a day, 7 days a week at http:// 

www.irs.gov to: 

• View forms, instructions, and 

publications. 

• See answers to frequently asked tax 

questions. 

• Search publications on-line by topic 

or keyword. 

• Send comments or request help by 

e-mail. 

• Sign up to receive local and 

national tax news by e-mail. 

You can order related forms and IRS 

publications by calling 1–800–TAX–

FORM (1–800–829–3676). You can 

order EBSA publications by calling 1–

866–444–3272. In addition, most IRS 

forms and publications are available at 

your local IRS office. 

Table of Contents 

Pension and Welfare Plans Required To File 

Annual Return/Report 

Plans Exempt From Filing 

Who May File Form 5500–SF 

What To File 

When To File 

Delinquent Filer Voluntary Compliance 

Program 

Change in Plan Year 

Penalties 

How To File—Electronic Filing Requirement 

Specific Instructions for One-Participant 

Plans 

Specific Line By Line Instructions 

Part I—Annual Report Identification 

Information 

Part II—Basic Plan Information 

Part III—Financial Information 

Part IV—Plan Characteristics 

Part V—Compliance Questions 

Part VI—Pension Funding Information 

Part VII—Plan Terminations & Transfers of 

Assets 

Pension and Welfare Plans Required To 

File Annual Return/Report 

All pension benefit plans and welfare 

benefit plans covered by ERISA must 

annually file a Form 5500 or Form 

5500–SF unless they are eligible for a 

filing exemption. (Code section 6058 

and ERISA sections 104 and 4065). An 

annual return/report must be filed even 

if the plan is not ‘‘tax qualified,’’

benefits no longer accrue, contributions 

were not made during this plan year, or 

contributions are no longer made. 

Pension benefit plans required to file 

include both defined benefit plans and 

defined contribution plans. Profit 


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sharing, stock bonus, money purchase, 

401(k) plans, Code section 403(b) plans 

and IRA plans established by an 

employer are among the pension benefit 

plans for which an annual return/report 

must be filed. Welfare benefit plans 

provide benefits such as medical, 

dental, life insurance, apprenticeship 

and training, scholarship funds, 

severance pay, disability, etc. 

Plans Exempt From Filing 

The DOL has issued regulations under 

which some pension plans and many 

welfare plans with fewer than 100 

participants are exempt from filing an 

annual return/report. Do not file a Form 

5500–SF for an employee benefit plan 

that is any of the following: 

1. A welfare plan that covers fewer 

than 100 participants as of the 

beginning of the plan year and is 

unfunded, fully insured, or a 

combination of insured and unfunded. 

For this purpose: 

a. An unfunded welfare benefit plan 

has its benefits paid as needed directly 

from the general assets of the employer 

or the employee organization that 

sponsors the plan. 

Note: Plans which are NOT unfunded 

include those plans that received employee 

(or former employee) contributions during 

the plan year and/or used a trust or 

separately maintained fund (including a 

Code section 501(c)(9) trust) to hold plan 

assets or act as a conduit for the transfer of 

plan assets during the plan year. 

b. A fully insured welfare benefit plan 

has its benefits provided exclusively 

through insurance contracts or policies, 

the premiums of which must be paid 

directly to the insurance carrier by the 

employer or employee organization 

from its general assets or partly from its 

general assets and partly from 

contributions by its employees or 

members (which the employer or 

organization forwards within 3 months 

of receipt). The insurance contracts or 

policies discussed above must be issued 

by an insurance company or similar 

organization (such as Blue Cross, Blue 

Shield or a health maintenance 

organization) that is qualified to do 

business in any state. 

c. A combination unfunded/insured 

welfare plan has its benefits provided 

partially as an unfunded plan and 

partially as a fully insured plan. An 

example of such a plan is a welfare plan 

that provides medical benefits as in a 

above and life insurance benefits as in 

b above. See 29 CFR 2520.104–20 and 

the DOL Technical Release 92–01. 

Note: A ‘‘voluntary employees’ beneficiary 

association’’ as used in Code section 

501(c)(9) (‘‘VEBA’’) should not be confused 

with the employee organization or employer 

that establishes and/or maintains (i.e., 

sponsors) the welfare benefit plan. 

2. An unfunded pension benefit plan 

or an unfunded or insured welfare 

benefit plan: (a) whose benefits go only 

to a select group of management or 

highly compensated employees, and (b) 

which meets the terms of 29 CFR 

2520.104–23 (including the requirement 

that a registration statement be timely 

filed with DOL) or 29 CFR 2520.104–24. 

3. Plans maintained only to comply 

with workers’ compensation, 

unemployment compensation, or 

disability insurance laws. 

4. An unfunded excess benefit plan. 

5. A welfare benefit plan maintained 

outside the United States primarily for 

persons substantially all of whom are 

nonresident aliens. 

6. A pension benefit plan maintained 

outside the United States primarily for 

the benefit of persons substantially all of 

whom are non-resident aliens. 

7. An annuity or custodial account 

arrangement under Code section 

403(b)(1) or (7) not established or 

maintained by an employer as described 

in DOL Regulation 29 CFR 2510.3–2(f). 

8. A simplified employee pension 

(SEP) described in Code section 408(k) 

that conforms to the alternative method 

of compliance described in 29 CFR 

2520.104–48 or 29 CFR 104–49. A SEP 

is a pension plan that meets certain 

minimum qualifications regarding 

eligibility and employer contributions. 

9. A Savings Incentive Match Plan for 

Employees of Small Employers 

(SIMPLE) that involves SIMPLE IRAs 

under Code section 408(p). 

10. A church welfare plan under 

ERISA section 3(33). 

11. A church pension plan if the 

pension plan did not elect coverage 

under Code section 410(d). 

12. An unfunded dues financed 

pension benefit plan that meets the 

alternative method of compliance 

provided by 29 CFR 2520.104–27. 

13. An individual retirement account 

or annuity not considered a pension 

plan under 29 CFR 2510.3–2(d). 

14. A governmental plan. 

15. A welfare benefit plan that 

participates in a group insurance 

arrangement that files a return/report 

Form 5500 on its behalf. A group 

insurance arrangement generally is an 

arrangement that provides benefits to 

the employees of two or more 

unaffiliated employers (not in 

connection with a multiemployer plan 

or a collectively bargained multipleemployer plan), fully insures one or 

more welfare plans of each participating 

employer, uses a trust (or other entity 

such as a trade association) as the 

holder of the insurance contracts and 

uses a trust as the conduit for payment 

of premiums to the insurance company. 

For further details, see 29 CFR 

2520.104–43. 

16. An apprenticeship or training plan 

meeting all of the conditions specified 

in 29 CFR 2520.104–22. 

17. A One-Participant (Owners and 

Their Spouses) Retirement Plan 

(generally referred to as a OneParticipant Plan) that has elected to file 

a Form 5500–EZ or is exempt from filing 

the Form 5500–EZ. A one-participant 

plan is: (1) A plan that covers only an 

individual or an individual and his or 

her spouse who wholly own a trade or 

business, whether incorporated or 

unincorporated; or (2) a plan for a 

partnership that covers only the 

partners or the partners and the 

partners’ spouses. See Specific 

Instructions for One-Participant Plans. 

One-participant plans may be eligible to 

file the Form 5500–SF electronically 

(See How to File—Electronic Filing 

Requirement instructions) or the paper 

Form 5500–EZ with the IRS. See 

http://www.irs.gov/ep or call 1–877–

829–5500. 

18. An unfunded dues financed 

pension benefit plan that meets the 

alternative method of compliance 

provided by 29 CFR 2520.104–27. 

For more information on plans that 

are exempt from filing an annual return/ 

report, see the Instructions for Form 

5500 Annual Return/Report of 

Employee Benefit Plan or call the 

EFAST Help Line at [number to be 

provided]. 

Who May File Form 5500–SF 

If your plan is required to file an 

annual return/report, you may file the 

Form 5500–SF instead of the Form 5500 

only if you meet all of the eligibility 

conditions listed below. 

1. The plan (a) covered fewer than 100 

participants at the beginning of plan 

year 2009, or (b) under 29 CFR 

2520.103–1(d) was eligible to and filed 

as a small plan for plan year 2008 and 

did not cover more than 120 

participants at the beginning of plan 

year 2009 (see instructions for line 5); 

TIP: If a Code section 403(b) plan 

would have been eligible to file as a 

small plan under 29 CFR 2520.103–1(d) 

in 2008 (i.e., the plan was eligible to file 

in the previous year under the small 

plans requirements and has a 

participant count of less than 121 at the 

beginning of the 2009 plan year), then 

it can rely on 29 CFR 2520.103–1(d) to 

file as a small plan in 2009. 

2. The plan does not hold any 

employer securities at any time during 

the plan year; 


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3. At all times during the plan year, 

the plan is 100% invested in certain 

secure, easy to value assets such as 

mutual fund shares, investment 

contracts with insurance companies and 

banks valued at least annually, publicly 

traded securities held by a registered 

broker dealer, cash and cash 

equivalents, and plan loans to 

participants (see the instructions for line 

6a); 

4. The plan is eligible for the waiver 

of the annual examination and report of 

an independent qualified public 

accountant (IQPA) under 29 CFR 

2520.104–46 (but not by reason of 

enhanced bonding), which requirement 

includes, among others, giving certain 

disclosures and supporting documents 

to participants and beneficiaries 

regarding the plan’s investments (see 

instructions for line 6b); and 

5. The plan is not a multiemployer 

plan. 

Note: Employee stock ownership plans 

(ESOPs) and Direct Filing Entities (DFEs) 

may not file the Form 5500–SF. 

TIP: Section III of Schedule D must be 

completed by DFEs for all participating 

plans even those plans filing the Form 

5500–SF. 

Note: One-participant plans should follow 

the ‘‘Specific Instructions for One-Participant 

Plans’’ in lieu of the instructions 1–5 above. 

CAUTION: One-participant plans that 

are ESOPs cannot file the Form 5500–

SF electronically. These plans must file 

the paper Form 5500–EZ with the IRS. 

What To File 

Plans required to file an annual 

return/report that meet all of the 

conditions for filing the Form 5500–SF 

may complete and file the Form 5500–

SF in accordance with its instructions. 

Single-employer Defined Benefit 

pension plans using the Form 5500–SF 

must also file the Schedule SB (Form 

5500), Single-Employer Defined Benefit 

Plan Actuarial Information (Schedule 

SB). Money Purchase plans amortizing a 

waiver using the Form 5500–SF must 

also file the Schedule MB (Form 5500), 

Multiemployer Defined Benefit Plan and 

Certain Money Purchase Plan Actuarial 

Information (Schedule MB). See the 

instructions for Schedules SB and MB. 

One-participant plans see Specific 

Instructions for One-Participant Plans. 

Plans filing under an extension of time 

or the DOL’s Delinquent Filer Voluntary 

Compliance Program must retain the 

required supporting documentation 

with their records (see instructions for 

box C). No other schedules or 

attachments have to be filed with the 

Form 5500–SF. 

When To File 

File the 2009 Form 5500–SF for plan 

years that began in 2009. The form, and 

any required schedules and 

attachments, must be filed by the last 

day of the 7th calendar month after the 

end of the plan year (not to exceed 12 

months in length) that began in 2009. 

Note: If the filing due date falls on a 

Saturday, Sunday, or Federal holiday, the 

return may be filed on the next day that is 

not a Saturday, Sunday, or Federal holiday. 

Extension of Time To File 

Using Form 5558 

If filing under an extension of time 

based on the filing of an IRS Form 5558, 

Application For Extension Of Time To 

File Certain Employee Plan Returns 

(Form 5558), check the appropriate box 

on the Form 5500–SF, Part I, item C. A 

one-time extension of time to file the 

Form 5500–SF (up to 21⁄2 months) may 

be obtained by filing IRS Form 5558 on 

or before the normal due date (not 

including any extensions) of the annual 

return/report. You must file the Form 

5558 with the Department of the 

Treasury, Internal Revenue Service 

Center, Ogden, UT 84201–0027. A copy 

of the completed extension request must 

be retained with the filer’s records. 

Using Extension of Time To File Federal 

Income Tax Return 

An automatic extension of time to file 

Form 5500 until the due date of the 

Federal income tax return of the 

employer will be granted if all of the 

following conditions are met: (1) The 

plan year and the employer’s tax year 

are the same; (2) the employer has been 

granted an extension of time to file its 

Federal tax return to a date later than 

the normal due date for filing the Form 

5500; and (3) a copy of the application 

for extension of time to file the Federal 

income tax return is maintained with 

the filer’s records. An extension of time 

granted by using this automatic 

extension procedure CANNOT be 

extended further by filing a Form 5558, 

nor can it be extended beyond a total of 

91⁄2 months beyond the close of the plan 

year. 

Note: An extension of time to file the Form 

5500–SF Return/Report described in this 

section does not operate as an extension of 

time to file the PBGC Form 1. 

Other Extensions of Time 

The IRS, DOL, and PBGC may 

announce special extensions of time 

under certain circumstances, such as 

extensions for presidentially declared 

disasters or for service in, or in support 

of, the Armed Forces of the United 

States in a combat zone. See http:// 

www.irs.gov and http:// 

www.efast.dol.gov for announcements 

regarding such special extensions. If you 

are relying on one of these announced 

special extensions, check the 

appropriate box on the Form 5500–SF, 

Part I, Line C and enter a brief citation 

to the announcement for the extension 

in the space provided. For example, 

indicate ‘‘Disaster Relief Extension’’ or 

‘‘Combat Zone Extension.’’ 

Delinquent Filer Voluntary Compliance 

(DFVC) Program 

The DFVC Program facilitates 

voluntary compliance by plan 

administrators who are delinquent in 

filing annual return/report forms under 

Title I of ERISA by permitting 

administrators to pay reduced civil 

penalties for voluntarily complying with 

their DOL annual reporting obligations. 

If the Form 5500–SF is being filed under 

the DFVC Program, check the 

appropriate box on Form 5500–SF. See 

http://www.efast.dol.gov for information 

concerning the DFVC Program. Do not 

submit penalty payments to EFAST. 

Change in Plan Year 

Generally, only defined benefit 

pension plans need to get approval for 

a change in plan year. (See Code section 

412(c)(5)). However, under Rev. Proc. 

87–27, 1987–1 C.B. 769, these pension 

plans may be eligible for automatic 

approval of a change in plan year. 

If a change in plan year for a pension 

or a welfare plan creates a short plan 

year, file the form and applicable 

schedules by the last day of the 7th 

month after the short plan year ends. 

Fill in the short plan year beginning and 

ending dates in the space provided and 

check the appropriate box in Part I, Line 

B of the Form 5500–SF. For purposes of 

this return/report, the short plan year 

ends on the date of the change in 

accounting period or upon the complete 

distribution of assets of the plan. Also 

see the instructions for Final Return/ 

Report to determine if ‘‘the final return/ 

report’’ in Line B should be checked. 

Penalties 

Plan administrators and plan sponsors 

must provide complete and accurate 

information and must otherwise comply 

fully with the filing requirements. 

ERISA and the Code provide for the 

DOL and the IRS, respectively, to assess 

or impose penalties for not giving 

complete information and for not filing 

statements and returns/reports. Certain 

penalties are administrative (i.e., they 

may be imposed or assessed in an 

administrative proceeding by one of the 

governmental agencies delegated to 


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administer the collection of the Form 

5500–SF data). Others require a legal 

conviction. 

Administrative Penalties 

Listed below are various penalties 

under ERISA and the Code that may be 

assessed or imposed for not meeting the 

annual return/report filing 

requirements. Generally, whether the 

penalty is assessed under ERISA or the 

Code, or both, depends upon the agency 

for which the information is required to 

be filed. One or more of the following 

administrative penalties may be 

assessed or imposed in the event of 

incomplete filings or filings received 

after the due date unless it is 

determined that your explanation for 

failure to file properly is for reasonable 

cause: 

1. A penalty of up to $1,100 a day for 

each day a plan administrator fails or 

refuses to file a complete report. See 

ERISA section 502(c)(2) and 29 CFR 

2560.502c–2. 

2. A penalty of $25 a day (up to 

$15,000) for not filing returns for certain 

plans of deferred compensation, trusts, 

and annuities, and bond purchase plans 

by the due date(s). See Code section 

6652(e). 

3. A penalty of $1,000 for not filing 

an actuarial statement. See Code section 

6692. 

Other Penalties 

1. Any individual who willfully 

violates any provision of Part 1 of Title 

I of ERISA shall be fined not more than 

$100,000 or imprisoned not more than 

10 years, or both. See ERISA section 

501. 

2. A penalty up to $10,000, five (5) 

years imprisonment, or both, may be 

imposed for making any false statement 

or representation of fact, knowing it to 

be false, or for knowingly concealing or 

not disclosing any fact required by 

ERISA. See section 1027, Title 18, U.S. 

Code, as amended by section 111 of 

ERISA. 

How To File—Electornic Filing 

Requirement 

Under the computerized ERISA Filing 

Acceptance System (EFAST), you must 

file your 2009 Form 5500–SF 

electronically. You may file your 2009 

Form 5500–SF on-line, using EFAST’s 

web-based filing system, or you may file 

through an EFAST-approved vendor. 

Detailed information on electronic filing 

is available at (insert web address). For 

telephone assistance, call the EFAST 

Help Line at [number to be provided]. 

The EFAST Help Line is available 

Monday through Friday from 8 a.m. to 

8 p.m., Eastern Time. 

CAUTION: Annual reports filed under 

Title I of ERISA must be made available 

by plan administrators to plan 

participants and by the DOL to the 

public pursuant to ERISA sections 104 

and 106. Even though the Form 5500–

SF must be filed electronically, the 

administrator must keep a copy of the 

Form 5500–SF, including schedules and 

attachments, with all required manual 

signatures on file as part of the plan’s 

records and must make a paper copy 

available on request to participants, 

beneficiaries, and the DOL as required 

by section 104 of ERISA and 29 CFR 

2520.103–1. 

Answer all questions with respect to 

the plan year unless otherwise explicitly 

stated in the instructions or on the form 

itself. Therefore, responses usually 

apply to the year entered at the top of 

the first page of the form. 

Your entries will be screened. Your 

entries must satisfy this screening in 

order to be filed. Once filed, your form 

may be subject to further detailed 

review, and your filing may be rejected 

based upon this further review. To 

reduce the possibility of correspondence 

and penalties: 

• Complete all lines on the Form 

5500–SF unless otherwise specified. 

Also complete or electronically attach, 

as required, any applicable schedules 

and attachments. 

• Do not enter ‘‘N/A’’ or ‘‘Not 

Applicable’’ on the Form 5500–SF or 

Schedules SB/MB unless specifically 

permitted. ‘‘Yes’’ or ‘‘No’’ questions on 

the forms and schedules cannot be left 

blank, but must be answered either 

‘‘Yes’’ or ‘‘No,’’ and not both. 

The Form 5500–SF, Schedules SB/ 

MB, and any attachments are open to 

public inspection, and the contents are 

public information subject to 

publication on the Internet. Do not enter 

social security numbers in response to 

questions asking for an employer 

identification number (EIN). Because of 

privacy concerns, the inclusion of a 

social security number on the Form 

5500–SF or on a schedule or attachment 

that is open to public inspection may 

result in the rejection of the filing. 

EINs may be obtained by applying for 

one on Form SS–4, Application for 

Employer Identification Number. You 

can obtain Form SS–4 by calling 1–800–

TAX–FORM (1–800–829–3676) or at the 

IRS Web site at http://www.irs.gov. The 

EBSA does not issue EINs. 

Signature and Date 

The Form 5500–SF Annual Return/ 

Report and any applicable schedules 

must be signed and dated. The 

administrator is required under ERISA 

to maintain a copy of the annual report 

with all required signatures, as part of 

the plan’s records, even though the 

return/report is filed electronically. See 

29 CFR 2520.103–1. 

Electronic signatures on annual 

returns/reports filed under EFAST2 are 

affected by the applicable statutory and 

regulatory requirements. Information on 

those requirements will be made 

available for electronic filing under 

EFAST2. 

Specific Instructions for OneParticipant Plans 

A one-participant plan is: (1) A 

pension benefit plan that covers only an 

individual or an individual and his or 

her spouse who wholly own a trade or 

business, whether incorporated or 

unincorporated; or (2) a pension benefit 

plan for a partnership that covers only 

the partners or the partners and the 

partners’ spouses. One-participant plans 

may be eligible to file an abbreviated 

version of the Form 5500–SF 

electronically or the paper Form 5500–

EZ with the IRS. 

One-participant plan filers that meet 

the following conditions are eligible to 

file an abbreviated Form 5500–SF 

electronically: 

1. The plan is a one-participant plan. 

2. The plan meets the minimum 

coverage requirements of section 410(b) 

without being combined with any other 

plan you may have that covers other 

employees of your business. 

3. The plan does not provide benefits 

for anyone except you, or you and your 

spouse, or one or more partners and 

their spouses. 

4. The plan does not hold any 

employer securities. 

If you do not meet all the conditions 

listed above, you must file either the 

complete Form 5500–SF or the Form 

5500–EZ. If you do not meet the fourth 

condition, you are not eligible to file the 

Form 5500–SF and must file the 

complete Form 5500–EZ. 

One-participant plans complete only 

the following questions on the Form 

5500–SF: Part I items A, B and C, Part 

II lines 1a–5a, Part III lines 7a–c, 8a, Part 

IV line 9a, Part V line 10g, Part VI lines 

11–12e. 

Note: A Form 5500–SF may be filed for 

one-participant plans that are either defined 

contribution plans (which include profitsharing and money purchase pension plans, 

but not an ESOP or stock bonus plan) or 

defined benefit plans. 

Note: Actuaries of one-participant plans 

that are defined benefit plans subject to the 

minimum funding standards for this plan 

year must complete Schedule SB and forward 

the completed Schedule SB to the person 

responsible for filing the Form 5500–SF. The 

completed Schedule SB is subject to the 


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records retention provisions of these 

instructions. See the instruction for Schedule 

SB. 

Note: If you are filing a paper form, you 

must file the Form 5500–EZ with the IRS 

(address to be added). You may order the 

paper Form 5500–EZ by calling 1–800–TAX–

FORM (1–800–829–3676). 

Note: If you are filing an amendment for a 

one-participant plan that filed a Form 5500–

SF electronically, you must submit the 

amendment using the Form 5500–SF 

electronically as well. Similarly, if you are 

filing an amendment for a one-participant 

plan that previously filed on a paper Form 

5500–EZ, you must submit the amendment 

using the paper Form 5500–EZ with the IRS. 

Specific Line by Line Instructions 

Part I—Annual Report Identification 

Information 

Box A—Single-Employer Plan. Check 

this box if the Form 5500–SF is filed for 

a single-employer plan. A singleemployer plan for purposes of the Form 

5500–SF is an employee benefit plan 

maintained by one employer or one 

employee organization. 

Box A—Multiple-Employer Plan. 

Check this box if the Form 5500–SF is 

being filed for a multiple-employer 

plan. A multiple-employer plan is a 

plan that is maintained by more than 

one employer and is not a 

multiemployer plan. Multiple-employer 

plans can be collectively bargained and 

collectively funded, but if covered by 

PBGC termination insurance, must have 

properly elected before September 27, 

1981, not to be treated as a 

multiemployer plan under Code section 

414(f)(5) or ERISA sections 3(37)(E) and 

4001(a)(3), and have not revoked that 

election, or made an election to be 

treated as a multiemployer plan under 

Code section 414(f)(6) or ERISA section 

3(37)(G). Participating employers do not 

file individually for multiple-employer 

plans. Do not check this box if the 

employers maintaining the plan are 

members of the same controlled group. 

CAUTION: Multiemployer plans 

cannot use the Form 5500–SF to satisfy 

their annual reporting obligations. They 

must file the Form 5500. For these 

purposes, a plan is a multiemployer 

plan if: (a) More than one employer is 

required to contribute; (b) the plan is 

maintained pursuant to one or more 

collective bargaining agreements 

between one or more employee 

organizations and more than one 

employer; and (c) an election under 

Code section 414(f)(5) and ERISA 

section 3(37)(E) has not been made. A 

plan that made a proper election under 

ERISA section 3(37)(G) and Code 

section 414(f)(6) on or before Aug. 17, 

2007, is also a multiemployer plan. 

Box A—One-Participant Plan. Check 

this box if the Form 5500–SF is being 

filed for a plan that is: (1) A pension 

benefit plan that covers only an 

individual or an individual and his or 

her spouse who wholly own a trade or 

business, whether incorporated or 

unincorporated; or (2) a pension benefit 

plan for a partnership that covers only 

the partners, or the partners and the 

partners’ spouses. See Specific 

Instructions for One-Participant Plans. 

Box B—First Annual Return/Report. 

Check this box if an annual return/ 

report has not been previously filed for 

this plan. For the purpose of completing 

box B, the Form 5500–EZ is not 

considered an annual return/report. 

Box B—Amended Return/Report. 

Check this box if you have already filed 

for the 2009 plan year and are now 

filing an amended return to correct 

errors and/or omissions on the 

previously filed return/report. 

Note: File an amended return/report to 

correct errors and/or omissions in a 

previously filed annual return/report for the 

2009 plan year. The amended Form 5500–SF 

and any amended schedules must conform to 

the requirements in these instructions. If you 

need to file an amended return/report to 

correct errors and or omissions in a 

previously filed annual return/report for the 

2009 plan year AND you are eligible to file 

the Form 5500–SF, you may use the Form 

5500-SF even if the original filing was a Form 

5500. If you determine that you were not 

eligible to file the Form 5500–SF, your 

amended return/report must be the Form 

5500. 

Box B—Final Return/Report. Check 

this box if this is the final report for the 

plan. Only check this box if all assets 

under the plan (including insurance/ 

annuity contracts) have been distributed 

to the participants and beneficiaries or 

legally transferred to the control of 

another plan, and when all liabilities for 

which benefits may be paid under a 

welfare benefit plan have been satisfied. 

Do not mark final return/report if you 

are reporting participants and/or assets 

at the end of the plan year. If a trustee 

is appointed for a terminated defined 

benefit plan pursuant to ERISA section 

4042, the last plan year for which a 

return/report must be filed is the year in 

which the trustee is appointed. 

Examples 

Mergers/Consolidations 

A final return/report should be filed 

for the plan year (12 months or less) that 

ends when all plan assets were legally 

transferred to the control of another 

plan. 

Pension and Welfare Plans That 

Terminated Without Distributing All 

Assets 

If the plan was terminated but all plan 

assets were not distributed, a return/ 

report must be filed for each year the 

plan has assets. The return/report must 

be filed by the plan administrator, if 

designated, or by the person or persons 

who actually control the plan’s assets/ 

property. 

Welfare Plans Still Liable To Pay 

Benefits 

A welfare plan cannot file a final 

return/report if the plan is still liable to 

pay benefits for claims that were 

incurred prior to the termination date, 

but not yet paid. See 29 CFR 2520.104b–

2(g)(2)(ii). 

Box B—Short Plan Year. Check this 

box if this form is filed for a period of 

less than 12 months. Show the dates in 

the space provided. 

Box C. Check the appropriate entry 

here if: 

• You filed for an extension of time 

to file this form with the IRS using a 

completed Form 5558, Application for 

Extension of Time To File Certain 

Employee Plan Returns (maintain a 

copy of the Form 5558 with the filer’s 

records). 

• You are filing using the automatic 

extension of time to file the Form 5500 

Return/Report until the due date of the 

Federal income tax return of the 

employer (maintain a copy of the 

employer’s extension of time to file the 

income tax return with the filer’s 

records). 

• You are filing using a special 

extension of time to file the Form 5500 

Return/Report that has been announced 

by the IRS, DOL, and PBGC. If you 

checked that you are using a special 

extension of time, enter a description of 

the extension of time in the space 

provided. 

Part II—Basic Plan Information 

Line 1a. Enter the formal name of the 

plan or enough information to identify 

the plan. Abbreviate if necessary. If an 

annual return/report has previously 

been filed on behalf of the plan, 

regardless of the type of Form that was 

filed (Form 5500, Form 5500-EZ, Form 

5500-SF) use the same abbreviation as 

was used on the prior filings. Once you 

use an abbreviation, continue to use it 

for that plan on all future annual return/ 

report filings with the IRS, DOL, and 

PBGC. Do not use the same name or 

abbreviation for any other plan, even if 

the first plan is terminated. 

Line 1b. Enter the three-digit plan or 

entity number (PN) that the employer or 


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plan administrator assigned to the plan. 

This three-digit number, in conjunction 

with the employer identification 

number (EIN) entered on line 2b, is used 

by the IRS, DOL, and PBGC as a unique 

12-digit number to identify the plan. 

Start at 001 for plans providing 

pension benefits. Start at 501 for welfare 

plans. Do not use 888 or 999. 

Once you use a plan number, 

continue to use it for that plan on all 

future filings with the IRS, DOL, and 

PBGC. Do not use it for any other plan, 

even if the first plan is terminated. 

For each Form 

5500–SF with same 

EIN (line 2b), when 

Assign PN 

Codes are entered in 

line 9a.

• 001 to the first 

plan. 

• Consecutively number others as 002, 

003 . . . 

Codes are entered in 

line 9b, and not in 

line 9a.

• 501 to the first 

plan. 

• Consecutively number others at 502, 

503 . . . 

Line 1c. Enter the date the plan first 

became effective. 

Line 2a. Enter the plan sponsor’s 

(employer, if for a single-employer plan) 

name, postal address (only use a P.O. 

Box number if the Post Office does not 

deliver mail to the employer’s street 

address), foreign routing code where 

applicable, and D/B/A (doing business 

as) or trade name of the employer if 

different from the employer’s name. 

Note: In the case of a multiple-employer 

plan, if an association or similar entity is not 

the sponsor, enter the name of a participating 

employer as sponsor. A plan of a controlled 

group of corporations should enter the name 

of one of the sponsoring members. In either 

case, the same name must be used in all 

subsequent filings of the Form 5500 Return/ 

Report for the multiple-employer plan or 

controlled group (see instructions to line 4 

concerning change in sponsorship). 

Line 2b. Enter the employer’s ninedigit employer identification number 

(EIN). Do not use a Social Security 

Number. The Form 5500–SF is open to 

public inspection, and the contents are 

public information and are subject to 

publication on the Internet. Because of 

privacy concerns, the inclusion of a 

Social Security Number on this line may 

result in the rejection of the filing. 

Employers who do not have an EIN 

must apply for one on Form SS–4, 

Application for Employer Identification 

Number, as soon as possible. You can 

obtain Form SS–4 by calling 1–800–

TAX–FORM (1–800–829–3676) or at the 

IRS Web Site at http://www.irs.gov. The 

EBSA does not issue EINs. 

A multiple-employer plan or plan of 

a controlled group of corporations 

should use the EIN of the sponsor 

identified in line 2a. The EIN must be 

used in all subsequent filings of the 

Form 5500–SF (or any subsequent Form 

5500 in a year where the plan is not 

eligible to file the Form 5500–SF) for 

these plans. (See instructions to line 4 

concerning change in EIN). 

Note: EINs for funds (trusts or custodial 

accounts) associated with plans are generally 

not required to be furnished on the Form 

5500–SF. The IRS, however, will issue EINs 

for such funds for other reporting purposes. 

EINs may be obtained by filing Form SS–4 as 

explained above. Plan sponsors should use 

the trust EIN when opening a bank account 

or conducting other transactions for a trust. 

Line 2c. Enter the telephone number 

for the plan sponsor. 

Line 2d. Enter the six-digit business 

code that best describes the nature of 

the plan sponsor’s business from the list 

of business codes. If more than one 

employer or employee organization is 

involved, enter the business code for the 

main business activity of the employers 

and/or employee organizations. 

Line 3a. Enter the plan administrator’s 

name, postal address (only use a P.O. 

Box number if the Post Office does not 

deliver mail to the employer’s street 

address), and foreign routing code 

where applicable. Enter ‘‘Same’’ if the 

plan administrator identified on line 3 

is the same as the plan sponsor 

identified on line 2. 

Plan administrator for this purpose 

means: 

• The person or group of persons 

specified as the administrator by the 

instrument under which the plan is 

operated; 

• The plan sponsor/employer if an 

administrator is not so designated; or 

• Any other person prescribed by 

regulations if an administrator is not 

designated and a plan sponsor cannot be 

identified. 

Line 3b. Enter the plan administrator’s 

nine-digit EIN. A plan administrator 

must have an EIN for Form 5500–SF 

reporting. If the plan administrator does 

not have an EIN, it must apply for one 

as explained in the instructions for line 

2b. One EIN should be entered for a 

group of individuals who are, 

collectively, the plan administrator. 

Note: Employees of the plan sponsor who 

perform administrative functions for the plan 

are generally not the plan administrator 

unless specifically designated in the plan 

document. If an employee of the plan 

sponsor is designated as the plan 

administrator, that employee must obtain an 

EIN. 

Line 3c. Enter the telephone number 

for the plan administrator. 

Line 4. If the plan sponsor’s name 

and/or EIN have changed since the last 

annual return/report was filed for this 

plan, enter the plan sponsor’s name, 

EIN, and the plan number as it appeared 

on the last annual return/report filed. 

CAUTION: Failure to indicate on line 

4 that a plan was previously identified 

by a different EIN or PN could result in 

correspondence from the DOL and the 

IRS. 

Line 5. Enter in element (a) the total 

number of participants at the beginning 

of the plan year. Enter in element (b) the 

total number of participants at the end 

of the plan year. Enter in element (c) the 

total number of participants with 

account balances as of the end of the 

plan year. Welfare plans and defined 

benefit plans do not complete element 

(c). 

The description of ‘‘participant’’ in 

the instructions below is only for 

purposes of these lines. 

An individual becomes a participant 

covered under an employee welfare 

benefit plan on the earliest of: the date 

designated by the plan as the date on 

which the individual begins 

participation in the plan; the date on 

which the individual becomes eligible 

under the plan for a benefit subject only 

to occurrence of the contingency for 

which the benefit is provided; or the 

date on which the individual makes a 

contribution to the plan, whether 

voluntary or mandatory. See 29 CFR 

2510.3–3(d)(1). This includes former 

employees who are receiving group 

health continuation coverage benefits 

pursuant to Part 6 of ERISA and who are 

covered by the employee welfare benefit 

plan. Covered dependents are not 

counted as participants. A child who is 

an ‘‘alternate recipient’’ entitled to 

health benefits under a qualified 

medical child support order (QMCSO) 

should not be counted as a participant 

for line 5. An individual is not a 

participant covered under an employee 

welfare plan on the earliest date on 

which the individual is ineligible to 

receive any benefit under the plan even 

if the contingency for which such 

benefit is provided should occur, and is 

not designated by the plan as a 

participant. See 29 CFR 2510.3–3(d)(2). 

TIP: Before counting the number of 

participants, especially in a welfare 

plan, it is important to determine 

whether the plan sponsor has 

established one or more plans for Form 

5500/Form 5500–SF reporting purposes. 

As a matter of plan design, plan 

sponsors can offer benefits through 

various structures and combinations. 

For example a plan sponsor could create 

(i) one plan providing major medical 

benefits, dental benefits, and vision 


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benefits, (ii) two plans with one 

providing major medical benefits and 

the other providing self-insured dental 

and vision benefits, or (iii) three 

separate plans. You must review the 

governing documents and actual 

operations to determine whether welfare 

benefits are being provided under a 

single plan or separate plans. 

The fact that you have separate 

insurance policies for each different 

welfare benefit does not necessarily 

mean that you have separate plans. 

Some plan sponsors use a ‘‘wrap’’

document to incorporate various 

benefits and insurance policies into one 

comprehensive plan. In addition, 

whether a benefit arrangement is 

deemed to be a single plan may be 

different for purposes other than Form 

5500–SF reporting. For example, special 

rules may apply for purposes of HIPAA, 

COBRA, and Internal Revenue Code 

compliance. If you need help 

determining whether you have a single 

welfare benefit plan for Form 5500–SF 

reporting purposes, you should consult 

a qualified benefits consultant or legal 

counsel. 

For pension benefit plans, ‘‘alternate 

payees’’ entitled to benefits under a 

qualified domestic relations order 

(QDRO) are not to be counted as 

participants for this line. 

For pension benefit plans, 

‘‘participant’’ for this line means any 

individual who is included in one of the 

categories below: 

1. Active participants, i.e., any 

individuals who are currently in 

employment covered by a plan and who 

are earning or retaining credited service 

under a plan. This includes any 

individuals who are eligible to elect to 

have the employer make payments into 

a Code section 401(k) qualified cash or 

deferred arrangement. Active 

participants also include any nonvested 

individuals who are earning or retaining 

credited service under a plan. This does 

not include (a) nonvested former 

employees who have incurred the break 

in service period specified in the plan 

or (b) former employees who have 

received a ‘‘cash-out’’ distribution or 

deemed distribution of their entire 

nonforfeitable accrued benefit. 

2. Retired or separated participants 

receiving benefits, i.e., individuals who 

are retired or separated from 

employment covered by the plan and 

who are receiving benefits under the 

plan. This does not include any 

individual to whom an insurance 

company has made an irrevocable 

commitment to pay all the benefits to 

which the individual is entitled under 

the plan. 

3. Other retired or separated 

participants entitled to future benefits, 

i.e., any individuals who are retired or 

separated from employment covered by 

the plan and who are entitled to begin 

receiving benefits under the plan in the 

future. This does not include any 

individual to whom an insurance 

company has made an irrevocable 

commitment to pay all the benefits to 

which the individual is entitled under 

the plan. 

4. Deceased individuals who had one 

or more beneficiaries who are receiving 

or are entitled to receive benefits under 

the plan. This does not include any 

individual to whom an insurance 

company has made an irrevocable 

commitment to pay all the benefits to 

which the beneficiaries of that 

individual are entitled under the plan. 

Note: One-participant plans skip to Part III. 

Line 6. Except for one-participant 

plans filing the Form 5500–SF in 

accordance with the instructions, to be 

eligible to file the Form 5500–SF, a 

pension or welfare plan must: (1) Cover 

fewer than 100 participants or be a 

pension plan eligible to file as a small 

plan under the 80 to 120 rule in 29 CFR 

2520.103–1(d); (2) be eligible for the 

small plan audit waiver under 29 CFR 

2520.104–46 (but not by virtue of 

enhanced bonding); (3) hold no 

employer securities; (4) have 100% of 

its assets in investments that have a 

readily determinable fair market value 

for purposes of this annual reporting 

requirement as described in 29 CFR 

2520.103–1(c)(2)(ii)(C); and (5) must not 

be a multiemployer plan. 

Line 6a. To be eligible to file the Form 

5500–SF, all of the plan’s assets must be 

‘‘eligible plan assets.’’ Answer line 6a 

‘‘Yes’’ or ‘‘No.’’ Do not leave this 

question blank. If the answer to line 6a 

is ‘‘No’’ you CANNOT file the Form 

5500–SF and must file the Form 5500. 

See discussion under Who May File 

Form 5500–SF. 

For purposes of this line, ‘‘eligible 

plan assets’’ are assets that have a 

readily determinable fair market value 

for purposes of this annual reporting 

requirement as described in 29 CFR 

2520.103–1(c)(2)(ii)(C), are not employer 

securities, and are held or issued by one 

of the following regulated financial 

institutions: a bank or similar financial 

institution as defined in 29 CFR 

2550.408b–4(c) (for example, banks, 

trust companies, savings and loan 

associations, domestic building and 

loan associations, and credit unions); an 

insurance company qualified to do 

business under the laws of a state; 

organizations registered as brokerdealers under the Securities Exchange 

Act of 1934; investment companies 

registered under the Investment 

Company Act of 1940; or any other 

organization authorized to act as a 

trustee for individual retirement 

accounts under Code section 408. 

Examples of assets that would qualify as 

eligible plan assets for this annual 

reporting purpose are: mutual fund 

shares; investment contracts with 

insurance companies or banks that 

provide the plan with valuation 

information at least annually; publicly 

traded stock held by a registered broker 

dealer; and cash and cash equivalents 

held by a bank. Participant loans 

meeting the requirements of ERISA 

section 408(b)(1) are also ‘‘eligible plan 

assets’’ for this purpose whether or not 

they have been deemed distributed. 

Line 6b. In addition to all of the plan’s 

assets being eligible plan assets as 

defined in line 6a, to be able to file the 

Form 5500–SF the plan also must be 

exempt from the requirement to be 

audited annually by an IQPA. 

Welfare plans that cover fewer than 

100 participants at the beginning of the 

plan year are exempt from the annual 

audit requirement. A pension plan is 

exempt from the annual audit 

requirement if it covered fewer than 100 

participants at the beginning of the plan 

year or is eligible to file as a small plan 

under the 80 to 120 rule (described 

above) and meets the following three 

requirements for the audit waiver under 

29 CFR 2520.104–46: (1) As of the end 

of the preceding plan year at least 95% 

of a small pension plan’s assets were 

‘‘qualifying plan assets;’’ (2) the plan 

includes the required audit waiver 

disclosure in the Summary Annual 

Report (SAR), or, in the case of plans 

subject to section 101(f) of the Act, the 

annual funding notice (described in 

§ 2520.101–5), furnished to participants 

and beneficiaries (see 29 CFR 2520.104–

46 and 2520.104b–10(d)(3) for a model 

audit waiver disclosure); and (3) in 

response to a request from any 

participant or beneficiary, the plan 

administrator must furnish without 

charge copies of statements from the 

regulated financial institutions holding 

or issuing the plan’s ‘‘qualifying plan 

assets.’’

‘‘Qualifying plan assets’’ for the 

purpose of determining whether the 

plan is exempt from the requirement to 

be audited annually by an IQPA 

include: shares issued by an investment 

company registered under the 

Investment Company Act of 1940 (e.g., 

mutual fund shares); investment and 

annuity contracts issued by any 

insurance company qualified to do 

business under the laws of a state; 

participant loans meeting the 


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requirements of ERISA section 

408(b)(1), whether or not they have been 

deemed distributed, and any eligible 

assets, e.g., publicly traded stocks and 

bonds, held by banks or similar 

financial institutions, including trust 

companies, savings and loan 

associations, domestic building and 

loan associations, and credit unions; 

insurance companies qualified to do 

business under the laws of a state; 

organizations registered as brokerdealers under the Securities Exchange 

Act of 1934; investment companies 

registered under the Investment 

Company Act of 1940; or any other 

organization authorized to act as a 

trustee for individual retirement 

accounts under Code section 408. In the 

case of an individual account plan, 

‘‘qualifying plan assets’’ also include 

any assets in the individual account of 

a participant or beneficiary over which 

the participant or beneficiary had the 

opportunity to exercise control and with 

respect to which the participant or 

beneficiary has been furnished, at least 

annually, a statement from one of the 

above regulated financial institutions 

describing the plan assets held or issued 

by the institution and the amount of 

such assets. 

CAUTION: In order to be able to file 

the Form 5500–SF, a small plan must 

meet the audit waiver conditions by 

virtue of having 95% or more of its 

assets as qualifying plan assets in 

accordance with 29 CFR 2520.104–

46(b)(1)(i)(A)(1). If the small plan 

satisfies the conditions of the audit 

waiver by virtue of having enhanced 

fidelity bond under 29 CFR 2520.104–

46(b)(1)(i)(A)(2), the plan does not 

satisfy the conditions for filing the Form 

5500–SF and must file the Form 5500, 

along with the appropriate schedules 

and attachments. Also, many 

‘‘qualifying plan assets’’ for audit waiver 

purposes will also be ‘‘eligible plan 

assets’’ as described in the instructions 

for line 6a, but the definitions are not 

the same. For example, real estate held 

by a bank as trustee for a plan could be 

a qualifying plan asset for purposes of 

the small pension plan audit waiver 

conditions but it would not be a 

‘‘eligible plan asset’’ for purposes of the 

plan being eligible to file the Form 

5500–SF because real estate would not 

have a readily determinable fair market 

value as described in described in 29 

CFR 2520.103–1(c)(2)(ii)(C). 

Part III—Financial Information 

Note: The cash, modified cash, or accrual 

basis may be used for recognition of 

transactions in Parts I and II, as long as you 

use one method consistently. Round off all 

amounts reported on the Form 5500–SF to 

the nearest dollar. Any other amounts are 

subject to rejection. Check all subtotals and 

totals carefully. 

Current value means fair market value 

where available. Otherwise, it means the 

fair value as determined in good faith 

under the terms of the plan by a trustee 

or a named fiduciary, assuming an 

orderly liquidation at the time of the 

determination. See ERISA section 3(26). 

Line 7—Plan Assets and Liabilities. 

Amounts reported on line 7a, 7b, and 

7c for the beginning of the plan year 

must be the same as reported for the end 

of the plan year for the corresponding 

lines on the return/report for the 

preceding plan year. That means that if 

the Form 5500 was filed for plan year 

2008, the amounts reported on the Form 

5500–SF line 7a, column (a), 7b, column 

(a), and 7c, column (a) should 

correspond to the amounts entered in 

line 1a, column (b), 1b, column (b), and 

1c, column (b) of the 2008 Schedule I 

(Form 5500) or the amounts entered in 

line 1f, column (b), 1k, column (b), and 

1l, column (b) of the 2008 Schedule H 

(Form 5500), whichever schedule was 

filed. 

Line 7a. Enter the total amount of plan 

assets at the beginning of the plan year 

in column (a). Do not include 

contributions designated for the 2009 

plan year in column (a). 

Enter the total amount of plan assets 

at the end of the plan year in column 

(b). Do not include in column (b) a 

participant loan that has been deemed 

distributed during the plan year under 

the provisions of Code section 72(p) and 

Treasury Regulation section 1.72(p)-1, if 

both the following circumstances apply: 

(1) Under the plan, the participant loan 

is treated as a direct investment solely 

of the participant’s individual account; 

and (2) as of the end of the plan year, 

the participant is not continuing 

repayment under the loan. 

If the deemed distributed participant 

loan is included in column (a) and both 

of these circumstances apply, include 

the value of the loan as a deemed 

distribution on line 8e. However, if 

either of these two circumstances does 

not apply, the current value of the 

participant loan (including interest 

accruing thereon after the deemed 

distribution) should be included in 

column (b) without regard to the 

occurrence of a deemed distribution. 

After a participant loan that has been 

deemed distributed is included in the 

amount reported on line 8e, it is no 

longer to be reported as an asset on line 

7a unless, in a later year, the participant 

resumes repayment under the loan. 

However, such a loan (including interest 

accruing thereon after the deemed 

distribution) that has not been repaid is 

still considered outstanding for 

purposes of applying Code section 

72(p)(2)(A) to determine the maximum 

amount of subsequent loans. Also, the 

deemed distribution is not treated as an 

actual distribution for other purposes, 

such as the qualification requirements 

of Code section 401, including, for 

example, the determination of top-heavy 

status under Code section 416 and the 

vesting requirements of Treasury 

Regulation section 1.411(a)-7(d)(5). See 

Q&As 12 and 19 of Treasury Regulation 

section 1.72(p)-1. 

The entry on line 7a, column (b) (plan 

assets at end of year) must include the 

current value of any participant loan 

included as a deemed distribution in the 

amount reported for any earlier year if, 

during the plan year, the participant 

resumes repayment under the loan. In 

addition, the amount to be entered on 

line 8e must be reduced by the amount 

of the participant loan reported as a 

deemed distribution for the earlier year. 

Line 7b. Enter the total liabilities at 

the beginning and end of the plan year. 

Liabilities to be entered here do not 

include the value of future pension 

payments to participants. The amount to 

be entered in line 7b for accrual basis 

filers includes, among other things: 

1. Benefit claims that have been 

processed and approved for payment by 

the plan but have not been paid 

(including all incurred but not reported 

welfare benefit claims); 

2. Accounts payable obligations owed 

by the plan that were incurred in the 

normal operations of the plan but have 

not been paid; and 

3. Other liabilities such as acquisition 

indebtedness and any other amount 

owed by the plan. 

Line 7c. Enter the net assets as of the 

beginning and end of the plan year. 

(Subtract line 7b from 7a). Line 7c, 

column (b) must equal the sum of line 

7c, column (a), plus lines 8i (net income 

(loss)) and 8j (transfers to (from) the 

plan). 

Line 8—Income, Expenses, and 

Transfers for this Plan Year 

Line 8a. Include the total cash 

contributions received and/or (for 

accrual basis plans) due to be received. 

Line 8a(1). Plans using the accrual 

basis of accounting must not include 

contributions designated for years 

before the 2009 plan year on line 8a(1). 

Line 8a(2). For welfare plans, report 

all employee contributions, including 

all elective contributions under a 

cafeteria plan (Code section 125). For 

pension plans, participant 

contributions, for purposes of this item, 

also include elective contributions 

under a qualified cash or deferred 

arrangement (Code section 401(k)). 


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Line 8a(3). Enter the current value, at 

date contributed, of all other 

contributions, including rollovers from 

other plans. 

Line 8b. Enter all other plan income 

for the plan year. Do not include 

transfers from other plans that are 

reported on line 8j. Examples of other 

income received and/or receivable 

include: 

1. Interest on investments (including 

money market accounts, sweep 

accounts, etc.) 

2. Dividends. (Accrual basis plans 

should include dividends declared for 

all stock held by the plan even if the 

dividends have not been received as of 

the end of the plan year.) 

3. Net gain or loss from the sale of 

assets. 

4. Other income such as unrealized 

appreciation (depreciation) in plan 

assets. 

Line 8c. Enter the total of all cash 

contributions (line 8a(1) through 8a(3)) 

and other plan income (line 8b) during 

the plan year. If entering a negative 

number, enter a minus sign ‘‘¥’’ to the 

left of the number. 

Line 8d. Include (1) payments made 

(and for accrual basis filers payments 

due) to or on behalf of participants or 

beneficiaries in cash, securities, or other 

property (including rollovers of an 

individual’s accrued benefit or account 

balance). Include all eligible rollover 

distributions as defined in Code section 

401(a)(31)(D) paid at the participant’s 

election to an eligible retirement plan 

(including an IRA within the meaning of 

section 401(a)(31)(E)); (2) payments to 

insurance companies and similar 

organizations such as Blue Cross, Blue 

Shield, and health maintenance 

organizations for the provision of plan 

benefits (e.g., paid-up annuities, 

accident insurance, health insurance, 

vision care, dental coverage, etc.); and 

(3) payments made to other 

organizations or individuals providing 

benefits. Generally, these payments 

discussed in (3) are made to individual 

providers of welfare benefits such as 

legal services, day care services, and 

training and apprenticeship services. If 

securities or other property are 

distributed to plan participants or 

beneficiaries, include the current value 

of the date of distribution. 

Line 8e. Include on this line all 

distributions paid during the plan year 

of excess deferrals under Code section 

402(g)(2)(A)(ii), excess contributions 

under Code section 401(k)(8), and 

excess aggregate contributions under 

Code section 401(m)(6). Include 

allocable income distributed. Also 

include on this line any elective 

deferrals and employee contributions 

distributed or returned to employees 

during the plan year in accordance with 

Treasury Regulation section 1.415–

6(b)(6)(iv), as well as any attributable 

gains that were also distributed. 

For line 8e, also include in the total 

amount a participant loan included in 

line 7a, column (a) that has been 

deemed distributed during the plan year 

under the provisions of Code section 

72(p) and Treasury Regulation section 

1.72(p)–1 only if both of the following 

circumstances apply: 

1. Under the plan, the participant loan 

is treated as a directed investment solely 

of the participant’s individual account; 

and 

2. As of the end of the plan year, the 

participant is not continuing repayment 

under the loan. 

If either of these circumstances does 

not apply, a deemed distribution of a 

participant loan should not be included 

in the total on line 8e. Instead, the 

current value of the participant loan 

(including interest accruing thereon 

after the deemed distribution) should be 

included on lines 7a, column (b) (plan 

assets—end of year), and 10j 

(participant loans—end of year), 

without regard to the occurrence of a 

deemed distribution. 

Note: The amount to be reported on line 8e 

must be reduced if, during the plan year, a 

participant resumes repayment under a 

participant loan reported as a deemed 

distribution on line 2g of Schedule H or 

Schedule I of a prior Form 5500 or line 8e 

of a prior Form 5500–SF for any earlier year. 

The amount of the required reduction is the 

amount of the participant loan that was 

reported as a deemed distribution on such 

line for any earlier year. If entering a negative 

number, enter a minus sign ‘‘¥’’ to the left 

of the number. The current value of the 

participant loan must then be included in 

line 7a, column (b) (plan assets—end of year). 

Although certain participant loans 

deemed distributed are to be reported 

on line 8e, and are not to be reported on 

the Form 5500–SF or on the Schedule 

H or Schedule I of the Form 5500 as an 

asset thereafter (unless the participant 

resumes repayment under the loan in a 

later year), they are still considered 

outstanding loans and are not treated as 

actual distributions for certain purposes. 

See Q&As 12 and 19 of Treasury 

Regulation section 1.72(p)–1. 

Line 8f. The amount to be reported for 

expenses involving administrative 

service providers (salaries, fees, and 

commissions) include the total fees paid 

(or in the case of accrual basis plans, 

costs incurred during the plan year but 

not paid as of the end of the plan year) 

by the plan for, among others: 

1. Salaries to employees of the plan; 

2. Fees and expenses for accounting, 

actuarial, legal, investment 

management, investment advice, and 

securities brokerage services; 

3. Contract administrator fees; and 

4. Fees and expenses for individual 

plan trustees, including reimbursement 

for travel, seminars, and meeting 

expenses. 

Line 8g. Other expenses (paid and/or 

payable) include other administrative 

and miscellaneous expenses paid by or 

charged to the plan, including among 

others office supplies and equipment, 

telephone, and postage. 

Line 8h. Enter the total of all benefits 

paid or due reported on lines 8d and 8e 

and all other plan expenses reported on 

lines 8f and 8g during the year. 

Line 8i. Subtract line 8h from line 8c. 

Line 8j. Enter the net value of all 

assets transferred to and from the plan 

during the plan year including those 

resulting from mergers and spin-offs. A 

transfer of assets or liabilities occurs 

when there is a reduction of assets or 

liabilities with respect to one plan and 

the receipt of these assets or the 

assumption of these liabilities by 

another plan. Transfers out at the end of 

the year should be reported as occurring 

during the plan year. 

Note: A distribution of all or part of an 

individual participant’s account balance that 

is reportable on Form 1099–R, Distributions 

From Pensions, Annuities, Retirement or 

Profit-Sharing Plans, IRAs, Insurance 

Contracts, etc., should not be included on 

line 8j but must be included in benefit 

payments reported on Line 8d. Do not submit 

IRS Form 1099–R with the Form 5500–SF. 

Part IV—Plan Characteristics 

Line 9. Enter in lines 9a and 9b, as 

appropriate, in the boxes provided all 

applicable plan characteristic codes that 

describe the characteristics of the plan 

being reported. 


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LIST OF PLAN CHARACTERISTIC CODES FOR FORM 550–SF LINES 9A AND 9B

Code 

Defined Benefit Pension Features 

1A ..................... Benefits are primarily pay related. 

1B ..................... Benefits are primarily flat dollar (includes dollars per year of service). 

1C ..................... Cash balance or similar plan ‘‘ Plan has a ‘‘cash balance’’ formula. For this purpose, a ‘‘cash balance’’ formula is a benefit 

formula in a defined benefit plan by whatever name (e.g., personal account plan, pension equity plan, life cycle plan, cash 

account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal 

retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single 

sum distribution amount (e.g., 10 percent of final average pay times years of service, or the amount of the employee’s hypothetical account balance). 

1D ..................... Floor offset plan ‘‘ Plan benefits are subject to offset for retirement benefits provided by an employer-sponsored defined contribution plan. 

1E ..................... Code section 401(h) arrangement ‘‘ Plan contains separate accounts under Code section 401(h) to provide employee health 

benefits. 

1F ..................... Code section 414(k) arrangement ‘‘ Benefits are based partly on the balance of the separate account of the participant (also 

include appropriate defined contribution pension feature codes). 

1G ..................... Covered by PBGC ‘‘ Plan is covered under the PBGC insurance program (see ERISA section 4021). 

1H ..................... Plan covered by PBGC that was terminated and closed out for PBGC purposes—Before the end of the plan year (or a prior 

plan year), (1) the plan terminated in a standard (or distress) termination and completed the distribution of plan assets in 

satisfaction of all benefit liabilities (or all ERISA Title IV benefits for distress termination); or (2) a trustee was appointed for 

a terminated plan pursuant to ERISA section 4042. 

1I ....................... Frozen Plan—As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation). 

Defined Contribution Pension Features 

2A ..................... Age/Service Weighted or New Comparability or Similar Plan—Age/Service Weighted Plan: Allocations are based on age, 

service, or age and service. New Comparability or Similar Plan: Allocations are based on participant classifications and a 

classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the threshold or additional rate exceeds the maximum 

threshold or rate allowed under the permitted disparity rules of Code section 401(l). 

2B ..................... Target benefit plan. 

2C ..................... Money purchase (other than target benefit). 

2D ..................... Offset plan ‘‘ Plan benefits are subject to offset for retirement benefits provided in another plan or arrangement of the employer. 

2E ..................... Profit-sharing. 

2F ..................... ERISA section 404(c) plan—This plan, or any part of it, is intended to meet the conditions of 29 CFR 2550.404c–1. 

2G ..................... Total participant-directed account plan—Participants have the opportunity to direct the investment of all the assets allocated 

to their individual accounts, regardless of whether 29 CFR 2550.404c–1 is intended to be met. 

2H ..................... Partial participant directed account plan—Participants have the opportunity to direct the investment of a portion of the assets 

allocated to their individual accounts, regardless of whether 29 CFR 2550.404c–1 is intended to be met. 

2I ....................... Stock bonus. 

2J ...................... Code section 401(k) feature—A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these 

amounts in cash. 

2K ..................... Code section 401(m) arrangement—Employee contributions are allocated to separate accounts under the plan or employer 

contributions are based, in whole or in part, on employee deferrals or contributions to the plan. Not applicable if plan is 

401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7), or 408 arrangements/accounts annuities. 

2L ...................... Code section 403(b)(1) arrangement. 

2M ..................... Code section 403(b)(7) accounts. 

2N ..................... Code section 408 accounts and annuities. 

2R ..................... Participant-directed brokerage accounts provided as an investment option under the plan. 

2S ..................... Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll. 

2T ..................... Total or partial participant-directed account plan—plan uses default investment account for participants who fail to direct assets in their account. 

Other Pension Benefit Features 

3B ..................... Plan covering Self-Employed Individuals. 

3C ..................... Plan not intended to be qualified—A plan not intended to be qualified under Code sections 401, 403, or 408. 

3D ..................... Master plan—A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable 

opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint 

use of all adopting employers. 

3E ..................... Prototype plan—A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a separate funding medium (for example, a separate trust or custodial 

account) is established for each participating employer. 

3F ..................... Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year. 

3H ..................... Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)). 

3J ...................... U.S.-based plan that covers residents of Puerto Rico and is qualified under both Code section 401 and section 8565 of Puerto Rico Code. 


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LIST OF PLAN CHARACTERISTIC CODES FOR FORM 550–SF LINES 9A AND 9B—Continued 

Code 

Welfare Benefit Features 

4A ..................... Health (other than vision or dental). 

4B ..................... Life Insurance. 

4C ..................... Supplemental unemployment. 

4D ..................... Dental. 

4E ..................... Vision. 

4F ..................... Temporary disability (accident and sickness). 

4G ..................... Prepaid legal. 

4H ..................... Long-term disability. 

4I ....................... Severance pay. 

4J ...................... Apprenticeship and training. 

4K ..................... Scholarship (funded). 

4L ...................... Death benefits (include travel accident but not life insurance). 

4P ..................... Taft-Hartley Financial Assistance for Employee Housing Expenses. 

4Q ..................... Other. 

4R ..................... Unfunded, fully insured, or combination unfunded/fully insured welfare plan that will not file an annual report for next plan year 

pursuant to 29 CFR 2520.104–20. 

4S ..................... Unfunded, fully insured, or combination unfunded/fully insured welfare plan that stopped filing annual reports in an earlier plan 

year pursuant to 29 CFR 2520.104–20. 

4T ..................... 10 or more employer plan under Code section 419A(f)(6). 

Part V—Compliance Questions 

Line 10. Answer all lines either ‘‘Yes’’

or ‘‘No.’’ Do not leave any answer blank. 

For items 10a, b, c, d, e, f, and g, if the 

answer is ‘‘Yes,’’ an amount must be 

entered. 

Note: One-participant plans should only 

complete question 10g. 

Line 10a. Amounts paid by a 

participant or beneficiary to an 

employer and/or withheld by an 

employer for contribution to the plan 

are participant contributions that 

become plan assets as of the earliest 

date on which such contributions can 

reasonably be segregated from the 

employer’s general assets. See 29 CFR 

2510.3–102. Plans that check ‘‘Yes’’

must enter the aggregate amount of all 

late contributions for the year. The total 

amount of the delinquent contributions 

should be included on line 10a for the 

year in which the contributions were 

delinquent and should be carried over 

and reported again on line 10a for each 

subsequent year (or on line 4a of 

Schedule H or I of the Form 5500 if not 

eligible to file the Form 5500–SF in the 

subsequent year) until the year after the 

violation has been fully corrected by 

payment of the late contributions and 

reimbursement of the plan for lost 

earnings or profits. If no participant 

contributions were received or withheld 

by the employer during the plan year, 

answer ‘‘No.’’

An employer holding participant 

contributions commingled with its 

general assets after the earliest date on 

which such contributions can 

reasonably be segregated from the 

employer’s general assets will have 

engaged in a prohibited use of plan 

assets (see ERISA section 406). If such 

a nonexempt prohibited transaction 

occurred with respect to a disqualified 

person (see Code section 4975(e)(2)), file 

IRS Form 5330, Return of Excise Taxes 

Related to Employee Benefit Plans, with 

the IRS to pay any applicable excise tax 

on the transaction. 

Participant loan repayments paid to 

and/or withheld by an employer for 

purposes of transmittal to the plan that 

were not transmitted to the plan in a 

timely fashion must be reported either 

on line 4a in accordance with the 

reporting requirements that apply to 

delinquent participant contributions or 

on line 4d. See Advisory Opinion 2002–

02A, available at http://www.dol.gov/ 

ebsa. 

Applicants that satisfy both the DOL 

Voluntary Fiduciary Correction Program 

(VFCP) and the conditions of Prohibited 

Transaction Exemption (PTE) 2002–51 

are eligible for immediate relief from 

payment of certain prohibited 

transaction excise taxes for certain 

corrected transactions, and are also 

relieved from the requirement to file the 

IRS Form 5330 with the IRS. For more 

information on how to apply under the 

VFCP, the specific transactions covered 

(which transactions include delinquent 

participant contributions to pension and 

welfare plans), and acceptable methods 

for correcting violations, see 71 FR 

20261 (Apr. 19, 2006), and 71 FR 20135 

(Apr. 19, 2006). All delinquent 

participant contributions must be 

reported on line 10a at least for the year 

in which they were delinquent even if 

violations have been fully corrected by 

the close of the plan year. Information 

about the VFCP is also available on the 

Internet at http://www.dol.gov/ebsa. 

Line 10b. Plans that check ‘‘Yes’’ must 

enter the amount. Check ‘‘Yes’’ if any 

nonexempt transaction with a party-ininterest occurred. Do not check ‘‘Yes’’

with respect to transactions that are: (1) 

Statutorily exempt under Part 4 of Title 

I of ERISA; (2) administratively exempt 

under ERISA section 408(a); (3) exempt 

under Code sections 4975(c) or 4975(d); 

(4) the holding of participant 

contributions in the employer’s general 

assets for a welfare plan that meets the 

conditions of ERISA Technical Release 

92–01; or (5) delinquent participant 

contributions reported on line 10a. You 

may indicate that an application for an 

administrative exemption is pending. If 

you are unsure whether a transaction is 

exempt or not, you should consult 

either with a qualified public 

accountant, legal counsel, or both. If the 

plan is a qualified pension plan and a 

nonexempt prohibited transaction 

occurred with respect to a disqualified 

person, an IRS Form 5330 is required to 

be filed with the IRS to pay the excise 

tax on the transaction. 

Non-exempt transactions with a partyin-interest include any direct or 

indirect: 

A. Sale or exchange, or lease, of any 

property between the plan and a partyin-interest. 

B. Lending of money or other 

extension of credit between the plan 

and a party-in-interest. 

C. Furnishing of goods, services, or 

facilities between the plan and a partyin-interest. 

D. Transfer to, or use by or for the 

benefit of, a party-in-interest, of any 

income or assets of the plan. 


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E. Acquisition, on behalf of the plan, 

of any employer security or employer 

real property in violation of ERISA 

section 407(a). 

F. Dealing with the assets of the plan 

for a fiduciary’s own interest or own 

account. 

G. Acting in a fiduciary’s individual 

or any other capacity in any transaction 

involving the plan on behalf of a party 

(or represent a party) whose interests are 

adverse to the interests of the plan or 

the interests of its participants or 

beneficiaries. 

H. Receipt of any consideration for his 

or her own personal account by a partyin-interest who is a fiduciary from any 

party dealing with the plan in 

connection with a transaction involving 

the income or assets of the plan. 

Party-in-Interest. For purposes of this 

form, party-in-interest is deemed to 

include a disqualified person. See Code 

section 4975(e)(2). The term ‘‘party-ininterest’’ means, as to an employee 

benefit plan: 

A. Any fiduciary (including, but not 

limited to, any administrator, officer, 

trustee or custodian), counsel, or 

employee of the plan; 

B. A person providing services to the 

plan; 

C. An employer, any of whose 

employees are covered by the plan; 

D. An employee organization, any of 

whose members are covered by the plan; 

E. An owner, direct or indirect, of 

50% or more of: (1) The combined 

voting power of all classes of stock 

entitled to vote or the total value of 

shares of all classes of stock of a 

corporation; (2) the capital interest or 

the profits interest of a partnership; or 

(3) the beneficial interest of a trust or 

unincorporated enterprise which is an 

employer or an employee organization 

described in C or D; 

F. A relative of any individual 

described in A, B, C, or E; 

G. A corporation, partnership, or trust 

or estate of which (or in which) 50% or 

more of: (1) The combined voting power 

of all classes of stock entitled to vote or 

the total value of shares of all classes of 

stock of such corporation, (2) the capital 

interest or profits interest of such 

partnership, or (3) the beneficial interest 

of such trust or estate, is owned directly 

or indirectly, or held by persons 

described in A, B, C, D, or E; 

H. An employee, officer, director (or 

an individual having powers or 

responsibilities similar to those of 

officers or directors), or a 10% or more 

shareholder directly or indirectly, of a 

person described in B, C, D, E, or G, or 

of the employee benefit plan; or 

I. A 10% or more (directly or 

indirectly in capital or profits) partner 

or joint venturer of a person described 

in B, C, D, E, or G. 

TIP: Applicants that satisfy the VFCP 

requirements and the conditions of PTE 

2002–51 (see the instructions for line 

10a) are eligible for immediate relief 

from payment of certain prohibited 

transaction excise taxes for certain 

corrected transactions and from the 

requirement to file the Form 5330 with 

the IRS. For more information, see 71 

FR 20261 (Apr. 19, 2006), and 71 FR 

20135 (Apr. 19, 2006). When the 

conditions of PTE 2002–51 have been 

satisfied, the corrected transactions 

should be treated as exempt under Code 

section 4975(c) for the purposes of 

answering line 10b. 

Line 10c. Plans that check ‘‘Yes’’ must 

enter the aggregate amount of fidelity 

bond coverage for all claims. Check 

‘‘Yes’’ only if the plan itself (as opposed 

to the plan sponsor or administrator) is 

a named insured under a fidelity bond 

that is from an approved surety covering 

plan officials and that protects the plan 

from losses due to fraud or dishonesty 

as described in 29 CFR Part 2580. 

Generally, every plan official of an 

employee benefit plan who ‘‘handles’’

funds or other property of such plan 

must be bonded. Generally, a person 

shall be deemed to be ‘‘handling’’ funds 

or other property of a plan, so as to 

require bonding, whenever his or her 

other duties or activities with respect to 

given funds are such that there is a risk 

that such funds could be lost in the 

event of fraud or dishonesty on the part 

of such person, acting either alone or in 

collusion with others. Section 412 of 

ERISA and 29 CFR Part 2580 describe 

the bonding requirements, including the 

definition of ‘‘handling’’ (29 CFR 

2580.412–6), the permissible forms of 

bonds (29 CFR 2580.412–10), the 

amount of the bond (29 CFR Part 2580, 

subpart C), and certain exemptions such 

as the exemption for certain banks and 

insurance companies and the exemption 

allowing plan officials to purchase 

bonds from surety companies 

authorized by the Secretary of the 

Treasury as acceptable reinsurers on 

Federal bonds (29 CFR 2580.412–23). 

Information concerning the list of 

approved sureties and reinsurers is 

available on the Internet at http:// 

www.fms.treas.gov/c570. 

Note: Plans are permitted under certain 

conditions to purchase fiduciary liability 

insurance with plan assets. These fiduciary 

liability insurance policies are not written 

specifically to protect the plan from losses 

due to dishonest acts and are not fidelity 

bonds reported in line 10c. 

Line 10d. Check ‘‘Yes’’ if the plan 

suffered or discovered any loss as a 

result of any dishonest or fraudulent 

act(s) even if the loss was reimbursed by 

the plan’s fidelity bond or from any 

other source. If ‘‘Yes’’ is checked enter 

the full amount of the loss. If the full 

amount of the loss has not yet been 

determined, provide an estimate as 

determined in good faith by a plan 

fiduciary. You must keep, in accordance 

with ERISA section 107, records 

showing how the estimate was 

determined. 

CAUTION: Willful failure to report is 

a criminal offense. See ERISA section 

501. 

Line 10e. If any benefits under the 

plan are provided by an insurance 

company, insurance service, or other 

similar organization (such as Blue Cross, 

Blue Shield, or a health maintenance 

organization) or if the plan has 

investments with insurance companies 

such as guaranteed investment contracts 

(GICs), report the total of all insurance 

fees and commissions paid to agents, 

brokers and/or other persons directly or 

indirectly attributable to the contract(s) 

placed with or retained by the plan. 

For purposes of line 10e, commissions 

and fees include sales or base 

commissions and all other monetary 

and non-monetary forms of 

compensation where the broker’s, 

agent’s, or other person’s eligibility for 

the payment or the amount of the 

payment is based, in whole or in part, 

on the value (e.g., policy amounts, 

premiums) of contracts or policies (or 

classes thereof) placed with or retained 

by an ERISA plan, including, for 

example, persistency and profitability 

bonuses. The amount (or pro rata share 

of the total) of such commissions or fees 

attributable to the contract or policy 

placed with or retained by the plan 

must be reported. Insurers must provide 

plan administrators with a 

proportionate allocation of commissions 

and fees attributable to each contract. 

Any reasonable method of allocating 

commissions and fees to policies or 

contracts is acceptable, provided the 

method is disclosed to the plan 

administrator. A reasonable allocation 

method could allocate fees and 

commissions based on a calendar year 

calculation even if the plan year or 

policy year was not a calendar year. For 

additional information on these 

reporting requirements, see ERISA 

Advisory Opinion 2005–02A, available 

on the Internet at http://www.dol.gov/ 

ebsa. 

Where (1) benefits under a plan have 

been purchased from and guaranteed by 

a licensed insurance company, 

insurance service, or other similar 

organization, (2) the payments by the 

insurer to affiliates or third parties for 

performing administrative activities 


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were part of the insurer satisfying its 

contractual obligation to provide 

benefits under the plan, and (3) there is 

no direct or indirect charge to the plan 

for the administrative services other 

than the insurance premium, the 

payments by the insurer to the affiliates 

or third parties do not need to be 

reported as ‘‘fees and other 

commissions.’’

Reporting is not required for 

compensation paid by the insurer to 

third parties for record keeping and 

claims processing services provided to 

the insurer as part of the insurer’s 

administration of the insurance policy. 

Reporting also is not required for 

compensation paid by the insurer to a 

‘‘general agent’’ or ‘‘manager’’ for that 

general agent’s or manager’s 

management of an agency or 

performance of administrative functions 

for the insurer. For this purpose, (1) a 

‘‘general agent’’ or ‘‘manager’’ does not 

include brokers representing insureds, 

and (2) payments would not be treated 

as paid for managing an agency or 

performance of administrative functions 

where the recipient’s eligibility for the 

payment or the amount of the payment 

is dependent or based on the value (e.g., 

policy amounts, premiums) of contracts 

or policies (or classes thereof) placed 

with or retained by ERISA plan(s). 

Reporting is not required for 

occasional gifts or meals of insubstantial 

value which are tax deductible for 

federal income tax purposes by the 

person providing the gift or meal and 

would not be taxable income to the 

recipient. For this exemption to be 

available, the gift or gratuity must be 

both occasional and insubstantial. For 

this exemption to apply, the gift must be 

valued at less than $50, the aggregate 

value of gifts from one source in a 

calendar year must be less than $100, 

but gifts with a value of less than $10 

do not need to be counted toward the 

$100 annual limit. If the $100 aggregate 

value limit is exceeded, then the 

aggregate value of all the gifts will be 

reportable. Gifts from multiple 

employees of one service provider 

should be treated as originating from a 

single source when calculating whether 

the $100 threshold applies. On the other 

hand, in applying the threshold to an 

occasional gift received from one source 

by multiple employees of a single 

service provider, the amount received 

by each employee should be separately 

determined in applying the $50 and 

$100 thresholds. For example, if six 

employees of a broker attend an 

business conference put on by an 

insurer designed to educate and explain 

the insurer’s products for employee 

benefit plans, and the insurer provides, 

at no cost to the attendees, refreshments 

valued at $20 per individual, the 

gratuities would not be reportable on 

this line even though the total cost of 

the refreshments for all the employees 

would be $120. These thresholds are for 

purposes of line 10a reporting. Filers are 

cautioned that the payment or receipt of 

gifts and gratuities of any amount by 

plan fiduciaries may violate ERISA and 

give rise to civil liabilities and criminal 

penalties. 

Important Reminder. The insurance 

company, insurance service, or other 

similar organization is required under 

ERISA section 103(a)(2) to provide the 

plan administrator with the information 

needed to complete this return/report. 

Your insurance company must provide 

you with the information you need to 

answer this question. If your insurance 

company, insurance service, or other 

similar organization does not 

automatically send you this 

information, you should make a written 

request for the information. If you have 

difficulty getting the information from 

your insurance company, contact the 

nearest office of the DOL’s Employee 

Benefits Security Administration. 

Line 10f. You must check ‘‘Yes’’ if any 

benefits due under the plan were not 

timely paid or not paid in full. Include 

in this amount the total of any 

outstanding amounts that were not paid 

when due in previous years that have 

continued to remain unpaid. 

Line 10g. You must check ‘‘Yes’’ if the 

plan had any participant loans 

outstanding at any time during the plan 

year and enter the amount outstanding 

as of the end of the plan year. If no 

participant loans are outstanding as of 

the end of the plan year, enter ‘‘0’’. 

Line 10h. Check ‘‘Yes’’ if there was a 

‘‘blackout period.’’ A blackout period is 

a temporary suspension of more than 

three consecutive business days during 

which participants or beneficiaries of a 

401(k) or other individual account 

pension plan were unable to, or were 

limited or restricted in their ability to, 

direct or diversify assets credited to 

their accounts, obtain loans from the 

plan, or obtain distributions from the 

plan. A ‘‘blackout period’’ generally 

does not include a temporary 

suspension of the right of participants 

and beneficiaries to direct or diversify 

assets credited to their accounts, obtain 

loans from the plan, or obtain 

distributions from the plan if the 

temporary suspension is: (1) Part of the 

regularly scheduled operations of the 

plan that has been disclosed to 

participants and beneficiaries; (2) due to 

a qualified domestic relations order 

(QDRO) or because of a pending 

determination as to whether a domestic 

relations order is a QDRO; (3) due to an 

action or a failure to take action by an 

individual participant or because of an 

action or claim by someone other than 

the plan regarding a participant’s 

individual account; or (4) by application 

of federal securities laws. For more 

information, see the DOL’s regulation at 

29 CFR 2520.101–3 (available at http:// 

www.dol.gov/ebsa). 

Line 10i. If there was a blackout 

period, did you provide the required 

notice not less than 30 days nor more 

than 60 days in advance of restricting 

the rights of participants and 

beneficiaries to change their plan 

investments, obtain loans from the plan, 

or obtain distributions from the plan? If 

so, check ‘‘Yes.’’ See 29 CFR 2520.101–

3 for specific notice requirements and 

for exceptions from the notice 

requirement. Also, answer ‘‘Yes’’ if one 

of the exceptions to the notice 

requirement under 29 CFR 2520.101–3 

applies. 

Part VI—Pension Funding Compliance 

Complete Part VI only if the plan is 

subject to the minimum funding 

requirements of Code section 412 or 

ERISA section 302. 

All qualified defined benefit and 

defined contribution plans are subject to 

the minimum funding requirements of 

Code section 412 unless they are 

described in the exceptions listed under 

section 412(e)(2). These exceptions 

include profit-sharing or stock bonus 

plans, insurance contract plans 

described in section 412(e)(3), and 

certain plans to which no employer 

contributions are made. 

Nonqualified employee pension 

benefit plans are subject to the 

minimum funding requirements of 

ERISA section 302 unless specifically 

exempted under ERISA sections 4(a) or 

301(a). 

The employer or plan administrator of 

a single-employer or multiple-employer 

defined benefit plan that is subject to 

the minimum funding requirements 

must file the Schedule SB as an 

attachment to the Form 5500–SF. 

Schedule MB is filed for multiemployer 

defined benefit plans and certain money 

purchase defined contribution plans 

(whether they are single or 

multiemployer plans). However, 

Schedule MB is not required to be filed 

for a money purchase defined 

contribution plan that is subject to the 

minimum funding requirements unless 

the plan is currently amortizing a 

waiver of the minimum funding 

requirements. 

Line 11. If ‘‘Yes’’ is checked, you must 

attach Schedule SB (Form 5500). If this 

is a defined contribution pension plan, 


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leave the box blank . One-participant 

plans, however, do not attach Schedule 

SB to the Form 5500–SF. Instead oneparticipant plans keep the Schedule SB 

in accordance with the applicable 

records retention requirements. 

Line 12. The ‘‘Yes’’ box should be 

checked if the plan is a defined 

contribution plan subject to the 

minimum funding requirements of Code 

section 412 and ERISA section 302. 

Those money purchase plans (including 

target benefit plans) that are amortizing 

a waiver of the minimum funding 

standard for a prior year should fill out 

line 12a and then skip to line 13. Those 

defined contribution plans answering 

‘‘Yes’’ to the line 12 question that do not 

fill out line 12a should fill out lines 

12b–12e. 

Line 12a. If a money purchase defined 

contribution plan (including a target 

benefit plan) has received a waiver of 

the minimum funding standard, and the 

waiver is currently being amortized, 

complete lines 3, 9, and 10 of Schedule 

MB. See instructions for Schedule MB. 

Attach Schedule MB to the Form 5500–

SF. 

Line 12b. The minimum required 

contribution for a money purchase 

defined contribution plan for a plan 

year is the amount required to be 

contributed for the year under the 

formula set forth in the plan document. 

If there is an accumulated funding 

deficiency for a prior year that has not 

been waived, that amount should also 

be included as part of the contribution 

required for the current year. 

Line 12c. Include all contributions for 

the plan year made not later than 81⁄2

months after the end of the plan year. 

Show only contributions actually made 

to the plan by the date the form is filed. 

For example, do not include receivable 

contributions for this purpose. 

Line 12d. If the minimum required 

contribution exceeds the contributions 

for the plan year made not later than 81⁄2

months after the end of the plan year, 

the excess is an accumulated funding 

deficiency for the plan year. File IRS 

Form 5330, Return of Excise Taxes 

Related to Employee Benefit Plans, with 

the IRS to pay the excise tax on the 

deficiency. There is a penalty for not 

filing IRS Form 5330 on time. 

Line 12e. Will the minimum required 

contribution remaining in 12d be made 

no later than 81⁄2 months after the end 

of the plan year? If ‘‘Yes,’’ and 

contributions are actually made by this 

date, then there will be no reportable 

deficiency and Form 5330 will not need 

to be filed. 

Part VII—Plan Terminations and 

Transfers of Assets 

Line 13a. Check ‘‘Yes’’ if a resolution 

to terminate the plan was adopted 

during this or any prior plan year, 

unless the termination was revoked and 

no assets reverted to the employer. If 

‘‘Yes’’ is checked, enter the amount of 

plan assets that reverted to the employer 

during the plan year in connection with 

the implementation of such termination. 

Enter ‘‘-0-’’ if no reversion occurred 

during the current plan year. 

CAUTION: A Form 5500 must be filed 

for each year the plan has assets, and, 

for a welfare benefit plan, if the plan is 

still liable to pay benefits for claims 

incurred before the termination date, 

but not yet paid. See 29 CFR 2520.104b–

2(g)(2)(ii). 

IRS Form 5310–A, Notice of Plan 

Merger or Consolidation, Spinoff, or 

Transfer of Plan Assets or Liabilities; 

Notice of Qualified Separate Lines of 

Business, must be filed at least 30 days 

before any plan merger or consolidation 

or any transfer of plan assets or 

liabilities to another plan. There is a 

penalty for not filing Form 5310–A on 

time. In addition, a transfer of benefit 

liabilities involving a plan covered by 

PBGC insurance may be reportable to 

the PBGC. See PBGC Form 10, PostEvent Notice of Reportable Events, and 

Form 10-Advance, Advance Notice of 

Reportable Events. 

Line 13b. Check ‘‘Yes’’ if all of the 

plan assets (including insurance/ 

annuity contracts) were distributed to 

the participants and beneficiaries, 

legally transferred to the control of 

another plan, or brought under the 

control of the PBGC. 

Check ‘‘No’’ for a welfare benefit plan 

that is still liable to pay benefits for 

claims that were incurred before the 

termination date, but not yet paid. See 

29 CFR 2520.104b-2(g)(2)(ii). 

Line 13c. Enter information 

concerning assets and/or liabilities 

transferred from this plan to another 

plan(s) (including spin-offs) during the 

plan year. A transfer of assets or 

liabilities occurs when there is a 

reduction of assets or liabilities with 

respect to one plan and the receipt of 

these assets or the assumption of these 

liabilities by another plan. Enter the 

name, EIN, and PN of the transferee 

plan(s) involved on lines 13c(1), (2), and 

(3). If you need additional space, 

include an attachment with the 

information required for lines 13c(1), 

(2), and (3) for each additional plan and 

label the attachment ‘‘Form 5500–SF, 

line 13c—Additional Plans.’’

Do not use a social security number 

in lieu of an EIN or include an 

attachment that contains visible social 

security numbers. The Form 5500–SF is 

open to public inspection, and the 

contents are public information and are 

subject to publication on the Internet. 

Because of privacy concerns, the 

inclusion of a social security number on 

this Form 5500–SF may result in the 

rejection of the filing. 

Note: A distribution of all or part of an 

individual participant’s account balance that 

is reportable on Form 1099–R should not be 

included on line 13c. Do not submit Form 

1099–R with the Form 5500. 

CAUTION: IRS Form 5310–A, Notice 

of Plan Merger or Consolidation, 

Spinoff, or Transfer of Plan Assets or 

Liabilities; Notice of Qualified Separate 

Lines of Business, must be filed at least 

30 days before any plan merger or 

consolidation or any transfer of plan 

assets or liabilities to another plan. 

There is a penalty for not filing Form 

5310–A on time. In addition, a transfer 

of benefit liabilities involving a plan 

covered by PBGC insurance may be 

reportable to the PBGC. See PBGC Form 

10, Post-Event Notice of Reportable 

Event, and Form 10—Advance, Advance 

Notice of Reportable Event. 

ERISA Compliance Quick Checklist 

Compliance with the Employee 

Retirement Income Security Act (ERISA) 

begins with knowing the rules. Plan 

administrators and other plan officials 

can use this checklist as a quick 

diagnostic tool for assessing a plan’s 

compliance with certain important 

ERISA rules; it is not a complete 

description of all ERISA’s rules and it is 

not a substitute for a comprehensive 

compliance review. Use of this checklist 

is voluntary, and it is not to be filed 

with your Form 5500–SF. 

If you answer ‘‘No’’ to any of the 

questions below, you should review 

your plan’s operations because you may 

not be in full compliance with ERISA’s 

requirements. 

1. Have you provided plan 

participants with a summary plan 

description, summaries of any material 

modifications of the plan, and annual 

summary financial reports? 

2. Do you maintain copies of plan 

documents at the principal office of the 

plan administrator for examination by 

participants and beneficiaries? 

3. Do you respond to written 

participant inquiries for copies of plan 

documents and information within 30 

days? 

4. Does your plan include written 

procedures for making benefit claims 

and appealing denied claims, and are 

you complying with those procedures? 


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5. Is your plan covered by a fidelity 

bond against losses due to fraud or 

dishonesty? 

6. Are the plan’s investments 

diversified so as to minimize the risk of 

large losses? 

7. If the plan permits participants to 

select the investments in their plan 

accounts, has the plan provided them 

with enough information to make 

informed decisions? 

8. Has a plan official determined that 

the investments are prudent and solely 

in the interest of the plan’s participants 

and beneficiaries, and evaluated the 

risks associated with plan investments 

before making the investments? 

9. Did the employer or other plan 

sponsor send participant contributions 

to the plan on a timely basis? 

10. Did the plan pay participant 

benefits on time and in the correct 

amounts? 

11. Did the plan give participants and 

beneficiaries 30 days advance notice 

before imposing a ‘‘blackout period’’ of 

at least three consecutive business days 

during which participants or 

beneficiaries of a 401(k) or other 

individual account pension plan were 

unable to change their plan investments, 

obtain loans from the plan, or obtain 

distributions from the plan? 

If you answer ‘‘Yes’’ to any of the 

questions below, you should review 

your plan’s operations because you may 

not be in full compliance with ERISA’s 

requirements. 

1. Has the plan engaged in any 

financial transactions with persons 

related to the plan or any plan official? 

(For example, has the plan made a loan 

to or participated in an investment with 

the employer?) 

2. Has the plan official used the assets 

of the plan for his/her own interest? 

3. Have plan assets been used to pay 

expenses that were not authorized in the 

plan document, were not necessary to 

the proper administration of the plan, or 

were more than reasonable in amount? 

If you need help answering these 

questions or want additional guidance 

about ERISA requirements, a plan 

official should contact the U.S. 

Department of Labor Employee Benefits 

Security Administration office in your 

region or consult with the plan’s legal 

counsel or professional employee 

benefit advisor. 

Forms 5500, 5500–SF, and 5500–EZ 

Codes for Principal Business Activity 

Note: The list of business codes published 

with the Form 5500 instructions will be 

included in the Short Form instructions and 

will be updated to reflect the North American 

Industry Classification System Update for 

2007. See 70 FR 12390 (Mar. 11, 2005) 

OMB CONTROL NUMBERS

Agency OMB Number 

Employee Benefits Security Administration ......... 1210–0110 

1210–0089 

Internal Revenue Service 1545–1610 

OMB CONTROL NUMBERS—Continued 

Agency OMB Number 

Pension Benefit Guaranty 

Corporation ................... 1212–0057 

Paperwork Reduction Act Notice 

We ask for the information on this 

form to carry out the law as specified in 

ERISA and in Code sections 6058(a), 

and 6059(a). You are required to give us 

the information. We need it to 

determine whether the plan is operating 

according to the law. 

You are not required to provide the 

information requested on a form that is 

subject to the Paperwork Reduction Act 

unless the form displays a valid OMB 

control number. Books and records 

relating to a form or its instructions 

must be retained as long as their 

contents may become material in the 

administration of the Internal Revenue 

Code or are required to be maintained 

pursuant to Title I or IV of ERISA. The 

Form 5500–SF returns/reports are open 

to public inspection and are subject to 

publication on the Internet. 

The time needed to complete and file 

the form 5500–SF and the Schedules 

SB/MB reflects the combined 

requirements of the Internal Revenue 

Service, Department of Labor, and 

Pension Benefit Guaranty Corporation. 

These times will vary depending on 

individual circumstances. The 

estimated average times are: 

Pension 

plans Welfare plans 

Form 5500–SF ............................................................................................................................................................ 2 hr., 32 min. 2 hr., 32 min. 

Schedule SB ............................................................................................................................................................... 6 hr., 49 min. N/A. 

Schedule MB .............................................................................................................................................................. 3 hr., 20 min. N/A. 

If you have comments concerning the 

accuracy of these time estimates or 

suggestions for making these forms 

simpler, we would be happy to hear 

from you. You can write to the Internal 

Revenue Service, Tax Products 

Coordinating Committee, 

SE:W:CAR:MP:T:T:SP, 1111 

Constitution Ave., NW., IR–6526, 

Washington, DC 20224. DO NOT send 

any of these forms or schedules to this 

address. The forms and schedules must 

be filed electronically. See How to 

File—Electronic Filing Requirement. 

Appendix C 

[Insert photo pages of Form 5500 and 

Schedules A, SB, MB, C, D, G, H, I, and 

R, numbered on back of pages as 197–

1 through 197–36] 

BILLING CODE 4510–29–P 


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BILLING CODE 4510–29–C 

Appendix D 

2009 Instructions for Form 5500 and 

Schedules 

Annual Return/Report of Employee 

Benefit Plan 

ERISA refers to the Employee 

Retirement Income Security Act of 1974, 

and Code references are to the Internal 

Revenue Code, unless otherwise noted. 

lllllllllllllllllll

EFAST Processing System 

Under the computerized ERISA Filing 

Acceptance System (EFAST), you must 

electronically file your 2009 Form 5500. 

You may file your 2009 Form 5500 online, using EFAST’s web-based filing 

system or you may file through an 

EFAST-approved vendor. For more 

information, see the instructions for 

Electronic Filing Requirement. 

About the Form 5500 

The Form 5500, Annual Return/ 

Report of Employee Benefit Plan, 

including all required schedules and 

attachments (Form 5500 Return/Report) 

is used to report information concerning 

employee benefit plans and Direct 

Filing Entities (DFEs). Any 

administrator or sponsor of an employee 

benefit plan subject to ERISA must file 

information about each benefit plan 

every year (Code section 6058 and 

ERISA sections 104 and 4065). Some 

plans participate in certain trusts, 

accounts, and other investment 

arrangements that file a Form 5500 

Return/Report as DFEs. See Who Must 

File and When to File. 

The Internal Revenue Service (IRS), 

Department of Labor (DOL), and 

Pension Benefit Guarantee Corporation 

(PBGC) have consolidated certain 

returns and report forms to reduce the 

filing burden for plan administrators 

and employers. Employers and 

administrators who comply with the 

instructions for the Form 5500 Return/ 

Report generally will satisfy the annual 

reporting requirements for the IRS and 

DOL. 

Plans covered by the PBGC have 

special additional requirements, 

including filing Annual Premium 

Payment (PBGC Form 1) and reporting 

certain transactions directly with that 

agency. See PBGC’s Premium Payment 

Instructions (Form 1 Package). 

Each Form 5500 Return/Report must 

accurately reflect the characteristics and 

operations of the plan or arrangement 

being reported. The requirements for 

completing the Form 5500 Return/ 

Report will vary according to the type 

of plan or arrangement. The section 

What to File summarizes what 

information must be reported for 

different types of plans and 

arrangements. The Quick Reference 

Chart for Form 5500, Schedules and 

Attachments gives a brief guide to the 

annual return/report requirements for 

the 2009 Form 5500. 

The Form 5500 Return/Report must 

be filed electronically. Your entries will 

be initially screened. Your entries must 

satisfy this screening in order to be 

filed. Once filed, your form may be 

subject to further detailed review and 

your filing may be rejected based on this 

further review. 

ERISA and the Code provide for the 

assessment or imposition of penalties 

for not submitting the required 

information when due. See Penalties. 

Annual reports filed under Title I of 

ERISA must be made available by plan 

administrators to plan participants and 

by the DOL to the public pursuant to 

ERISA sections 104 and 106. 

How To Get Assistance 

If you need help completing this form 

or have related questions, call the 

EFAST Help Line at [number to be 

provided] (toll free). The EFAST Help 


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Line is available Monday through 

Friday from 8 a.m. to 8 p.m., Eastern 

Time. 

You can access the EFAST Web site 

24 hours a day, 7 days a week at http:// 

www.efast.dol.gov to: 

• View forms and related 

instructions. 

• Get information regarding EFAST, 

including approved software vendors. 

• See answers to frequently asked 

questions about the Form 5500–SF, the 

Form 5500 and its Schedules, and 

EFAST. 

• Access the main EBSA and DOL 

Web sites for news, regulations, and 

publications. 

You can access the IRS Web site 24 

hours a day, 7 days a week at http:// 

www.irs.gov to: 

• View forms, instructions, and 

publications. 

• See answers to frequently asked tax 

questions. 

• Search publications online by topic 

or keyword. 

• Send comments or request help by 

e-mail. 

• Sign up to receive local and 

national tax news by e-mail. 

You can order related forms and IRS 

publications by calling 1–800–TAX–

FORM (1–800–829–3676). You can 

order EBSA publications by calling 1–

866–444–3272. In addition, most IRS 

forms and publications are available at 

your local IRS office. 

Table of Contents 

Section 1: Who Must File 

Pension Benefit Plan 

Welfare Benefit Plan 

Direct Filing Entity (DFE) 

Section 2: When To File 

Extension of Time To File 

Section 3: Electronic Filing Requirement 

Amended Return/Report 

Final Return/Report 

Signature and Date 

Change in Plan Year 

Penalties 

Administrative Penalties 

Other Penalties 

Section 4: What To File 

Form 5500 Schedules 

Pension Benefit Schedules 

Pension and Welfare Benefit Schedules 

Pension Benefit Plan Filing Requirements 

Limited Pension Plan Reporting 

Welfare Benefit Plan Filing Requirements 

Direct Filing Entity (DFE) Filing 

Requirements 

Master Trust Investment Account (MTIA) 

Common/Collective Trust (CCT) and 

Pooled Separate Account (PSA) 

103–12 Investment Entity (103–12 IE) 

Group Insurance Arrangement (GIA) 

Section 5: Line-by-Line Instructions for the 

2009 Form 5500 and Schedules 

Part I—Form 5500 Annual Return/Report 

Identification Information 

Part II—Basic Plan Information 

Schedule A Insurance Information 

Schedule MB Multiemployer Defined 

Benefit Plan and Certain Money 

Purchase Plan Actuarial Information 

Schedule SB Single-Employer Defined 

Benefit Plan Actuarial Information 

Schedule C Service Provider Information 

Schedule D DFE/Participating Plan 

Information 

Schedule G Financial Transaction 

Schedules 

Schedule H Financial Information 

Schedule I Financial Information—Small 

Plan 

Schedule R Retirement Plan Information 

ERISA Compliance Quick Checklist 

Quick Reference Chart of Form 5500 

Schedules and Attachments 

Paperwork Reduction Act Notice 

Codes for Principal Business Activity 

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Section 1: Who Must File 

A return/report must be filed every 

year for every pension benefit plan, 

welfare benefit plan, and for every 

entity that files as a DFE as specified 

below (Code section 6058 and ERISA 

sections 104 and 4065). 

TIP: Plans that have fewer than 100 

participants at the beginning of the plan 

year, are exempt from the requirement 

that the plan’s books and records be 

audited by an independent qualified 

public accountant (IQPA) (but not by 

reason of enhanced bonding), have 

100% of their assets invested in certain 

secure investments with a readily 

determinable fair market value, hold no 

employer securities, and are not 

multiemployer plans, generally are 

eligible to file the Form 5500–SF, Short 

Form Annual Return/Report of Small 

Employer Benefit Plan (Form 5500–SF), 

in lieu of the Form 5500 Return/Report. 

For more information on who may file 

the Form 5500–SF, see http:// 

www.dol.gov/ebsa. 

Pension Benefit Plan 

All pension benefit plans covered by 

ERISA must file an annual return/report 

except as provided in this section. This 

return/report must be filed whether or 

not the plan is ‘‘tax qualified,’’ benefits 

no longer accrue, contributions were not 

made this plan year, or contributions are 

no longer made. Pension benefit plans 

required to file include both defined 

benefit plans and defined contribution 

plans. 

The following are among the pension 

benefit plans for which a return/report 

must be filed: 

1. Profit-sharing, stock bonus, money 

purchase, 401(k) plans, etc. 

2. Annuity arrangements under Code 

section 403(b)(1). 

3. Custodial accounts established 

under Code section 403(b)(7) for 

regulated investment company stock. 

4. Individual retirement accounts 

(IRAs) established by an employer 

under Code section 408(c). 

5. Church pension plans electing 

coverage under Code section 410(d). 

6. Pension benefit plans that cover 

residents of Puerto Rico, the U.S. Virgin 

Islands, Guam, Wake Island, or 

American Samoa. This includes a plan 

that elects to have the provisions of 

section 1022(i)(2) of ERISA apply. 

7. Plans that satisfy the Actual 

Deferral Percentage requirements of 

Code section 401(k)(3)(A)(ii) by 

adopting the ‘‘SIMPLE’’ provisions of 

section 401(k)(11). 

See What to File for more information 

about what must be completed for 

pension plans. 

Do Not File a Form 5500 for a Pension 

Benefit Plan That Is Any of the 

Following: 

1. An unfunded excess benefit plan. 

See ERISA section 4(b)(5). 

2. An annuity or custodial account 

arrangement under Code section 

403(b)(1) or (7) not established or 

maintained by an employer as described 

in DOL Regulation 29 CFR 2510.3–2(f). 

3. A Savings Incentive Match Plan for 

Employees of Small Employers 

(SIMPLE) that involves SIMPLE IRAs 

under Code section 408(p). 

4. A simplified employee pension 

plan (SEP) or a salary reduction SEP 

described in Code section 408(k) that 

conforms to the alternative method of 

compliance in 29 CFR 2520.104–48 or 

2520.104–49. 

5. A church plan not electing coverage 

under Code section 410(d). 

6. A pension plan that is maintained 

outside the United States primarily for 

the benefit of persons substantially all of 

whom are nonresident aliens. 

7. An unfunded pension plan for a 

select group of management or highly 

compensated employees that meets the 

requirements of 29 CFR 2520.104–23, 

including timely filing of a registration 

statement with the DOL. 

8. An unfunded dues financed 

pension benefit plan that meets the 

alternative method of compliance 

provided by 29 CFR 2520.104–27. 

9. An individual retirement account 

or annuity not considered a pension 

plan under 29 CFR 2510.3–2(d). 

10. A governmental plan. 

11. One-Participant (Owners and 

Their Spouses) Retirement Plan 

(generally referred to as a OneParticipant Plan). However, OneParticipant Plans must file either the 

Form 5500–EZ with the IRS or, if 

eligible, may file the Form 5500–SF 


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electronically with EFAST. For this 

purpose, a One-Participant Plan is: (1) A 

pension benefit plan that covers only an 

individual or an individual and his or 

her spouse who wholly own a trade or 

business, whether incorporated or 

unincorporated; or (2) a pension benefit 

plan for a partnership that covers only 

the partners or the partners and the 

partners’ spouses. See the instructions 

to the Form 5500–EZ, Annual Return of 

One-Participant (Owners and Their 

Spouses) Retirement Plan, and the Form 

5500–SF for eligibility conditions and 

filing requirements. For more 

information go to http://www.irs.gov/ep 

or call 1–877–829–5500. 

Welfare Benefit Plan 

All welfare benefit plans covered by 

ERISA are required to file a Form 5500 

except as provided in this section. 

Welfare benefit plans provide benefits 

such as medical, dental, life insurance, 

apprenticeship and training, scholarship 

funds, severance pay, disability, etc. See 

What to File for more information. 

Reminder: The administrator of an 

employee welfare benefit plan that 

provides benefits wholly or partially 

through a Multiple-employer Welfare 

Arrangement (MEWA), as defined in 

ERISA section 3(40), must file a Form 

5500, unless otherwise exempt. 

Do Not File a Form 5500 for a Welfare 

Benefit Plan That Is Any of the 

Following: 

1. A welfare benefit plan that covered 

fewer than 100 participants as of the 

beginning of the plan year and is 

unfunded, fully insured, or a 

combination of insured and unfunded. 

Note: To determine whether the plan 

covers fewer than 100 participants for 

purposes of these filing exemptions for 

insured and unfunded welfare plans, see 

instructions for lines 6 and 7 on counting 

participants in a welfare plan. See also 29 

CFR 2510.3–3(d). 

a. An unfunded welfare benefit plan 

has its benefits paid as needed directly 

from the general assets of the employer 

or employee organization that sponsors 

the plan. 

Note: Plans that are NOT unfunded include 

those plans that received employee (or 

former employee) contributions during the 

plan year and/or used a trust or separately 

maintained fund (including a Code section 

501(c)(9) trust) to hold plan assets or act as 

a conduit for the transfer of plan assets 

during the year. A welfare plan with 

employee contributions that is associated 

with a cafeteria plan under Code section 125 

may be treated for annual reporting purposes 

as an unfunded welfare plan if it meets the 

requirements of DOL Technical Release 92–

01, 57 FR 23272 (June 2, 1992) and 58 FR 

45359 (Aug. 27, 1993). The mere receipt of 

COBRA contributions or other after-tax 

participant contributions would not by itself 

affect the availability of the relief provided 

for cafeteria plans that otherwise meet the 

requirements of DOL Technical Release 92–

01. See 61 FR 41220, 41222–23 (Aug. 7, 

1996). 

b. A fully insured welfare benefit plan 

has its benefits provided exclusively 

through insurance contracts or policies, 

the premiums of which must be paid 

directly to the insurance carrier by the 

employer or employee organization 

from its general assets or partly from its 

general assets and partly from 

contributions by its employees or 

members (which the employer or 

employee organization forwards within 

three (3) months of receipt). The 

insurance contracts or policies 

discussed above must be issued by an 

insurance company or similar 

organization (such as Blue Cross, Blue 

Shield or a health maintenance 

organization) that is qualified to do 

business in any state. 

c. A combination unfunded/insured 

welfare plan has its benefits provided 

partially as an unfunded plan and 

partially as a fully insured plan. An 

example of such a plan is a welfare 

benefit plan that provides medical 

benefits as in a above and life insurance 

benefits as in b above. See 29 CFR 

2520.104–20. 

Note: A ‘‘voluntary employees’ beneficiary 

association,’’ as used in Code section 

501(c)(9) (‘‘VEBA’’), should not be confused 

with the employer or employee organization 

that sponsors the plan. See ERISA section 

3(4). 

2. A welfare benefit plan maintained 

outside the United States primarily for 

persons substantially all of whom are 

nonresident aliens. 

3. A governmental plan. 

4. An unfunded or insured welfare 

plan for a select group of management 

or highly compensated employees, 

which meets the requirements of 29 CFR 

2520.104–24. 

5. An employee benefit plan 

maintained only to comply with 

workers’ compensation, unemployment 

compensation, or disability insurance 

laws. 

6. A welfare benefit plan that 

participates in a group insurance 

arrangement that files a Form 5500 

Return/Report on behalf of the welfare 

benefit plan as specified in 29 CFR 

2520.103–2. See 29 CFR 2520.104–43. 

7. An apprenticeship or training plan 

meeting all of the conditions specified 

in 29 CFR 2520.104–22. 

8. An unfunded dues financed welfare 

benefit plan exempted by 29 CFR 

2520.104–26. 

9. A church plan under ERISA section 

3(33). 

10. A welfare benefit plan solely for 

(1) an individual or an individual and 

his or her spouse, who wholly owns a 

trade or business, whether incorporated 

or unincorporated, or (2) partners or the 

partners and the partners’ spouses in a 

partnership. See 29 CFR 2510.3–3(b). 

Direct Filing Entity (DFE) 

Some plans participate in certain 

trust, accounts, and other investment 

arrangements that file the Form 5500 

Return/Report as a DFE in accordance 

with the Direct Filing Entity (DFE) 

Filing Requirements. A Form 5500 

Return/Report must be filed for a master 

trust investment account (MTIA). A 

Form 5500 is not required, but may be 

filed for a common/collective trust 

(CCT), pooled separate account (PSA), 

103–12 investment entity (103–12 IE), or 

group insurance arrangement (GIA). 

Plans that participate in CCTs, PSAs, 

103–12 IEs, or GIAs that file as DFEs, 

however, generally are eligible for 

certain annual reporting relief. For 

reporting purposes, a CCT, PSA, 103–12 

IE, or GIA is not considered a DFE 

unless a Form 5500 Return/Report is 

filed for it in accordance with the Direct 

Filing Entity (DFE) Filing Requirements. 

Note: Special requirements also apply to 

Schedules D and H attached to the Form 

5500 filed by plans participating in MTIAs, 

CCTs, PSAs, and 103–12 IEs. See the 

instructions for these schedules. 

lllllllllllllllllll

Section 2: When to File 

Plans and GIAs. File 2009 returns/ 

reports for plan and GIA years that 

began in 2009. All required forms, 

schedules, statements, and attachments 

must be filed by the last day of the 7th 

calendar month after the end of the plan 

or GIA year (not to exceed 12 months in 

length) that began in 2009. If the plan 

or GIA year differs from the 2009 

calendar year, fill in the fiscal year 

beginning and ending dates in the space 

provided. 

DFEs other than GIAs. File 2009 

Returns/Reports no later than 91⁄2

months after the end of the DFE year 

that ended in 2009. A Form 5500 

Return/Report filed for a DFE must 

report information for the DFE year (not 

to exceed 12 months in length). If the 

DFE year differs from the 2009 calendar 

year, fill in the fiscal year beginning and 

ending dates in the space provided. 

Short Years. For a plan year of less 

than 12 months (short plan year), file 

the form and applicable schedules by 

the last day of the 7th month after the 

short plan year ends. Fill in the short 

plan year beginning and ending dates in 

the space provided and check the 

appropriate box in Part I, Line B of the 


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Form 5500. For purposes of this return/ 

report, the short plan year ends on the 

date of the change in accounting period 

or upon the complete distribution of 

assets of the plan. Also see the 

instructions for Final Return/Report to 

determine if ‘‘the final return/report’’ in 

Line B should be checked. Generally, 

only defined benefit pension plans need 

to get approval for a change in plan 

year. 

Notes: (1) If the filing due date falls on a 

Saturday, Sunday, or Federal holiday, the 

return/report may be filed on the next day 

that is not a Saturday, Sunday, or Federal 

holiday. (2) If the 2010 Form 5500 is not 

available before the plan or DFE filing due 

date, you may use the 2009 Form 5500 and 

enter the 2009 fiscal year beginning and 

ending dates in the space provided. 

Extension of Time To File 

Using Form 5558 

A plan or GIA may obtain a one-time 

extension of time to file a Form 5500 

Return/Report (up to 21⁄2 months) by 

filing IRS Form 5558, Application for 

Extension of Time To File Certain 

Employee Plan Returns, on or before the 

normal due date (not including any 

extensions) of the return/report. You 

MUST file the Form 5558 with the IRS. 

Approved copies of the Form 5558 will 

not be returned to the filers. A copy of 

the completed extension request must, 

however, be retained with the filer’s 

records. 

File Form 5558 with the Department 

of the Treasury, Internal Revenue 

Service Center, Ogden, UT 84201–0027. 

Using Extension of Time To File Federal 

Income Tax Return 

An automatic extension of time to file 

the Form 5500 Return/Report until the 

due date of the Federal income tax 

return of the employer will be granted 

if all of the following conditions are 

met: (1) The plan year and the 

employer’s tax year are the same; (2) the 

employer has been granted an extension 

of time to file its Federal income tax 

return to a date later than the normal 

due date for filing the Form 5500 

Return/Report; and (3) a copy of the 

application for extension of time to file 

the Federal income tax return is 

maintained with the filer’s records. An 

extension of time granted by using this 

automatic extension procedure 

CANNOT be extended further by filing 

a Form 5558, nor can it be extended 

beyond a total of 91⁄2 months beyond the 

close of the plan year. 

Note: An extension of time to file the Form 

5500 Return/Report described in this section 

does not operate as an extension of time to 

file a Form 5500 Return/Report for a DFE 

(other than a GIA) or the PBGC Form 1. 

Other Extensions of Time 

The IRS, DOL, and PBGC may 

announce special extensions of time 

under certain circumstances, such as 

extensions for Presidentially-declared 

disasters or for service in, or in support 

of, the Armed Forces of the United 

States in a combat zone. See http:// 

www.irs.gov and http:// 

www.efast.dol.gov for announcements 

regarding such special extensions. If you 

are relying on one of these announced 

special extensions, check the 

appropriate box on Form 5500, Part I, 

line D and enter a description of the 

announced authority for the extension. 

Delinquent Filer Voluntary Compliance 

(DFVC) Program 

The DFVC Program facilitates 

voluntary compliance by plan 

administrators who are delinquent in 

filing annual reports under Title I of 

ERISA by permitting administrators to 

pay reduced civil penalties for 

voluntarily complying with their DOL 

annual reporting obligations. If the Form 

5500 Return/Report is being filed under 

the DFVC Program, check the 

appropriate item in Form 5500, Part I, 

line D to indicate that the Form 5500 

Return/Report is being filed under the 

DFVC Program. 

See http://www.efast.dol.gov for 

information concerning the submission 

of penalty payments to the DFVC 

Program processing center. Do not 

submit penalty payments to EFAST. 

[Current instructions for penalty 

payment submissions will be provided] 

lllllllllllllllllll

Section 3: Electronic Filing 

Requirement 

Under the computerized ERISA Filing 

Acceptance System (EFAST), you must 

file your 2009 Form 5500 Return/Report 

electronically. You may file on-line, 

using EFAST’s web-based filing system, 

or you may file through an EFASTapproved vendor. Detailed information 

on electronic filing is available at (insert 

web address). For telephone assistance, 

call the EFAST Help Line at [number to 

be provided]. The EFAST Help Line is 

available Monday through Friday from 

8:00 a.m. to 8:00 p.m., Eastern Time. 

CAUTION: Annual reports filed under 

Title I of ERISA must be made available 

by plan administrators to plan 

participants and by DOL to the public 

pursuant to ERISA sections 104 and 

106. Even though the Form 5500 

Return/Report must be filed 

electronically, the administrator must 

keep a copy of the Form 5500, including 

schedules and attachments, with all 

required manual signatures on file as 

part of the plan’s records and must 

make a paper copy available on request 

to participants, beneficiaries, and the 

DOL as required by section 104 of 

ERISA and 29 CFR 2520.103–1. 

Answer all questions with respect to 

the plan year unless otherwise explicitly 

stated in the instructions or on the form 

itself. Therefore, responses usually 

apply to the 2009 plan year. 

Your entries will be initially screened. 

Your entries must satisfy this screening 

in order to be filed. Once filed, your 

form may be subject to further detailed 

review, and your filing may be rejected 

based upon this further review. To 

reduce the possibility of correspondence 

and penalties: 

• Complete all lines on the Form 

5500 unless otherwise specified. Also 

complete or electronically attach, as 

required, applicable schedules and 

attachments. 

• Do not enter ‘‘N/A’’ or ‘‘Not 

Applicable’’ on the Form 5500 Return/ 

Report unless specifically permitted. 

‘‘Yes’’ or ‘‘No’’ questions on the forms 

and schedules cannot be left blank, but 

must be answered either ‘‘Yes’’ or ‘‘No,’’

and not both. 

The Form 5500, Schedules, and 

attachments are open to public 

inspection, and the contents are public 

information subject to publication on 

the Internet. Do not enter social security 

numbers in response to questions asking 

for an employer identification number 

(EIN). Because of privacy concerns, the 

inclusion of a social security number on 

the Form 5500 or on a schedule or 

attachment may result in the rejection of 

the filing. EINs may be obtained by 

applying for one on Form SS–4, 

Application for Employer Identification 

Number. You can obtain Form SS–4 by 

calling 1–800–TAX–FORM (1–800–829–

3676) or at the IRS Web site at http:// 

www.irs.gov. The EBSA does not issue 

EINs. 

Amended Return/Report 

File an amended return/report to 

correct errors and/or omissions in a 

previously filed and accepted annual 

return/report for the 2009 plan year. The 

amended Form 5500 and any amended 

schedules and/or attachments must 

conform to the requirements in these 

Instructions. See the DOL Web site at 

http://www.efast.dol.gov for information 

on filing amended returns/reports for 

prior years. 

Final Return/Report 

If all assets under the plan (including 

insurance/annuity contracts) have been 

distributed to the participants and 

beneficiaries or legally transferred to the 

control of another plan, and when all 


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liabilities for which benefits may be 

paid under a welfare benefit plan have 

been satisfied, check the final return/ 

report box in Part I, line B at the top of 

the Form 5500. If a trustee is appointed 

for a terminated defined benefit plan 

pursuant to ERISA section 4042, the last 

plan year for which a return/report must 

be filed is the year in which the trustee 

is appointed. 

Examples: 

Mergers/Consolidations 

A final return/report should be filed 

for the plan year (12 months or less) that 

ends when all plan assets were legally 

transferred to the control of another 

plan. 

Pension and Welfare Plans That 

Terminated Without Distributing All 

Assets 

If the plan was terminated, but all 

plan assets were not distributed, a 

return/report must be filed for each year 

the plan has assets. The return/report 

must be filed by the plan administrator, 

if designated, or by the person or 

persons who actually control the plan’s 

assets/property. 

Welfare Plans Still Liable To Pay 

Benefits 

A welfare plan cannot file a final 

return/report if the plan is still liable to 

pay benefits for claims that were 

incurred prior to the termination date, 

but not yet paid. See 29 CFR 2520.104b–

2(g)(2)(ii). 

Signature and Date 

The Form 5500 Annual Return/Report 

and any applicable schedules must be 

signed and dated. The administrator is 

required under ERISA to maintain a 

copy of the annual report with all 

required signatures, as part of the plan’s 

records, even though the return/report is 

filed electronically. See 29 CFR 

2520.103–1. 

Electronic signatures on annual 

returns/reports filed under EFAST2 are 

affected by the applicable statutory and 

regulatory requirements. Information on 

those requirements will be made 

available for electronic filing under 

EFAST2. 

Change in Plan Year 

Generally, only defined benefit 

pension plans need to get approval for 

a change in plan year. (See Code section 

412(c)(5).) However, under Rev. Proc. 

87–27, 1987–1 C.B. 769, these pension 

benefit plans may be eligible for 

automatic approval of a change in plan 

year. If a change in plan year for a 

pension or a welfare plan creates a short 

plan year, the appropriate Box in Part I, 

line B of the Form 5500 must be 

checked and a Form 5500, with all 

required schedules and attachments, 

must be filed by the last day of the 7th 

calendar month after the end of the 

short plan year. 

Penalties 

Plan administrators and plan sponsors 

must provide complete and accurate 

information and must otherwise comply 

fully with the filing requirements. 

ERISA and the Code provide for the 

DOL and IRS, respectively, to assess or 

impose penalties for not giving 

complete information and for not filing 

statements and returns/reports. Certain 

penalties are administrative (i.e., they 

may be imposed or assessed by one of 

the governmental agencies delegated to 

administer the collection of the annual 

return/report data). Others require a 

legal conviction. 

Administrative Penalties 

Listed below are various penalties 

under ERISA and the Code that may be 

assessed or imposed for not meeting the 

annual return/report filing 

requirements. Generally whether the 

penalty is assessed under ERISA or the 

Code, or both, depends upon the agency 

for which the information is required to 

be filed. One or more of the following 

administrative penalties may be 

assessed or imposed in the event of 

incomplete filings or filings received 

after the due date unless it is 

determined that your explanation for 

failure to file properly is for reasonable 

cause: 

1. A penalty of up to $1,100 a day for 

each day a plan administrator fails or 

refuses to file a complete report. See 

ERISA section 502(c)(2) and 29 CFR 

2560.502c–2. 

2. A penalty of $25 a day (up to 

$15,000) for not filing returns for certain 

plans of deferred compensation, trusts 

and annuities, and bond purchase plans 

by the due date(s). See Code section 

6652(e). 

3. A penalty of $1,000 for not filing 

an actuarial statement. See Code section 

6692. 

Other Penalties 

1. Any individual who willfully 

violates any provision of Part 1 of Title 

I of ERISA shall be fined not more than 

$100,000 or imprisoned not more than 

10 years, or both. See section 501 of 

ERISA. 

2. A penalty up to $10,000, five (5) 

years imprisonment, or both, may be 

imposed for making any false statement 

or representation of fact, knowing it to 

be false, or for knowingly concealing or 

not disclosing any fact required by 

ERISA. See section 1027, Title 18, U.S. 

Code, as amended by section 111 of 

ERISA. 

lllllllllllllllllll

Section 4: What To File 

The Form 5500 Return/Report 

reporting requirements vary depending 

on whether the Form 5500 is being filed 

for a ‘‘large plan,’’ a ‘‘small plan,’’ and/ 

or a DFE, and on the particular type of 

plan or DFE involved (e.g., welfare plan, 

pension plan, common/collective trust 

(CCT), pooled separate account (PSA), 

master trust investment account (MTIA), 

103–12 IE, or group insurance 

arrangement (GIA)). 

The Instructions below provide 

detailed information about each of the 

Form 5500 Return/Report schedules and 

which plans and DFEs are required to 

file them. First, the schedules are 

grouped by type: (1) Pension Schedules 

and (2) General Schedules. Each 

schedule is listed separately with a 

description of the subject matter 

covered by the schedule and the plans 

and DFEs that are required to file the 

schedule. 

Filing requirements are also listed by 

type of filer: (1) Pension Benefit Plan 

Filing Requirements; (2) Welfare Benefit 

Plan Filing Requirements; and (3) DFE 

Filing Requirements. For each filer type 

there is a separate list of the schedules 

that must be filed with the Form 5500 

(including where applicable, separate 

lists for large plan filers, small plan 

filers, and different types of DFEs). 

The filing requirements are 

summarized in a ‘‘Quick Reference 

Chart for Form 5500, Schedules, and 

Attachments.’’

Generally, a return/report filed for a 

pension benefit plan or welfare benefit 

plan that covered fewer than 100 

participants as of the beginning of the 

plan year should be completed 

following the requirements below for a 

‘‘small plan,’’ and a return/report filed 

for a plan that covered 100 or more 

participants as of the beginning the plan 

year should be completed following the 

requirements below for a ‘‘large plan.’’

Use the number of participants 

required to be entered in line 5 of the 

Form 5500 to determine whether a plan 

is a ‘‘small plan’’ or a ‘‘large plan.’’

Exceptions: 

(1) 80–120 Participant Rule: If the 

number of participants reported on line 

5 is between 80 and 120, and a Form 

5500 Return/Report was filed for the 

prior plan year, you may elect to 

complete the return/report in the same 

category (‘‘large plan’’ or ‘‘small plan’’) 

as was filed for the prior return/report. 

Thus, if a Form 5500 Return/Report was 

filed for the 2008 plan year as a small 


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plan, including the Schedule I if 

applicable, and the number entered on 

line 5 of the 2009 Form 5500 is 120 or 

less, you may elect to complete the 2009 

Form 5500 and schedules in accordance 

with the instructions for a small plan, 

including, for eligible filers, filing the 

Form 5500–SF, instead of the Form 

5500 Return/Report. 

(2) Short Plan Year Rule: If the plan 

had a short plan year of 7 months or less 

for either the prior plan year or the plan 

year being reported on the 2009 Form 

5500, an election can be made to defer 

filing the accountant’s report in 

accordance with 29 CFR 2520.104–50. If 

such an election was made for the prior 

plan year, the 2009 Form 5500 Return/ 

Report must be completed following the 

requirements for a large plan, including 

the attachment of the Schedule H and 

the accountant’s reports, regardless of 

the number of participants entered in 

Part II, line 5. 

Form 5500 Schedules 

Pension Schedules 

Schedule R (Retirement Plan 

Information)—is required for a pension 

benefit plan that is a defined benefit 

plan or is otherwise subject to Code 

section 412 or ERISA section 302. 

Schedule R may also be required for 

certain other pension benefit plans 

unless otherwise specified under 

Limited Pension Plan Reporting. For 

additional information, see the 

Schedule R instructions. 

Schedule SB (Single-Employer 

Defined Benefit Plan Actuarial 

Information)— is required for most 

single-employer defined benefit plans, 

including multiple-employer defined 

benefit pension plans. For additional 

information, see the instructions for the 

Schedule SB. 

Schedule MB (Multiemployer Defined 

Benefit Plan and Certain Money 

Purchase Plan Actuarial Information)—

is required for most multiemployer 

defined benefit pension plans and for 

defined contribution pension plans that 

currently amortize a waiver of the 

minimum funding requirements 

specified in the instructions for the 

Schedule MB. For additional 

information, see the instructions for the 

Schedule MB. 

General Schedules 

Schedule H (Financial Information)—

is required for pension benefit plans and 

welfare plans filing as ‘‘large plans’’ and 

for all DFE filings. Employee benefit 

plans, 103–12 IEs, and GIAs filing the 

Schedule H are generally required to 

engage an independent qualified pubic 

accountant (IQPA) and attach a report of 

the IQPA pursuant to ERISA section 

103(a)(3)(A). These plans and DFEs are 

also generally required to attach to the 

Form 5500 Return/Report a ‘‘Schedule 

of Assets (Held at End of Year)’’ and, if 

applicable, a ‘‘Schedule of Assets 

(Acquired and Disposed of Within 

Year),’’ a ‘‘Schedule of Reportable 

Transactions,’’ and a ‘‘Schedule of 

Delinquent Participant Contributions.’’

For additional information, see the 

Schedule H instructions. 

Exceptions: Insured, unfunded, or 

combination unfunded/insured welfare 

plans, as described in 29 CFR 2520.104–

44(b)(1), and certain pension plans and 

arrangements described in 29 CFR 

2520.104–44(b)(2) and in Limited 

Pension Plan Reporting, are exempt 

from completing the Schedule H. 

Schedule I (Financial Information—

Small Plan) is required for all pension 

benefit plans and welfare benefit plans 

filing the Form 5500 Return/Report, 

rather than the Form 5500–SF, as ‘‘small 

plans,’’ except for certain pension 

benefit plans and arrangements 

described in 29 CFR 2520.104–44(b)(2) 

and in Limited Pension Plan Reporting. 

For additional information, see the 

Schedule I instructions. 

Schedule A (Insurance Information)—

is required if any benefits under an 

employee benefit plan are provided by 

an insurance company, insurance 

service or other similar organization 

(such as Blue Cross, Blue Shield, or a 

health maintenance organization). This 

includes investment contracts with 

insurance companies, such as 

guaranteed investment contracts and 

pooled separate accounts. For additional 

information, see the Schedule A 

instructions. 

Note: Do not file Schedule A for 

Administrative Services Only (ASO) 

contracts. Do not file Schedule A if a 

Schedule A is filed for the contract as part 

of the Form 5500 Return/Report filed directly 

by an MTIA or 103–12 IE. 

Schedule C (Service Provider 

Information)—is required for a large 

plan, MTIA, 103–12 IE, or GIA if (1) any 

service provider who rendered services 

to the plan or DFE during the plan or 

DFE year received $5,000 or more in 

compensation, directly or indirectly 

from the plan or DFE, or (2) an 

accountant and/or enrolled actuary has 

been terminated. For additional 

information, see the Schedule C 

instructions. 

Schedule D (DFE/Participating Plan 

Information)—Part I is required for a 

plan or DFE that invested or 

participated in any MTIAs, 103–12 IEs, 

CCTs, and/or PSAs. Part II is required 

when the Form 5500 Return/Report is 

filed for a DFE. For additional 

information, see the Schedule D 

instructions. 

Schedule G (Financial Transaction 

Schedules)—is required for a large plan, 

MTIA, 103–12 IE, or GIA when 

Schedule H (Financial Information) 

lines 4b, 4c, and/or 4d are checked 

‘‘Yes.’’ Part I of the Schedule G reports 

loans or fixed income obligations in 

default or classified as uncollectible. 

Part II of the Schedule G reports leases 

in default or classified as uncollectible. 

Part III of the Schedule G reports nonexempt transactions. For additional 

information, see the Schedule G 

instructions. 

CAUTION: An unfunded, fully 

insured, or combination unfunded/ 

insured welfare plan with 100 or more 

participants exempt under 29 CFR 

2520.104–44 from completing Schedule 

H must still complete Schedule G, Part 

III, to report nonexempt transactions. 

Pension Benefit Plan Filing 

Requirements 

Pension benefit plan filers must 

complete the Form 5500, including the 

signature block, and unless otherwise 

specified, attach the following 

schedules and information: 

Small Pension Plan 

The following schedules (including 

any additional information required by 

the instructions to the schedules) must 

be attached to a Form 5500 filed for a 

small pension plan that is neither 

exempt from filing nor is filing the Form 

5500–SF. 

1. Schedule A (as many as needed), to 

report insurance, annuity, and 

investment contracts held by the plan. 

2. Schedule SB or MB, to report 

actuarial information, if applicable. 

3. Schedule D, Part I, to list any CCTs, 

PSAs, MTIAs, and 103–12 IEs in which 

the plan invested at any time during the 

plan year. 

4. Schedule I, to report small plan 

financial information, unless exempt. 

5. Schedule R, to report retirement 

plan information, if applicable. 

CAUTION: If Schedule I, line 4k, is 

checked ‘‘No,’’ you must attached the 

report of the independent qualified 

public accountant (IQPA) or a statement 

that the plan is eligible and elects to 

defer attaching the IQPA’s opinion 

pursuant to 29 CFR 2520.104–50 in 

connection with a short plan year of 

seven months or less. 

Large Pension Plan 

The following schedules (including 

any additional information required by 

the instructions to the schedules) must 


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64816 Federal Register / Vol. 72, No. 221 / Friday, November 16, 2007 / Notices 

be attached to a Form 5500 filed for a 

large pension plan. 

1. Schedule A (as many as needed), to 

report insurance, annuity, and 

investment contracts held by the plan. 

2. Schedule SB or MB, to report 

actuarial information, if applicable. 

3. Schedule C, if applicable, to report 

information on service providers and, if 

applicable, any terminated accountants 

or enrolled actuaries. 

4. Schedule D, Part I, to list any CCTs, 

PSAs, MTIAs, and 103–12 IEs in which 

the plan invested at any time during the 

plan year. 

5. Schedule G, to report loans or fixed 

income obligations in default or 

determined to be uncollectible as of the 

end of the plan year, leases in default or 

classified as uncollectible, and 

nonexempt transaction, i.e., file 

Schedule G if Schedule H (Form 5500) 

lines 4b, 4c, and/or 4d are checked 

‘‘Yes.’’

6. Schedule H, to report large plan 

financial information, unless exempt. 

7. Schedule R, to report retirement 

plan information, if applicable. 

CAUTION: You must attach the report 

of the independent qualified public 

accountant (IQPA) identified on 

Schedule H, Line 3c, unless line 3d(2) 

is checked. 

Limited Pension Plan Reporting 

The pension benefit plans or 

arrangements described below are 

eligible for limited annual reporting: 

1. IRA Plans: A pension plan using 

individual retirement accounts or 

annuities (as described in Code section 

408) as the sole funding vehicle for 

providing pension benefits need 

complete only Form 5500, Part I and 

Part II, lines 1 through 5, and 8 (enter 

pension feature code 2N). 

2. Fully Insured Pension Plan: A 

pension benefit plan providing benefits 

exclusively through an insurance 

contract or contracts that are fully 

guaranteed and that meet all of the 

conditions of 29 CFR 2520.104–44(b)(2) 

during the entire plan year must 

complete all the requirements listed 

under this Pension Benefit Plan Filing 

Requirements section, except that such 

a plan is exempt from attaching 

Schedule H, Schedule I, and an 

independent qualified public 

accountant’s (IQPA’s) opinion, and from 

the requirement to engage an IQPA. 

A pension benefit plan that has 

insurance contracts of the type 

described in 29 CFR 2520.104–44 as 

well as other assets must complete all 

requirements for a pension benefit plan, 

except that the value of the plan’s 

allocated contracts (see below) should 

not be reported in Part I of Schedule H 

or I. All other assets should be reported 

on Schedule H or Schedule I, and any 

other required schedules. If Schedule H 

is filed, an IQPA’s report must be 

attached in accordance with the 

Schedule H instructions. 

Note: For purposes of the annual return/ 

report and the alternative method of 

compliance set forth in 29 CFR 2520.104–44, 

a contract is considered to be ‘‘allocated’’

only if the insurance company or 

organization that issued the contract 

unconditionally guarantees, upon receipt of 

the required premium or consideration, to 

provide a retirement benefit of a specified 

amount. This amount must be provided to 

each participant without adjustment for 

fluctuations in the market value of the 

underlying assets of the company or 

organization, and each participant must have 

a legal right to such benefits, which is legally 

enforceable directly against the insurance 

company or organization. For example, 

deposit administration, immediate 

participation guarantee, and guaranteed 

investment contracts are NOT allocated 

contracts for Form 5500 Return/Report 

purposes. 

Welfare Benefit Plan Filing 

Requirements 

Welfare benefit plan filers must 

complete the Form 5500, including the 

signature block and, unless otherwise 

specified, attach the following 

schedules and information: 

Small Welfare Plan 

The following schedules (including 

any additional information required by 

the instructions to the schedules) must 

be attached to a Form 5500 filed for a 

small welfare plan not exempt from 

filing that also is not eligible to file 

Form 5500–SF: 

1. Schedule A (as many as needed), to 

report insurance contracts held by the 

plan. 

2. Schedule D, Part I, to list any CCTs, 

PSAs, MTIAs, and 103–12 IEs in which 

the plan participated at any time during 

the plan year. 

3. Schedule I, to report small plan 

financial information. 

Large Welfare Plan 

The following schedules (including 

any additional information required by 

the instructions to the schedules) must 

be attached to a Form 5500 filed for a 

large welfare plan. 

1. Schedule A (as many as needed), to 

report insurance and investment 

contracts held by the plan. 

2. Schedule C, if applicable, to report 

information on service providers and 

any terminated accountants or actuaries. 

3. Schedule D, Part I, to list any CCTs, 

PSAs, MTIAs, and 103–12 IEs in which 

the plan invested at any time during the 

plan year. 

4. Schedule G, to report loans or fixed 

income obligations in default or 

determined to be uncollectible as of the 

end of the plan year, leases in default or 

classified as uncollectible, and 

nonexempt transactions, i.e., file 

Schedule G if Schedule H (Form 5500) 

lines 4b, 4c, and/or 4d are checked 

‘‘Yes’’ or if a large welfare plan that is 

not required to file a Schedule H has 

nonexempt transactions. 

5. Schedule H, to report financial 

information, unless exempt. 

CAUTION: Attach the report of the 

independent qualified public 

accountant (IQPA) identified on 

Schedule H, line 3c, unless line 3d(2) is 

checked. 

TIP: Neither Schedule H nor an 

IQPA’s opinion should be attached to a 

Form 5500 filed for an unfunded, fully 

insured or combination unfunded/ 

insured welfare plan that covered 100 or 

more participants as of the beginning of 

the plan year which meets the 

requirements of 29 CFR 2520.104–44. 

However, Schedule G, Part III, must be 

attached to the Form 5500 to report any 

nonexempt transactions. A welfare 

benefit plan that uses a ‘‘voluntary 

employees’ beneficiary association’’

(VEBA) under Code section 501(c)(9) is 

generally not exempt from the 

requirement of engaging an IQPA. 

Direct Filing Entity (DFE) Filing 

Requirements 

Some plans participate in certain 

trusts, accounts, and other investment 

arrangements that file the Form 5500 

Return/Report as a DFE. A Form 5500 

Return/Report must be filed for a master 

trust investment account (MTIA). A 

Form 5500 Return/Report is not 

required but may be filed for a common/ 

collective trust (CCT), pooled separate 

account (PSA), 103–12 investment 

entity (103–12 IE), or group insurance 

arrangement (GIA). However, plans that 

participate in CCTs, PSAs, 103–12 IEs, 

or GIAs that file as DFEs generally are 

eligible for certain annual reporting 

relief. For reporting purposes, a CCT, 

PSA, 103–12 IE, or GIA is considered a 

DFE only when a Form 5500 and all 

required schedules attachments are filed 

for it in accordance with the following 

instructions. 

Only one Form 5500 Return/Report 

should be filed for each DFE for all 

plans participating in the DFE; however, 

the Form 5500 Return/Report filed for 

the DFE, including all required 

schedules and attachments, must report 

information for the DFE year (not to 

exceed 12 months in length) that ends 

with or within the participating plan’s 

year. Any Form 5500 Return/Report 

filed for a DFE is an integral part of the 


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annual report of each participating plan, 

and the plan administrator may be 

subject to penalties for failing to file a 

complete annual report unless both the 

DFE’s Form 5500 Return/Report and the 

plan’s Form 5500 Return/Report are 

properly filed. The information required 

for a Form 5500 Return/Report filed for 

a DFE varies according to the type of 

DFE. The following paragraphs provide 

specific guidance for the reporting 

requirements for each type of DFE. 

Master Trust Investment Account 

(MTIA) 

The administrator filing a Form 5500 

Return/Report for an employee benefit 

plan is required to file or have a 

designee also file a Form 5500 Return/ 

Report for each MTIA in which the plan 

participated at any time during the plan 

year. For reporting purposes, a ‘‘master 

trust’’ is a trust for which a regulated 

financial institution (as defined below) 

serves as trustee or custodian (regardless 

of whether such institution exercises 

discretionary authority or control with 

respect to the management of assets 

held in the trust), and in which assets 

of more than one plan sponsored by a 

single-employer or by a group of 

employers under common control are 

held. 

‘‘Common control’’ is determined on 

the basis of all relevant facts and 

circumstances (whether or not such 

employers are incorporated). A 

‘‘regulated financial institution’’ means 

a bank, trust company, or similar 

financial institution that is regulated, 

supervised, and subject to periodic 

examination by a state or Federal 

agency. A securities brokerage firm is 

not a ‘‘similar financial institution’’ as 

used here. See DOL Advisory Opinion 

93–21A (available at http:// 

www.dol.gov/ebsa). 

The assets of a master trust are 

considered for reporting purposes to be 

held in one or more ‘‘investment 

accounts.’’ A ‘‘master trust investment 

account’’ may consist of a pool of assets 

or a single asset. Each pool of assets 

held in a master trust must be treated as 

a separate MTIA if each plan that has an 

interest in the pool has the same 

fractional interest in each asset in the 

pool as its fractional interest in the pool, 

and if each such plan may not dispose 

of its interest in any asset in the pool 

without disposing of its interest in the 

pool. A master trust may also contain 

assets that are not held in such a pool. 

Each such asset must be treated as a 

separate MTIA. 

Notes: (1) If a MTIA consists solely of one 

plan’s asset(s) during the reporting period, 

the plan may report the asset(s) either as an 

investment account on a MTIA’s Form 5500, 

or as a plan asset(s) that is not part of the 

master trust (and therefore subject to all 

instructions concerning assets not held in a 

master trust) on the plan’s Form 5500. (2) If 

a master trust holds assets attributable to 

participant or beneficiary directed 

transactions under an individual account 

plan and the assets are interests in registered 

investment companies, interests in contracts 

issued by an insurance company licensed to 

do business in any state, interests in 

common/collective trusts maintained by a 

bank, trust company or similar institution, or 

have a current value that is readily 

determinable on an established market, those 

assets may be treated as a single MTIA. The 

Form 5500 Return/Report submitted for the 

MTIA must comply with the instructions for 

a Large Pension Plan, unless otherwise 

specified in the forms and instructions. 

The MTIA must file: 

1. Form 5500, except lines C, D, 1c, 

2d, and 6 through 9. Be certain to enter 

‘‘M’’ in Part 1, A. 

2. Schedule A (as many as needed) to 

report insurance, annuity and 

investment contracts held by the MTIA. 

3. Schedule C, if applicable, to report 

service provider information. Part II is 

not required for a MTIA. 

4. Schedule D, to list CCTs, PSAs, and 

103–12 IEs in which the MTIA invested 

at any time during the MTIA year and 

to list all plans that participated in the 

MTIA during its year. 

5. Schedule G, to report loans or fixed 

income obligations in default or 

determined to be uncollectible as of the 

end of the MTIA year, all leases in 

default or classified as uncollectible, 

and nonexempt transactions. 

6. Schedule H, except lines 1b(1), 

1b(2), 1c(8), 1g, 1h, 1i, 2a, 2b(1)(E), 2e, 

2f, 2g, 4a, 4e, 4f, 4g, 4h, 4k, 4l, 4m, 4n, 

and 5, to report financial information. 

An independent qualified public 

accountant’s (IQPA’s) opinion is not 

required for a MTIA. 

7. Additional information required by 

the instructions to the above schedules, 

including, for example, the schedules of 

assets held for investment and the 

schedule of reportable transactions. For 

purposes of the schedule of reportable 

transactions, the 5% figure shall be 

determined by comparing the current 

value of the transaction at the 

transaction date with the current value 

of the investment account assets at the 

beginning of the applicable fiscal year of 

the MTIA. All attachments must be 

properly labeled. 

Common/Collective Trust (CCT) and 

Pooled Separate Account (PSA) 

A Form 5500 Return/Report is not 

required to be filed for a CCT or PSA. 

However, the administrator of a large 

plan or DFE that participates in a CCT 

or PSA that files as specified below is 

entitled to reporting relief that is not 

available to plans or DFEs participating 

in a CCT or PSA for which a Form 5500 

Return/Report is not filed. 

For reporting purposes, ‘‘common/ 

collective trust’’ and ‘‘pooled separate 

account’’ are, respectively: (1) A trust 

maintained by a bank, trust company, or 

similar institution or (2) an account 

maintained by an insurance carrier, 

which are regulated, supervised, and 

subject to periodic examination by a 

state or Federal agency in the case of a 

CCT, or by a state agency in the case of 

a PSA, for the collective investment and 

reinvestment of assets contributed 

thereto from employee benefit plans 

maintained by more than one employer 

or controlled group of corporations as 

that term is used in Code section 1563. 

See 29 CFR 2520.103–3, 103–4, 103–5, 

and 103–9. 

Note: For reporting purposes, a separate 

account that is not considered to be holding 

plan assets pursuant to 29 CFR 2510.3–

101(h)(1)(iii) does not constitute a pooled 

separate account. The Form 5500 Return/ 

Report submitted for a CCT or PSA must 

comply with the instructions for a Large 

Pension Plan, unless otherwise specified in 

the forms and instructions. 

The CCT or PSA must file: 

1. Form 5500, except lines C, D, 1c, 

2d, and 6 through 9. Enter ‘‘C’’ or ‘‘P, 

as appropriate, in Part I, line A. 

2. Schedule D, to list all CCTs, PSAs, 

MTIAs, and 103–12 IEs in which the 

CCT or PSA invested at any time during 

the CCT or PSA year and to list in Part 

II all plans that participated in the CCT 

or PSA during its year. 

3. Schedule H, except lines 1b(1), 

1b(2), 1c(8), 1d, 1e, 1g, 1h, 1i, 2a, 

2b(1)(E), 2e, 2f, and 2g, to report 

financial information. Part IV and an 

independent qualified public 

accountant’s (IQPA’s) opinion are not 

required for a CCT or PSA. 

CAUTION: Different requirements 

apply to the Schedules D and H 

attached to the Form 5500 filed by plans 

and DFEs participating in CCTs and 

PSAs, depending upon whether a DFE 

Form 5500 Return/Report has been filed 

for the CCT or PSA. See the instructions 

for these schedules. 

103–12 Investment Entity (103–12 IE) 

DOL Regulation 2520.103–12 

provides an alternative method of 

reporting for plans that invest in an 

entity (other than a MTIA, CCT, or 

PSA), whose underlying assets include 

‘‘plan assets’’ within the meaning of 29 

CFR 2510.3–101 of two or more plans 

that are not members of a ‘‘related 

group’’ of employee benefit plans. Such 

an entity for which a Form 5500 Return/ 

Report is filed constitutes a ‘‘103–12 


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IE.’’ A Form 5500 Return/Report is not 

required to be filed for such entities; 

however, filing a Form 5500 Return/ 

Report as a 103–12 IE provides certain 

reporting relief, including the limitation 

of the examination and report of the 

independent qualified public 

accountant (IQPA) provided by 29 CFR 

2520.103–12(d), to participating plans 

and DFEs. For this reporting purpose, a 

‘‘related group’’ of employee benefit 

plans consists of each group of two or 

more employee benefit plans (1) each of 

which receives 10% or more of its 

aggregate contributions from the same 

employer or from a member of the same 

controlled group of corporations (as 

determined under Code section 1563(a), 

without regard to Code section 

1563(a)(4) thereof); or (2) each of which 

is either maintained by, or maintained 

pursuant to a collective-bargaining 

agreement negotiated by, the same 

employee organization or affiliated 

employee organizations. For purposes of 

this paragraph, an ‘‘affiliate’’ of an 

employee organization means any 

person controlling, controlled by, or 

under common control with such 

organization. See 29 CFR 2520.103–12. 

The Form 5500 Return/Report 

submitted for a 103–12 IE must comply 

with the instructions for a Large Pension 

Plan, unless otherwise specified in the 

forms and instructions. 

The 103–12 IE must file: 

1. Form 5500, except lines C, D, 1c, 

2d, and 6 through 9. Enter ‘‘E’’ in Part 

I, line A. 

2. Schedule A (as many as needed), to 

report insurance, annuity and 

investment contracts held by the 103–12 

IE. 

3. Schedule C, if applicable, to report 

service provider information and any 

terminated accountants. 

4. Schedule D, to list all CCTs, PSAs, 

and 103–12 IEs in which the 103–12 IE 

invested at any time during the 103–12 

IE’s year, and to list all plans that 

participated in the 103–12 IE during its 

year. 

5. Schedule G, to report loans or fixed 

income obligations in default or 

determined to be uncollectible as of the 

end of the 103–12 IE year, leases in 

default or classified as uncollectible, 

and nonexempt transactions. 

6. Schedule H, except lines 1b(1), 

1b(2), 1c(8), 1d, 1e, 1g, 1h, 1i, 2a, 

2b(1)(E), 2e, 2f, 2g, 4a, 4e, 4f, 4g, 4h, 4j, 

4k, 4l, 4m, 4n, and 5, to report financial 

information. 

7. Additional information required by 

the instructions to the above schedules, 

including, for example, the report of the 

independent qualified public account 

(IQPA) identified on Schedule H, line 

3c, and the schedule(s) of assets held for 

investment. All attachments must be 

properly labeled. 

Group Insurance Arrangement (GIA) 

Each welfare benefit plan that is part 

of a group insurance arrangement is 

exempted from the requirement to file a 

Form 5500 Return/Report if a 

consolidated Form 5500 Return/Report 

for all the plans in the arrangement was 

filed in accordance with 29 CFR 

2520.104–43. For reporting purposes, a 

‘‘group insurance arrangement’’

provides benefits to the employees of 

two or more unaffiliated employers (not 

in connection with a multiemployer 

plan or a collectively-bargained 

multiple-employer plan), fully insures 

one or more welfare plans of each 

participating employer, uses a trust or 

other entity as the holder of the 

insurance contracts, and uses a trust as 

the conduit for payment of premiums to 

the insurance company. 

The GIA must file: 

1. Form 5500, except lines C and 2d. 

Enter ‘‘G’’ in Part I, line A. 

2. Schedule A (as many as needed), to 

report insurance, annuity and 

investment contracts held by the GIA. 

3. Schedule C, if applicable, to report 

service provider information and any 

terminated accountants. 

4. Schedule D, to list all CCTs, PSAs, 

and 103–12 IEs in which the GIA 

invested at any time during the GIA 

year, and to list all plans that 

participated in the GIA during its year. 

5. Schedule G, to report loans or fixed 

income obligations in default or 

determined to be uncollectible as of the 

end of the GIA year, leases in default or 

classified as uncollectible, and 

nonexempt transactions. 

6. Schedule H, except lines 4a, 4e, 4f, 

4g, 4h, 4k, 4m, 4n, and 5, to report 

financial information. 

7. Additional information required by 

the instructions to the above schedules, 

including, for example, the report of the 

independent qualified accountant 

(IQPA) identified on Schedule H, line 

3c, the schedules of assets held for 

investment and the schedule of 

reportable transactions. All attachments 

must be properly labeled. 

Section 5: Line-by-Line Instructions 

Instructions of Part I and Part II of 2009 

Form 5500 

lllllllllllllllllll

Part I—Annual Return/Report 

Identification Information 

File the 2009 Form 5500 Return/ 

Report for a plan year that began in 2009 

or a DFE year that ended in 2009. If the 

plan or DFE year is not the 2009 

calendar year, enter the dates in Part I. 

The 2009 Form 5500 Return/Report 

must be filed electronically. Because of 

this, filings for 2009 plan years, 

including short plan years, cannot use 

prior year paper forms. 

One Form 5500 is generally filed for 

each plan or entity described in the 

instructions to boxes in line A. Do not 

check more than one box. 

A separate Form 5500 must be filed 

by each employer participating in a plan 

or program of benefits in which the 

funds attributable to each employer are 

available to pay benefits only for that 

employer’s employees, even if the plan 

is maintained by a controlled group. 

A ‘‘controlled group’’ is generally 

considered one employer for Form 5500 

reporting purposes. A ‘‘controlled 

group’’ is a controlled group of 

corporations under Code section 414(b), 

a group of trades or businesses under 

common control under Code section 

414(c), or an affiliated service group 

under Code section 414(m). 

Box A (Multiemployer Plan). Check 

this box if the Form 5500 is filed for a 

multiemployer plan. A plan is a 

multiemployer plan if: (a) More than 

one employer is required to contribute, 

(b) the plan is maintained pursuant to 

one or more collective bargaining 

agreements between one or more 

employee organizations and more than 

one employer, and (c) an election under 

Code section 414(f)(5) and ERISA 

section 3(37)(E) has not been made. A 

plan that has made a proper election 

under ERISA section 3(37)(G) and Code 

section 414(f)(6) on or before Aug. 17, 

2007, is also a multiemployer plan. 

Participating employers do not file 

individually for these plans. See 29 CFR 

2510.3–37. 

Box A (Single-Employer Plan). Check 

this box if the Form 5500 is filed for a 

single-employer plan. A singleemployer plan for this Form 5500 

reporting purpose is an employee 

benefit plan maintained by one 

employer or one employee organization. 

Box A (Multiple-Employer Plan). 

Check this box if the Form 5500 is being 

filed for a multiple-employer plan. A 

multiple-employer plan is a plan that is 

maintained by more than one employer 

and is not one of the plans already 

described. Multiple-employer plans can 

be collectively bargained and 

collectively funded, but, if covered by 

PBGC termination insurance, must have 

properly elected before September 27, 

1981, not to be treated as a 

multiemployer plan under Code section 

414(f)(5) or ERISA sections 3(37)(E) and 

4001(a)(3). Participating employers do 

not file individually for these plans. Do 

not check this box if the employers 


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maintaining the plan are members of the 

same controlled group. 

Box A (Direct Filing Entity). Check 

this box and enter the correct letter from 

the following chart in the space 

provided to indicate the type of entity. 

Type of entity Enter the letter 

Master trust investment account ................................... M 

Common/collective trust ......... C 

Pooled separate account ........ P 

103–12 investment entity ....... E 

Group insurance arrangement G 

Note: A separate annual report with an 

‘‘M’’ entered on Form 5500, box A, must be 

filed for each MTIA. 

Box B (First Return/Report). Check 

this box if an annual return/report has 

not been previously filed for this plan 

or DFE. For the purpose of completing 

box B, the Form 5500-EZ is not 

considered an annual return/report. 

Box B (Amended Return/Report). 

Check this box if this Form 5500 

Return/Report is being submitted as an 

amended return/report to correct errors 

and/or omissions on a previously filed 

Form 5500 Return/Report for the 2009 

plan year. 

Box B (Final Return/Report). Check 

this box if this Form 5500 Return/Report 

is the last annual return/report required 

to be submitted for this plan. (See Final 

Return/Report.) 

Note: Do not check box B (Final Return/ 

Report) if ‘‘4R’’ is entered on line 8b for a 

welfare plan that is not required to file a 

Form 5500 Return/Report for the next plan 

year because the welfare plan has become 

eligible for an annual reporting exemption. 

For example, certain unfunded and insured 

welfare plans may be required to file the 

2008 Form 5500 and be exempt from filing 

a Form 5500 Return/Report for the plan year 

2009 if the number of participants covered as 

of the beginning of the 2009 plan year drops 

below 100. See Who Must File. Should the 

number of participants covered by such a 

plan increase to 100 or more in a future year, 

the plan must resume filing the Form 5500 

Return/Report and enter ‘‘4S’’ on line 8b on 

that year’s Form 5500. See 29 CFR 2520.104–

20. 

Box B (Short Plan Year Return/ 

Report). Check this box if this Form 

5500 Return/Report is being filed for a 

plan year of less than 12 months. Show 

the dates in the space provided. 

Box C. Check box C when the 

contributions to the plan and/or the 

benefits paid by the plan are subject to 

the collective bargaining process (even 

if the plan is not established and 

administered by a joint board of trustees 

and even if only some of the employees 

covered by the plan are members of a 

collective bargaining unit that negotiates 

contributions and/or benefits). The 

contributions and/or benefits do not 

have to be identical for all employees 

under the plan. 

Box D. Check the appropriate entry 

here if: 

• You filed for an extension of time 

to file this form with the IRS using a 

completed Form 5558, Application for 

Extension of Time To File Certain 

Employee Plan Returns (maintain a 

copy of the Form 5558 with the filer’s 

records). 

• You are filing using the automatic 

extension of time to file the Form 5500 

Return/Report until the due date of the 

Federal income tax return of the 

employer (maintain a copy of the 

employer’s extension of time to file the 

income tax return with the filer’s 

records). 

• You are filing using a special 

extension of time to file the Form 5500 

Return/Report that has been announced 

by the IRS, DOL, and PBGC. If you 

checked that you are using a special 

extension of time, enter a description of 

the extension of time in the space 

provided. 

• You are filing under DOL’s 

Delinquent Filer Voluntary Compliance 

(DVFC) Program. 

Part II—Basic Plan Information 

Line 1a. Enter the formal name of the 

plan or DFE, or enough information to 

identify the plan or DFE. Abbreviate if 

necessary. If an annual return/report has 

previously been filed on behalf of the 

plan, regardless of the type of Form that 

was filed (Form 5500, Form 5500-EZ, 

Form 5500-SF) use the same 

abbreviation as was used on the prior 

filings. Once you use an abbreviation, 

continue to use it for that plan on all 

future annual return/report filings with 

the IRS, DOL, and PBGC. Do not use the 

same name or abbreviation for any other 

plan, even if the first plan is terminated. 

Line 1b. Enter the three-digit plan or 

entity number (PN) the employer or 

plan administrator assigned to the plan 

or DFE. This three-digit number, in 

conjunction with the employer 

identification number (EIN) entered on 

line 2b, is used by the IRS, DOL, and 

PBGC as a unique 12-digit number to 

identify the plan or DFE. 

Start at 001 for plans providing 

pension benefits or DFEs as illustrated 

in the table below. Start at 501 for 

welfare plans and GIAs. Do not use 888 

or 999. Once you use a plan or DFE 

number, continue to use it for that plan 

or DFE on all future filings with the IRS, 

DOL, and PBGC. Do not use it for any 

other plan or DFE, even if the first plan 

or DFE is terminated. 

For each Form 5500 with the same EIN (line 2b), when Assign PN 

Part II, box 8a is checked, or Part I, A is checked and an M, C, P, or E 

is entered.

001 to the first plan or DFE. Consecutively number others as 002, 003, 

. . . 

Part II, Box 8b is checked and 8a is not checked, or Part I, A is 

checked and a G is entered.

501 to the first plan or GIA. Consecutively number others as 502, 503, 

. . . 

Line 1c. Enter the date the plan first 

became effective. 

Line 2a. 

1. Enter the name of the plan sponsor 

or, in the case of a Form 5500 filed for 

a DFE, the name of the insurance 

company, financial institution, or other 

sponsor of the DFE (e.g., in the case of 

a GIA, the trust or other entity that 

holds the insurance contract, or in the 

case of an MTIA, one of the sponsoring 

employers). If the plan covers only the 

employees of one employer, enter the 

employer’s name. 

The term ‘‘plan sponsor’’ means: 

• The employer, for an employee 

benefit plan that a single-employer 

established or maintains; 

• The employee organization in the 

case of a plan of an employee 

organization; or 

• The association, committee, joint 

board of trustees, or other similar group 

of representatives of the parties who 

establish or maintain the plan, if the 

plan is established or maintained jointly 

by one or more employers and one or 

more employee organizations, or by two 

or more employers. 

Note: In the case of a multiple-employer 

plan, if an association or similar entity is not 

the sponsor, enter the name of a participating 

employer as sponsor. A plan of a controlled 

group of corporations should enter the name 

of one of the sponsoring members. In either 

case, the same name must be used in all 

subsequent filings of the Form 5500 Return/ 

Report for the multiple-employer plan or 

controlled group (see instructions to line 4 

concerning change in sponsorship). 

2. Enter any ‘‘in care of ‘‘ (C/O) name. 


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3. Enter the street address. A post 

office box number may be entered if the 

Post Office does not deliver mail to the 

sponsor’s street address. 

4. Enter the name of the city. 

5. Enter the two-character 

abbreviation of the U.S. state or 

possession and zip code. 

6. Enter the foreign routing code, if 

applicable. Leave U.S. state and zip 

code blank if entering a foreign routing 

code and country name. 

7. Enter the foreign country, if 

applicable. 

8. Enter the D/B/A (doing business as) 

or trade name of the sponsor if different 

from the plan sponsor’s name. 

9. Enter any second address. Use only 

a street address, not a P.O. Box, here. 

Line 2b. Enter the nine-digit employer 

identification number (EIN) assigned to 

the plan sponsor/employer, for example, 

00–1234567. In the case of a DFE, enter 

the EIN assigned to the CCT, PSA, 

MTIA, 103–12 IE, or GIA. Do not use a 

social security number in lieu of an EIN. 

The Form 5500 is open to public 

inspection, and the contents are public 

information and are subject to 

publication on the Internet. Because of 

privacy concerns, the inclusion of a 

social security number on this line may 

result in the rejection of the filing. 

EINs may be obtained by applying for 

one on Form SS–4, Application for 

Employer Identification Number, as 

soon as possible. You can obtain Form 

SS–4 by calling 1–800–TAX–FORM (1–

800–829–3676) or at the IRS Web Site at 

http://www.irs.gov. The EBSA does not 

issue EINs. 

A multiple-employer plan or plan of 

a controlled group of corporations 

should use the EIN of the sponsor 

identified in line 2a. This EIN must be 

used in all subsequent filings of the 

Form 5500 Return/Report for these 

plans (see instructions to line 4 

concerning change in EIN). 

If the plan sponsor is a group of 

individuals, get a single EIN for the 

group. When you apply for a number, 

enter on line 1 of Form SS–4 the name 

of the group, such as ‘‘Joint Board of 

Trustees of the Local 187 Machinists’’

Retirement Plan.’’ EINs may be obtained 

by filing Form SS–4 as explained above. 

Note: EINs for funds (trusts or custodial 

accounts) associated with plans (other than 

DFEs) are generally not required to be 

furnished on the Form 5500; the IRS will 

issue EINs for such funds for other reporting 

purposes. EINs may be obtained by filing 

Form SS–4 as explained above. Plan sponsors 

should use the trust EIN described above 

when opening a bank account or conducting 

other transactions for a trust that require an 

EIN. 

Line 2c. Enter the telephone number 

for the plan sponsor. 

Line 2d. Enter the six-digit business 

code that best describes the nature of 

the plan sponsor’s business from the list 

of business codes in Form 5500 Codes 

for Principal Business Activity, 

contained in these Instructions. If more 

than one employer or employee 

organization is involved, enter the 

business code for the main business 

activity of the employers and/or 

employee organizations. 

Line 3a. Please limit your response to 

the information required below: 

1. Enter the name of the plan 

administrator unless the administrator 

is the sponsor identified in line 2 or the 

Form 5500 is submitted for a DFE (Part 

I, box A should be checked and enter 

the appropriate DFE code). If this is the 

case, enter the word ‘‘same’’ on line 3a 

and leave the remainder of line 3a, and 

all of lines 3b and 3c blank. 

Plan administrator means: 

• The person or group of persons 

specified as the administrator by the 

instrument under which the plan is 

operated; 

• The plan sponsor/employer if an 

administrator is not so designated; or 

• Any other person prescribed by 

regulations if an administrator is not 

designated and a plan sponsor cannot be 

identified. 

2. Enter any ‘‘in care of’’ (C/O) name. 

3. Enter the street address. A post 

office box number may be entered if the 

Post Office does not deliver mail to the 

administrator’s street address. 

4. Enter the name of the city. 

5. Enter the two-character 

abbreviation of the U.S. state or 

possession and zip code. 

6. Enter the foreign routing code and 

foreign country, if applicable. Leave 

U.S. state and zip code blank if entering 

foreign routing code and country 

information. 

Line 3b. Enter the plan administrator’s 

nine-digit EIN. A plan administrator 

must have an EIN for Form 5500 

reporting purposes. If the plan 

administrator does not have an EIN, 

apply for one as explained in the 

instructions for line 2b. One EIN should 

be entered for a group of individuals 

who are, collectively, the plan 

administrator. 

Note: Employees of the plan sponsor who 

perform administrative functions for the plan 

are generally not the plan administrator 

unless specifically designated in the plan 

document. If an employee of the plan 

sponsor is designated as the plan 

administrator, that employee must get an 

EIN. 

Line 4. If the plan sponsor’s or DFE’s 

name and/or EIN have changed since 

the last return/report was filed for this 

plan or DFE, enter the plan sponsor’s or 

DFE’s name, EIN, and the plan number 

as it appeared on the last return/report 

filed. 

CAUTION: The failure to indicate on 

Line 4 that a plan was previously 

identified by a different Employer 

Identification Number (EIN) or Plan 

Number (PN) could result in 

correspondence from the DOL and the 

IRS. 

Lines 5 and 6. All filers must 

complete both lines 5 and 6 unless the 

Form 5500 is filed for an IRA Plan 

eligible for Limited Pension Plan 

Reporting or for a DFE. 

The description of ‘‘participant’’ in 

the instructions below is only for 

purposes of these lines. 

For welfare plans, the number of 

participants should be determined by 

reference to 29 CFR 2510.3–3(d)(1), 

which provides that an individual 

becomes a participant covered under an 

employee welfare benefit plan on the 

earlier of: the date designated by the 

plan as the date on which the individual 

begins participation in the plan; the date 

on which the individual becomes 

eligible under the plan for a benefit 

subject only to occurrence of the 

contingency for which the benefit is 

provided; or the date on which the 

individual makes a contribution to the 

plan, whether voluntary or mandatory. 

‘‘Participants’’ includes former 

employees who are receiving group 

health continuation coverage benefits 

pursuant to Part 6 of ERISA and who are 

covered by the employee welfare benefit 

plan. Covered dependents are not 

counted as participants or beneficiaries. 

A child who is an ‘‘alternate 

recipient’’ entitled to health benefits 

under a qualified medical child support 

order should not be counted as a 

participant for lines 5 and 6. An 

individual is not a participant covered 

under an employee welfare plan on the 

earliest date on which the individual 

(A) is ineligible to receive any benefit 

under the plan even if the contingency 

for which such benefit is provided 

should occur, and (B) is not designated 

by the plan as a participant. See 29 CFR 

2510.3–3(d)(2). 

TIP: Before counting the number of 

participants in welfare plans, it is 

important for Form 5500 Return/Report 

purposes to determine whether the plan 

sponsor has established one or more 

plans. As a matter of plan design, plan 

sponsors can offer benefits through 

various structures and combinations. 

For example, a plan sponsor could 

create (i) one plan providing major 

medical benefits, dental benefits, and 

vision benefits, (ii) two plans with one 

providing major medical benefits and 

the other providing self-insured dental 


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and vision benefits, or (iii) three 

separate plans. You must review the 

governing documents and actual 

operations to determine whether welfare 

benefits are being provided under a 

single plan or separate plans. 

The fact that you have separate 

insurance policies for each different 

welfare benefit does not necessarily 

mean that you have separate plans. 

Some plan sponsors use a ‘‘wrap’’

document to incorporate various 

benefits and insurance policies into one 

comprehensive plan. In addition, 

whether a benefit arrangement is 

deemed to be a single plan may be 

different for purposes other than the 

Form 5500 Return/Report. For example, 

special rules may apply for purposes of 

HIPAA, COBRA, and Internal Revenue 

Code compliance. If you need help 

determining whether you have a single 

welfare benefit plan for purposes of the 

Form 5500 Return/Report, you should 

consult a qualified benefits consultant 

or legal counsel. 

For pension benefit plans, ‘‘alternate 

payees’’ entitled to benefits under a 

qualified domestic relations order 

(QDRO) are not to be counted as 

participants for these lines. 

For pension benefit plans, 

‘‘participant’’ means any individual 

who is included in one of the categories 

below: 

1. Active participants include any 

individuals who are currently in 

employment covered by a plan and who 

are earning or retaining credited service 

under a plan. This category includes 

any individuals who are eligible to elect 

to have the employer make payments to 

a Code section 401(k) qualified cash or 

deferred arrangement. Active 

participants also include any nonvested 

individuals who are earning or retaining 

credited service under a plan. This 

category does not include (a) nonvested 

former employees who have incurred 

the break in service period specified in 

the plan or (b) former employees who 

have received a ‘‘cash-out’’ distribution 

or deemed distribution of their entire 

nonforfeitable accrued benefit. 

2. Retired or separated participants 

receiving benefits are any individuals 

who are retired or separated from 

employment covered by the plan and 

who are receiving benefits under the 

plan. This category does not include any 

individual to whom an insurance 

company has made an irrevocable 

commitment to pay all the benefits to 

which the individual is entitled under 

the plan. 

3. Other retired or separated 

participants entitled to future benefits 

are any individuals who are retired or 

separated from employment covered by 

the plan and who are entitled to begin 

receiving benefits under the plan in the 

future. This category does not include 

any individual to whom an insurance 

company has made an irrevocable 

commitment to pay all the benefits to 

which the individual is entitled under 

the plan. 

4. Deceased individuals who had one 

or more beneficiaries who are receiving 

or are entitled to receive benefits under 

the plan. This category does not include 

an individual if an insurance company 

has made an irrevocable commitment to 

pay all the benefits to which the 

beneficiaries of that individual are 

entitled under the plan. 

Line 6g. Enter the number of 

participants included on line 6f (total 

participants at the end of the plan year) 

who have account balances. For 

example, for a Code section 401(k) plan 

the number entered on line 6g should be 

the number of participants counted on 

line 6f who have made a contribution to 

the plan for this plan year or any prior 

plan year. Defined benefit plans should 

leave line 6g blank. 

Line 6h. Include any individual who 

terminated employment during this 

plan year, whether or not he or she (a) 

incurred a break in service, (b) received 

an irrevocable commitment from an 

insurance company to pay all the 

benefits to which he or she is entitled 

under the plan, and/or (c) received a 

cash distribution or deemed cash 

distribution of his or her nonforfeitable 

accrued benefit. Multiemployer plans 

and multiple-employer plans that are 

collectively bargained do not have to 

complete line 6h. 

Line 7. For multiemployer plans, 

enter the total number of employers 

obligated to contribute to the plan. For 

purposes of line 7 of the Form 5500, an 

employer obligated to contribute means 

each employer for the 2009 plan year, 

who is a party to the collective 

bargaining agreement(s) pursuant to 

which the plan is maintained or who 

otherwise may be subject to withdrawal 

liability pursuant to section 4203 of the 

Act. Any two or more contributing 

entities (e.g., places of business with 

separate collective bargaining 

agreements) that have the same ninedigit employer identification number 

(EIN) must be aggregated and counted as 

a single-employer for this purpose. 

Line 8—Benefits Provided Under the 

Plan. In Line 8a or 8b, as appropriate, 

enter all applicable plan characteristic 

codes from the List of Plan 

Characteristic Codes in these 

Instructions that describe the 

characteristics of the plan being 

reported. 

CAUTION: Applicable to plan 

sponsors of Puerto Rico plans. Enter 

condition code 3C only in instances 

where there was no election made under 

section 1022(i)(2) of ERISA and, 

therefore, the plan does not intend to 

qualify under section 401(a) of the Code. 

If an election was made under section 

1022(i)(2) of ERISA, do not enter 

condition code 3C. 

Line 9—Funding and Benefit 

Arrangements. Check all boxes that 

apply to indicate the funding and 

benefit arrangements used during the 

plan year. The ‘‘funding arrangement’’ is 

the method for the receipt, holding, 

investment, and transmittal of plan 

assets prior to the time the plan actually 

provides benefits. The ‘‘benefit 

arrangement’’ is the method by which 

the plan provides benefits to 

participants. 

For the purposes of line 9: 

‘‘Insurance’’ means the plan has an 

account, contract, or policy with an 

insurance company, insurance service, 

or other similar organization (such as 

Blue Cross, Blue Shield, or a health 

maintenance organization) during the 

plan or DFE year. (This includes 

investments with insurance companies 

such as guaranteed investment contracts 

(GICs).) An annuity account 

arrangement under Code section 

403(b)(1) that is required to complete 

the Form 5500 Return/Report should 

mark ‘‘insurance’’ for both the plan 

funding arrangement and plan benefit 

arrangement. Do not check ‘‘insurance’’

if the sole function of the insurance 

company was to provide administrative 

services. 

‘‘Code section 412(e)(3) insurance 

contracts’’ are contracts that provide 

retirement benefits under a plan that are 

guaranteed by an insurance carrier. In 

general, such contracts must provide for 

level premium payments over the 

individual’s period of participation in 

the plan (to retirement age), premiums 

must be timely paid as currently 

required under the contract, no rights 

under the contract may be subject to a 

security interest, and no policy loans 

may be outstanding. If a plan is funded 

exclusively by the purchase of such 

contracts, the otherwise applicable 

minimum funding requirements of 

section 412 of the Code and section 302 

of ERISA do not apply for the year and 

neither the Schedule MB nor SB is 

required to be filed. 

‘‘Trust’’ includes any fund or account 

that receives, holds, transmits, or 

invests plan assets other than an 

account or policy of an insurance 

company. A custodial account 

arrangement under Code section 

403(b)(7) that is required to complete 


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the Form 5500 Return/Report should 

mark ‘‘trust’’ for both the plan funding 

arrangement and plan benefit 

arrangement. 

‘‘General assets of the sponsor’’ means 

either the plan had no assets or some 

assets were commingled with the 

general assets of the plan sponsor prior 

to the time the plan actually provided 

the benefits promised. 

Example. If the plan holds all its 

assets invested in registered investment 

companies and other non-insurance 

company investments until it purchases 

annuities to pay out the benefits 

promised under the plan, box 9a(3) 

should be checked as the funding 

arrangement and box 9b(1) should be 

checked as the benefit arrangement. 

Note: An employee benefit plan that 

checks boxes 9a(1), 9a(2), 9b(1), and/or 9b(2) 

must attach Schedule A (Form 5500), 

Insurance Information, to provide 

information concerning each contract year 

ending with or within the plan year. See the 

instructions to the Schedule A and enter the 

number of Schedules A on line 10b(3), if 

applicable. 

Line 10. Check the boxes on line 10 

to indicate the schedules being filed 

and, where applicable, count the 

schedules and enter the number of 

attached schedules in the space 

provided. 

2009 Instructions for Schedule A (Form 

5500) Insurance Information 

General Instructions 

Who Must File 

Schedule A (Form 5500), Insurance 

Information (Schedule A), must be 

attached to the Form 5500 filed for 

every defined benefit pension plan, 

defined contribution pension plan, and 

welfare benefit plan required to file a 

Form 5500 if any benefits under the 

plan are provided by an insurance 

company, insurance service, or other 

similar organization (such as Blue Cross, 

Blue Shield, or a health maintenance 

organization). This includes investment 

contracts with insurance companies 

such as guaranteed investment contracts 

(GICs). In addition, Schedules A must 

be attached to a Form 5500 filed for 

GIAs, MTIAs, and 103–12 IEs for each 

insurance or annuity contract held in 

the MTIA, or 103–12 IE or by the GIA. 

TIP: If Form 5500 line 9a(1), 9a(2), 

9b(1), or 9b(2) is checked, indicating 

that either the plan funding arrangement 

or plan benefit arrangement includes an 

account, policy, or contract with an 

insurance company (or similar 

organization), at least one Schedule A 

would be required to be attached to the 

Form 5500 filed for the pension or 

welfare plan to provide information 

concerning the contract year ending 

with or within the plan year. 

Do not file Schedule A for a contract 

that is an Administrative Services Only 

(ASO) contract, a fidelity bond or 

policy, or a fiduciary liability insurance 

policy. Also, if a Schedule A for a 

contract or policy is filed as part of a 

Form 5500 Return/Report for a MTIA or 

103–12 IE that holds the contract, do not 

include a Schedule A for the contract or 

policy on the Form 5500s filed for the 

plans participating in the MTIA or 103–

12 IE. 

Check the Schedule A box on the 

Form 5500 (Part II, line 10b(3)), and 

enter the number attached in the space 

provided if one or more Schedules A are 

attached to the Form 5500. 

Specific Instructions 

Information entered on Schedule A 

should pertain to the insurance contract 

or policy year ending with or within the 

plan year (for reporting purposes, a year 

cannot exceed 12 months). 

Example: If an insurance contract year 

begins on July 1 and ends on June 30, 

and the plan year begins on January 1 

and ends on December 31, the 

information on the Schedule A attached 

to the 2009 Form 5500 should be for the 

insurance contract year ending on June 

30, 2009. 

Exception: If the insurance company 

maintains records on the basis of a plan 

year rather than a policy or contract 

year, the information entered on 

Schedule A may pertain to the plan year 

instead of the policy or contract year. 

Include only the contracts issued to or 

held by the plan, GIA, MTIA, or 103–

12 IE for which the Form 5500 Return/ 

Report is being filed. 

Lines A, B, C, and D. This information 

must be the same as reported in Part II 

of the Form 5500 to which this 

Schedule A is attached. The plan name 

may be abbreviated. 

Do not use a social security number 

in lieu of an EIN. The Schedule A and 

its attachments are open to public 

inspection, and the contents are public 

information and are subject to 

publication on the Internet. Because of 

privacy concerns, the inclusion of a 

social security number on this Schedule 

A or any of its attachments may result 

in the rejection of the filing. EINs may 

be obtained by applying for one on 

Form SS–4, Application for Employer 

Identification Number, as soon as 

possible. You can obtain Form SS–4 by 

calling 1–800–TAX–FORM (1–800–829–

3676) or at the IRS Web Site at http:// 

www.irs.gov. The EBSA does not issue 

EINs. 

Part I—Information Concerning 

Insurance Contract Coverage, Fees, and 

Commissions 

Line 1(c). Enter the code number 

assigned by the National Association of 

Insurance Commissioners (NAIC) to the 

insurance company. If none has been 

assigned, enter zeros (-0-) in the spaces 

provided. 

Line 1(d). If individual policies with 

the same carrier are grouped as a unit 

for purposes of this report, and the 

group does not have one identification 

number, you may use the contract or 

identification number of one of the 

individual contracts, provided this 

number is used consistently to report 

these contracts as a group and the plan 

administrator maintains the records 

necessary to disclose all the individual 

contract numbers in the group upon 

request. Use separate Schedules A to 

report individual contracts that cannot 

be grouped as a unit. 

Line 1(e). Since plan coverage may 

fluctuate during the year, the 

administrator should estimate the 

number of persons that were covered by 

the contract at the end of the policy or 

contract year. Where contracts covering 

individual employees are grouped, 

compute entries as of the end of the 

plan year. 

Lines 1(f) and (g). Enter the beginning 

and ending dates of the policy year for 

the contract identified in 1(d). Enter ‘‘N/ 

A’’ in 1(f) if separate contracts covering 

individual employees are grouped. 

Line 2. Report on line 2 the totals of 

all insurance fees and commissions 

directly or indirectly attributable to the 

contract or policy placed with or 

retained by the plan. 

Totals. Enter on line 2 the total of all 

such commissions and fees paid to 

agents, brokers, and other persons listed 

on line 3. Complete a separate line 3 

item (elements (a) through (e)) for each 

person listed. 

For purposes of lines 2 and 3, 

commissions and fees include sales and 

base commissions and all other 

monetary and non-monetary forms of 

compensation where the broker’s, 

agent’s, or other person’s eligibility for 

the payment or the amount of the 

payment is based, in whole or in part, 

on the value (e.g., policy amounts, 

premiums) of contracts or policies (or 

classes thereof) placed with or retained 

by an ERISA plan, including, for 

example, persistency and profitability 

bonuses. The amount (or pro rata share 

of the total) of such commissions or fees 

attributable to the contract or policy 

placed with or retained by the plan 

must be reported in line 2 and in line 

3, elements (b) and/or (c) as appropriate. 


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Insurers must provide plan 

administrators with a proportionate 

allocation of commissions and fees 

attributable to each contract. Any 

reasonable method of allocating 

commissions and fees to policies or 

contracts is acceptable, provided the 

method is disclosed to the plan 

administrator. A reasonable allocation 

method could allocate fees and 

commissions to a Schedule A based on 

a calendar year calculation even if the 

plan year or policy year was not a 

calendar year. For additional 

information on these Schedule A 

reporting requirements, ‘‘see’’ ERISA 

Advisory Opinion 2005–02A, available 

on the Internet at http://www.dol.gov/ 

ebsa. 

Where benefits under a plan are 

purchased from and guaranteed by an 

insurance company, insurance service, 

or other similar organization, and the 

contract or policy is reported on a 

Schedule A, payments of reasonable 

monetary compensation by the insurer 

out of its general assets to affiliates or 

third parties for performing 

administrative activities necessary for 

the insurer to fulfill its contractual 

obligation to provide benefits, where 

there is no direct or indirect charge to 

the plan for the administrative services 

other than the insurance premium, then 

the payments for administrative services 

by the insurer to the affiliates or third 

parties do not need to be reported on 

lines 2 and 3 of Schedule A. This would 

include compensation for services such 

as recordkeeping and claims processing 

services provided by a third party 

pursuant to a contract with the insurer 

to provide those services but would not 

include compensation provided by the 

insurer incidental to the sale or renewal 

of a policy, such as finder’s fees, 

insurance brokerage commissions and 

fees, or similar fees. 

Schedule A reporting also is not 

required for compensation paid by the 

insurer to a ‘‘general agent’’ or 

‘‘manager’’ for that general agent’s or 

manager’s management of an agency or 

performance of administrative functions 

for the insurer. For this purpose, (1) a 

‘‘general agent’’ or ‘‘manager’’ does not 

include brokers representing insureds, 

and (2) payments would not be treated 

as paid for managing an agency or 

performance of administrative functions 

where the recipient’s eligibility for the 

payment or the amount of the payment 

is dependent or based on the value (e.g., 

policy amounts, premiums) of contracts 

or policies (or classes thereof) placed 

with or retained by ERISA plan(s). 

Schedule A reporting is not required 

for occasional gifts or meals of 

insubstantial value which are tax 

deductible for federal income tax 

purposes by the person providing the 

gift or meal and would not be taxable 

income to the recipient. For this 

exemption to be available, the gift or 

gratuity must be both occasional and 

insubstantial. For this exemption to 

apply, the gift must be valued at less 

than $50, the aggregate value of gifts 

from one source in a calendar year must 

be less than $100, but gifts with a value 

of less than $10 do not need to be 

counted toward the $100 annual limit. 

If the $100 aggregate value limit is 

exceeded, then the aggregate value of all 

the gifts will be reportable. Gifts from 

multiple employees of one service 

provider should be treated as originating 

from a single source when calculating 

whether the $100 threshold applies. On 

the other hand, in applying the 

threshold to an occasional gift received 

from one source by multiple employees 

of a single service provider, the amount 

received by each employee should be 

separately determined in applying the 

$50 and $100 thresholds. For example, 

if six employees of a broker attend a 

business conference put on by an 

insurer designed to educate and explain 

the insurer’s products for employee 

benefit plans, and the insurer provides, 

at no cost to the attendees, refreshments 

valued at $20 per individual, the 

gratuities would not be reportable on 

lines 2 and 3 of the Schedule A even 

though the total cost of the refreshments 

for all the employees would be $120. 

These thresholds are for purposes of 

Schedule A reporting. Filers are 

cautioned that the payment or receipt of 

gifts and gratuities of any amount by 

plan fiduciaries may violate ERISA and 

give rise to civil liabilities and criminal 

penalties. 

Line 3. Identify agents, brokers, and 

other persons individually in 

descending order of the amount paid. 

Complete as many entries as necessary 

to report all required information. 

Complete elements (a) through (e) for 

each person as specified below. 

Element (a). Enter the name and 

address of the agents, brokers, or other 

persons to whom commissions or fees 

were paid. 

Element (b). Report all sales and base 

commissions here. For purposes of this 

element, sales and/or base commissions 

are monetary amounts paid by an 

insurer that are charged directly to the 

contract or policy and that are paid to 

a licensed agent or broker for the sale or 

placement of the contract or policy. All 

other payments should be reported in 

element (c) as fees. 

Element (c). Fees to be reported here 

represent payments by an insurer 

attributable directly or indirectly to a 

contract or policy to agents, brokers, and 

other persons for items other than sales 

and/or base commissions (e.g., service 

fees, consulting fees, finders’ fees, 

profitability and persistency bonuses, 

awards, prizes, and non-monetary forms 

of compensation). Fees paid to persons 

other than agents and brokers should be 

reported here, not in Parts II and III on 

Schedule A as acquisition costs, 

administrative charges, etc. 

Element (d). Enter the purpose(s) for 

which fees were paid. 

Element (e). Enter the most 

appropriate organization code for the 

broker, agent, or other person entered in 

element (a). 

Code Type of Organization 

1—Banking, Savings & Loan 

Association, Credit Union, or other 

similar financial institution. 

2—Trust Company. 

3—Insurance Agent or Broker. 

4—Agent or Broker other than 

insurance. 

5—Third party administrator. 

6—Investment Company/Mutual 

Fund. 

7—Investment Manager/Adviser. 

8—Labor Union. 

9—Foreign entity (e.g., an agent or 

broker, bank, insurance company, etc., 

not operating within the jurisdictional 

boundaries of the United States). 

0—Other. 

For plans, GIAs, MTIAs, and 103–12 

IEs required to file Part I of Schedule C, 

commissions and fees listed on the 

Schedule A are also to be reported on 

Schedule C, unless the only 

compensation in relation to the plan or 

DFE consists of insurance fees and 

commissions listed on the Schedule A. 

Part II—Investment and Annuity 

Contract Information 

Line 4. Enter the current value of the 

plan’s interest at year end in the 

contract reported on line 7, e.g., deposit 

administration (DA), immediate 

participation guarantee (IPG), or 

guaranteed investment contracts (GIC). 

Exception: Contracts reported on line 

7 need not be included on line 4 if (1) 

the Schedule A is filed for a defined 

benefit pension plan and the contract 

was entered into before March 20, 1992, 

or (2) the Schedule A is filed for a 

defined contribution pension plan and 

the contract is a fully benefit-responsive 

contract, i.e., it provides a liquidity 

guarantee by a financially responsible 

third party of principal and previously 

accrued interest for liquidations, 

transfers, loans, or hardship 

withdrawals initiated by plan 

participants exercising their rights to 

withdraw, borrow, or transfer funds 


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under the terms of a defined 

contribution plan that does not include 

substantial restrictions to participants’

access to plan funds. 

Important Reminder. Plans may treat 

multiple individual annuity contracts, 

including Code section 403(b)(1) 

annuity contracts, issued by the same 

insurance company as a single group 

contract for reporting purposes on 

Schedule A. 

Line 6a. The rate information called 

for here may be furnished by attaching 

the appropriate schedules of current 

rates filed with the appropriate state 

insurance department or by providing a 

statement regarding the basis of the 

rates. Enter ‘‘see attached’’ if 

appropriate. 

Lines 7a through 7f. Report contracts 

with unallocated funds. Do not include 

portions of these contracts maintained 

in separate accounts. Show deposit fund 

amounts rather than experience credit 

records when both are maintained. 

Part III—Welfare Benefit Contract 

Information 

Line 8i. Report a stop-loss insurance 

policy that is an asset of the plan. 

Note: Employers sponsoring welfare plans 

may purchase a stop-loss insurance policy 

with the employer as the insured to help the 

employer manage its risk associated with its 

liabilities under the plan. These employer 

contracts with premiums paid exclusively 

out of the employer’s general assets without 

any employee contributions generally are not 

plan assets and are not reportable on 

Schedule A. 

Part IV—Provision of Information 

The insurance company, insurance 

service, or other similar organization is 

required under ERISA section 103(a)(2) 

to provide the plan administrator with 

the information needed to complete this 

return/report. If you do not receive this 

information in a timely manner, contact 

the insurance company, insurance 

service, or other similar organization. If 

information is missing on Schedule A 

due to a refusal to provide information, 

check ‘‘Yes’’ on line 11 and enter a 

description of the information not 

provided on line 12. 

TIP. As noted above, the insurance 

company, insurance service, or other 

similar organization is statutorily 

required to provide all of the 

information necessary to complete the 

return/report, but need not provide the 

information on a Schedule itself. If you 

do not receive this information in a 

timely manner, you should contact the 

insurance company, insurance service, 

or other similar organization and advise 

them that the plan administrator will 

identify the provider on the Schedule A 

if the required information is not 

provided. 

2009 Instructions for Schedule MB 

(Multiemployer Defined Benefit Plan 

and Certain Money Purchase Plan 

Actuarial Information) 

[reserved] 

2009 Instructions for Schedule SB 

(Single-employer Defined Benefit Plan 

Actuarial Information) 

[reserved] 

2009 Instructions for Schedule C (Form 

5500) Service Provider Information 

Who Must File 

Schedule C (Form 5500), Service 

Provider Information (Schedule C) must 

be attached to a Form 5500 filed for a 

large pension or welfare benefit plan, an 

MTIA, a 103–12IE, or a GIA, to report 

certain information concerning service 

providers. Remember to check the 

Schedule C box on the form 5500 (Part 

II, line 10b(4)) if a Schedule C is 

attached to the Form 5500. 

Part I of the Schedule C must be 

completed to report persons who 

rendered services to or who had 

transactions with the plan or DFE 

during the reporting year if the person 

received, directly or indirectly, $5,000 

or more in reportable compensation in 

connection with services rendered to 

the plan or DFE, or their position with 

the plan except: 

1. Employees of the plan whose only 

compensation in relation to the plan 

was less than $25,000 for the plan year; 

2. Employees of the plan sponsor or 

other business entity where the plan 

sponsor or business entity is reported on 

the Schedule C as a service provider, 

provided the employee did not 

separately receive reportable direct or 

indirect compensation in relation to the 

plan; 

3. Persons whose only compensation 

in relation to the plan consists of 

insurance fees and commissions listed 

in a Schedule A filed for the plan; and 

4. Payments made directly by the plan 

sponsor that are not reimbursed by the 

plan. 

Only line 1 of Part I of the Schedule 

C must be completed for persons who 

received only ‘‘eligible indirect 

compensation’’ as defined below. 

Part II of the Schedule C must be 

completed to report service providers 

who fail or refuse to provide 

information necessary to complete Part 

I of this Schedule. 

Part III of the Schedule C must be 

completed to report a termination in the 

appointment of an accountant or 

enrolled actuary during the 2009 plan 

year. 

TIP: Health and welfare plans that 

meet the conditions of the limited 

exemption at 2520.104–44 or Technical 

Release 92–01 are not required to 

complete and file a Schedule C. 

GENERAL INSTRUCTIONS 

Lines A, B, C, and D. This information 

must be the same as reported in Part II 

of the Form 5500 to which this 

Schedule C is attached. The plan name 

may be abbreviated. 

Do not use a social security number 

in line D in lieu of an EIN. The Schedule 

C and its attachments are open to public 

inspection, and the contents are public 

information subject to publication on 

the Internet. Because of privacy 

concerns, the inclusion of a social 

security number on this Schedule C or 

any of its attachments may result in the 

rejection of the filing. EINs may be 

obtained by applying for one on Form 

SS–4, Application for Employer 

Identification Number. You can obtain 

Form SS–4 by calling 1–800–TAX–

FORM (1–800–829–3676) or at the IRS 

Web Site at http://www.irs.gov. The 

EBSA does not issue EINs. 

Do not list the PBGC or the IRS on 

Schedule C as service providers. 

Either the cash or accrual basis may 

be used for the recognition of 

transactions reported on the Schedule C 

as long as you use one method 

consistently. 

If service provider compensation is 

reported on a Schedule C filed as part 

of a Form 5500 filed for a MTIA or 103–

12IE, do not report the same 

compensation again on the Schedules C 

filed for the plans that participate in the 

MTIA or 103–12IE. 

SPECIFIC INSTRUCTIONS 

Part I—Service Provider Information 

You must enter the information 

required for each person receiving 

$5,000 or more in total direct or indirect 

compensation (i.e., money or anything 

else of value) in connection with 

services rendered to the plan or the 

person’s position with the plan during 

the plan year. 

Example. A plan had service 

providers, A, B, C, and D, who received 

$12,000, $6,000, $4,500, and $430, 

respectively, in direct and indirect 

compensation from the plan. Service 

providers A and B must be identified 

separately by name, EIN, etc. As service 

providers C and D each received less 

than $5,000, they do not need to be 

reported on the Schedule C. 

For Schedule C purposes, reportable 

compensation includes money and any 

other thing of value (for example, gifts, 

awards, trips) received by a person, 


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directly or indirectly, from the plan 

(including fees charged as a percentage 

of assets and deducted from investment 

returns) in connection with services 

rendered to the plan, or the person’s 

position with the plan. The term 

‘‘person’’ includes individuals, trades 

and businesses (whether incorporated or 

unincorporated). See ERISA section 

3(9). Persons that provide investment 

management, recordkeeping, claims 

processing, participant communication, 

brokerage, and other services to the plan 

as part of an investment contract are 

considered to be providing services to 

the plan for purposes of Schedule C 

reporting and would be required to be 

identified in Part I if they received 

$5,000 or more in reportable 

compensation for providing those 

services. The investment of plan assets 

and payment of premiums for insurance 

contracts, however, are not in and of 

themselves payments for services 

rendered to the plan for purposes of 

Schedule C reporting and the 

investment and payment of premiums 

themselves are not reportable 

compensation for purposes of Part I. 

Direct Compensation: Payments made 

directly by the plan for services 

rendered to the plan or because of a 

person’s position with the plan are 

reportable as direct compensation. 

Direct payments by the plan would 

include, for example, direct payments 

by the plan out of a plan account, 

charges to plan forfeiture accounts and 

fee recapture accounts, charges to a 

plan’s trust account before allocations 

are made to individual participant 

accounts, and direct charges to plan 

participant individual accounts. 

Payments made by the plan sponsor, 

which are not reimbursed by the plan, 

are not subject to Schedule C reporting 

requirements even if the sponsor is 

paying for services rendered to the plan. 

Indirect Compensation: Compensation 

received from sources other than 

directly from the plan or plan sponsor 

is reportable on Schedule C as indirect 

compensation from the plan if the 

compensation was received in 

connection with services rendered to 

the plan during the plan year or the 

person’s position with the plan. For this 

purpose, compensation is considered to 

have been received in connection with 

the person’s position with the plan or 

for services rendered to the plan if the 

person’s eligibility for a payment or the 

amount of the payment is based, in 

whole or in part, on services that were 

rendered to the plan or on a transaction 

or series of transactions with the plan. 

Indirect compensation would not 

include compensation that would have 

been received had the service not been 

rendered or the transaction had not 

taken place and that cannot be 

reasonably allocated to the services 

performed or transaction(s) with the 

plan. Examples of reportable indirect 

compensation include fees and expense 

reimbursement payments received by a 

person from mutual funds, bank 

commingled trusts, insurance company 

pooled separate accounts, and other 

separately managed accounts and 

pooled investment funds in which the 

plan invests that are charged against the 

fund or account and reflected in the 

value of the plan’s investment (such as 

management fees paid by a mutual fund 

to its investment adviser, sub-transfer 

agency fees, shareholder servicing fees, 

account maintenance fees, and 12b–1 

distribution fees). Other examples of 

reportable indirect compensation are 

finder’s fees, float revenue, brokerage 

commissions (regardless of whether the 

broker is granted discretion), research or 

other products or services, other than 

execution, received from a broker-dealer 

or other third party in connection with 

securities transactions (soft dollars), and 

other transaction based fees received in 

connection with transactions or services 

involving the plan whether or not they 

are capitalized as investment costs. 

Special Rules for non-monetary 

compensation of insubstantial value, 

guaranteed benefit insurance policies, 

bundled service arrangements, and 

allocating compensation among 

multiple plans: 

Excludable Non-Monetary 

Compensation: You may exclude nonmonetary compensation of insubstantial 

value (such as gifts or meals of 

insubstantial value) which is tax 

deductible for federal income tax 

purposes by the person providing the 

gift or meal and would not be taxable 

income to the recipient. The gift or 

gratuity must be valued at less than $50, 

and the aggregate value of gifts from one 

source in a calendar year must be less 

than $100, but gifts with a value of less 

than $10 do not need to be counted 

toward the $100 limit. If the $100 

aggregate value limit is exceeded, then 

the value of all the gifts will be 

reportable. Gifts received by one person 

from multiple employees of one entity 

must be treated as originating from a 

single source when calculating whether 

the $100 threshold applies. On the other 

hand, gifts received from one person by 

multiple employees of one entity can be 

treated as separate compensation when 

calculating the $50 and $100 thresholds. 

CAUTION: These thresholds are for 

purposes of Schedule C reporting only. 

Filers are strongly cautioned that gifts 

and gratuities of any amount paid to or 

received by plan fiduciaries may violate 

ERISA and give rise to civil liabilities 

and criminal penalties. 

Fully Insured Group Health And 

Similarly Fully Insured Benefits: Where 

benefits under a plan are purchased 

from and guaranteed by an insurance 

company, insurance service, or other 

similar organization, and the contract or 

policy is reported on a Schedule A, 

payments of reasonable monetary 

compensation by the insurer out of its 

general assets to persons for performing 

administrative activities necessary for 

the insurer to fulfill its contractual 

obligation to provide benefits, where 

there is no direct or indirect charge to 

the plan for the administrative services 

other than the insurance premium, 

would not be treated as indirect 

compensation for services provided to 

the plan for Schedule C reporting 

purposes. This would include 

compensation for services such as 

recordkeeping and claims processing 

services provided by a third party 

pursuant to a contract with the insurer 

to provide those services but would not 

include compensation provided by the 

insurer incidental to the sale or renewal 

of a policy, such as finder’s fees, 

insurance brokerage commissions and 

fees, or similar fees. Insurance 

investment contracts are not eligible for 

this exception. 

Bundled Service Arrangements: For 

Schedule C reporting purposes, a 

bundled service arrangement includes 

any service arrangements where the 

plan hires one company to provide a 

range of services either directly from the 

company, through affiliates or 

subcontractors, or through a 

combination, which are priced to the 

plan as a single package rather than on 

a service-by-service basis. A bundled 

service arrangement would also include 

an investment transaction in which the 

plan receives a range of services either 

directly from the investment provider, 

through affiliates or subcontractors, or 

through a combination. 

Direct payments by the plan to the 

bundled service provider should be 

reported as direct compensation to the 

bundled service provider. Such direct 

payments by the plan do not need to be 

allocated among affiliates or 

subcontractors and also reported as 

indirect compensation received by the 

affiliates or subcontractors unless the 

amount paid to the affiliate or 

subcontractor is set on a per transaction 

basis, e.g., brokerage fees and 

commissions. 

Fees charged to the plan’s investment 

and reflected in the net value of the 

investment, such as management fees 

paid by mutual funds to their 

investment advisers, float revenue, 


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64826 Federal Register / Vol. 72, No. 221 / Friday, November 16, 2007 / Notices 

commissions (including ‘‘soft dollars’’), 

finder’s fees, 12b–1 distribution fees, 

account maintenance fees, and 

shareholder servicing fees, must be 

treated as separate compensation by the 

person receiving the fee for purposes of 

Schedule C reporting. For each person 

who is a fiduciary to the plan or 

provides one or more of the following 

services to the plan—contract 

administrator, consulting, investment 

advisory (plan or participants), 

investment management, securities 

brokerage, or recordkeeping—

commissions and other transaction 

based fees, finder’s fees, float revenue, 

soft dollar and other non-monetary 

compensation, would also be required 

to be treated as separate compensation 

for Schedule C purposes even if those 

fees were paid from mutual fund 

management fees or other fees charged 

to the plan’s investment and reflected in 

the net value of the investment. Other 

revenue sharing payments among 

members of a bundled service 

arrangement do not need to be allocated 

among affiliates or subcontractors and 

treated as indirect compensation 

received by the affiliates or 

subcontractors in determining whether 

the affiliate or subcontractor must be 

separately identified on line 2 of the 

Schedule C. 

Allocating Compensation Among 

Multiple Plans: Where reportable 

compensation is received in connection 

with several plans or DFEs, any 

reasonable method of allocating the 

compensation among the plans or DFEs 

may be used provided that the 

allocation method is disclosed to the 

plan administrator. In calculating the 

$5,000 threshold for purposes of 

determining whether a person must be 

identified in Part I, include the amount 

of compensation received by the person 

that is attributable to the plan or DFE 

filing the Form 5500, not the aggregate 

amount received in connection with all 

the plans or DFEs. 

Affiliates: For purposes of Schedule C 

reporting, an ‘‘affiliate’’ of a person 

includes any person, directly or 

indirectly, through one or more 

intermediaries, controlling, controlled 

by, or under common control with the 

person applying principles consistent 

with the regulations prescribed under 

section 414(c) of the Code. 

Line 1. Check ‘‘Yes’’ or ‘‘No’’ on line 

1a to indicate whether you are relying 

on the alternative reporting option for a 

person or persons who received only 

eligible indirect compensation. If you 

check ‘‘Yes’’ on line 1a, provide as 

many entries in line 1b as necessary to 

identify the person or persons who 

provided you with the necessary 

disclosures regarding the indirect 

compensation. 

If any indirect compensation is either 

not of the type described below or if the 

plan did not receive the written 

disclosures described below, the 

indirect compensation is not ‘‘eligible 

indirect compensation’’ for purposes of 

Part I. 

(1) Eligible Indirect Compensation: 

Indirect compensation that is fees or 

expense reimbursement payments 

charged to investment funds and 

reflected in the value of the investment 

or return on investment of the 

participating plan or its participants 

finders’ fees ‘‘soft dollar’’ revenue, float 

revenue, and/or brokerage commissions 

or other transaction-based fees for 

transactions or services involving the 

plan that were not paid directly by the 

plan or plan sponsor (whether or not 

they are capitalized as investment 

costs). 

(2) Written Disclosures: For the 

indirect compensation to be eligible 

indirect compensation you must have 

received written materials that disclosed 

and described (a) the existence of the 

indirect compensation; (b) the services 

provided for the indirect compensation 

or the purpose for payment of the 

indirect compensation; (c) the amount 

(or estimate) of the compensation or a 

description of the formula used to 

calculate or determine the 

compensation; and (d) the identity of 

the party or parties paying and receiving 

the compensation. The written 

disclosures for a bundled arrangement 

must separately disclose and describe 

each element of indirect compensation 

that would be required to be separately 

reported if you were not relying on this 

alternative reporting option. 

CAUTION: If any person received 

eligible indirect compensation and 

either direct compensation and/or 

indirect compensation that does not 

meet the requirements of this line to be 

eligible indirect compensation, you 

cannot rely on the alternative reporting 

option for that person and must 

complete line 2 for each such person 

who received $5,000 or more in direct 

and indirect compensation. 

Line 2. Except for those persons for 

whom you answered ‘‘Yes’’ to line 1 

above, complete as many entries as 

needed to list each person receiving, 

directly or indirectly, $5,000 or more in 

total compensation. Start with the most 

highly compensated and list in 

descending order of compensation. 

Enter in element (a) the person’s name 

and complete elements (a) through (h) 

as specified below. Use as many entries 

as necessary to list all persons and 

information required to be reported. 

Element (a). Enter the EIN for the 

person identified in element (a). If the 

name of an individual is entered in 

element (a) and the individual does not 

have an EIN, enter the EIN of the 

individual’s employer. If the person is 

self-employed and does not have an 

EIN, you may enter the person’s address 

and telephone number. Do not use a 

social security number in lieu of an EIN. 

The Schedule C and its attachments are 

open to public inspection and are 

subject to publication on the Internet. 

Because of privacy concerns, the 

inclusion of a social security number on 

this Schedule C or any of its 

attachments may result in the rejection 

of the filing. 

Element (b). Select from the list below 

all codes that describe the services 

provided and compensation received. 

Enter as many codes as apply. 

10 Accounting (including auditing) 50 Direct payments from the plan 

11 Actuarial 51 Investment management fees paid directly by plan 

12 Claims processing 52 Investment management fees paid indirectly by plan (e.g., mutual 

fund investment adviser management fees) 

13 Contract Administrator 53 Insurance brokerage commissions and fees 

14 Plan Administrator 54 Sales loads (front end and deferred) 

15 Recordkeeping and information management (computing, tabulating, 

data processing, etc.) 

55 Other commissions 

16 Consulting (general) 56 Non-monetary compensation 

17 Consulting (pension) 57 Redemption fees 

18 Custodial (other than securities) 58 Product termination fees (surrender charges, etc.) 

19 Custodial (securities) 59 Shareholder servicing fees 

20 Trustee (individual) 60 Sub-transfer agency fees 

21 Trustee (bank, trust company or similar financial institution) 61 Finders fees/placement fees 

22 Insurance agents and brokers 62 Float revenue 


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23 Insurance services 63 Distribution (12b–1) fees 

24 Trustee (discretionary) 64 Recordkeeping fees 

25 Trustee (directed) 65 Shareholder servicing fees 

26 Investment advisory (participants) 65 Account maintenance fees 

27 Investment advisory (plan) 66 Insurance mortality and expense charge 

28 Investment management 67 Other insurance wrap fees 

29 Legal 68 ‘‘Soft dollar’’ commissions 

30 Employee (plan) 69 Insurance brokerage commissions and fees 

31 Named fiduciary 70 Consulting fees 

32 Real estate brokerage 71 Securities brokerage commissions and fees 

33 Securities brokerage 72 Other investment fees and expenses 

34 Valuation (appraisals, etc.) 73 Other insurance fees and expenses 

35 Employee (plan sponsor) 

36 Copying and duplicating 

37 Participant loan processing 

38 Participant communication 

39 Investment Company/Mutual Fund 

40 Foreign entity (e.g., an agent or broker, bank, insurance company, 

etc. not operating within jurisdictional boundaries of the United States 

49 Other Services 99 Other Fees 

Element (c). Enter any relationship of 

the person identified in element (a) to 

the plan sponsor, to the participating 

employer or employee organization, or 

to any person known to be a party-ininterest, for example, employee of 

employer, vice-president of employer, 

union officer, affiliate of plan 

recordkeeper, etc. 

Element (d). Enter the total amount of 

compensation received directly from the 

plan for services rendered to the plan 

during the plan year. If a service 

provider charges the plan a fee or 

commission, but agrees to offset the fee 

or commission with any revenue 

received from a party other than the 

plan or plan sponsor, for example, as 

part of a commission recapture or other 

offset arrangement, only the amount 

paid directly by the plan after any 

revenue sharing offset should be entered 

in Element (d). Do not leave element (d) 

blank—if no direct compensation was 

received, enter ‘‘0.’’

Element (e). Check ‘‘Yes’’ if the person 

identified in element (a), or any related 

person, received during the plan year 

indirect compensation in connection 

with the person’s position with the plan 

or services provided to the plan. (See 

instructions above on definition of 

indirect compensation). If the answer is 

‘‘No,’’ skip elements (f) through (h) for 

the person identified in element (a). 

Element (f). Check ‘‘Yes’’ if any of the 

indirect compensation was eligible 

indirect compensation for which the 

plan received the necessary disclosures. 

See instructions for Line 1 for definition 

of eligible indirect compensation. Check 

‘‘No’’ if none of the indirect 

compensation was eligible indirect 

compensation. 

Element (g). Enter the total of all 

indirect compensation that is not 

eligible indirect compensation for 

which the plan received the necessary 

disclosures. Do not leave blank. If none, 

enter ‘‘0’’. 

Element (h). Check ‘‘Yes’’ if the 

service provider, instead of an amount 

or an estimated amount, gave the plan 

a formula or other description of the 

method used to determine some or all 

of the indirect compensation received. 

Line 3. For each person identified in 

Line 2 who is a fiduciary to the plan or 

provides one or more of the following 

services to the plan ‘‘ contract 

administrator, consulting, investment 

advisory (plan or participants), 

investment management, securities 

brokerage, or recordkeeping ‘‘ enter the 

requested information for each source 

from whom the person received indirect 

compensation if (1) the amount of the 

compensation was $1,000 or more, or (2) 

the plan was given a formula or other 

description of the method used to 

determine the indirect compensation 

rather than an amount or estimated 

amount of the indirect compensation. 

Part II—Service Providers Who Fail or 

Refuse To Provide Information 

Line 4. Provide the requested 

information for each plan fiduciary or 

service provider who you believe failed 

or refused to provide any of the 

information necessary to complete Part 

I of this Schedule. 

Important Reminder. Before 

identifying a fiduciary or service 

provider as a person who failed or 

refused to provide information, you 

should contact the fiduciary or service 

provider to request the necessary 

information and tell them that you will 

list them on the Schedule C as a 

fiduciary or service provider who failed 

or refused to provide information if they 

do not provide the necessary 

information. 

Part III—Termination Information on 

Accountants and Enrolled Actuaries 

Complete Part III if there was a 

termination in the appointment of an 

accountant or enrolled actuary during 

the 2009 plan year. This information 

must be provided on the Form 5500 

Return/Report for the plan year during 

which the termination occurred. For 

example, if an accountant was 

terminated in the 2009 plan year after 

completing work on an audit for the 

2007 plan year, the termination should 

be reported on the Schedule C filed with 

the 2009 plan year Form 5500. If the 

accountant is a firm (such as a 

corporation, partnership, etc.), report 

when the service provider (not an 

individual within the firm) was 

terminated. An enrolled actuary is by 

definition an individual and not a firm, 

and you must report when the 

individual is terminated. 

Provide an explanation of the reasons 

for the termination of an accountant or 

enrolled actuary. Include a description 

of any material disputes or matters of 

disagreement concerning the 

termination, even if resolved prior to the 

termination. If an individual is listed, 

and the individual does not have an 

EIN, the EIN to be entered should be the 

EIN of the individual’s employer. Do not 

use a social security number in lieu of 

an EIN. The Schedule C and its 

attachments are open to public 

inspection, and the contents are public 

information and are subject to 

publication on the Internet. Because of 

privacy concerns, the inclusion of a 

social security number on this Schedule 

C or any of its attachments may result 

in the rejection of the filing. 

The plan administrator must also 

provide the terminated accountant or 

enrolled actuary with a copy of the 

explanation for the termination 

provided in Part III of the Schedule C, 


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64828 Federal Register / Vol. 72, No. 221 / Friday, November 16, 2007 / Notices 

along with a completed copy of the 

notice below. 

Notice to Terminated Accountant Or 

Enrolled Actuary 

I, as plan administrator, verify that the 

explanation that is reproduced below or 

attached to this notice is the explanation 

concerning your termination reported 

on the Schedule C (Form 5500) attached 

to the 2009 Form 5500, Annual Return/ 

Report of Employee Benefit Plan for the 

________(enter name of plan). This Form 

5500 is identified in line 2b by the ninedigit EIN__–____(enter sponsor’s EIN), 

and in line 1b by the three-digit 

PN____(enter plan number). 

You have the opportunity to comment 

to the Department of Labor concerning 

any aspect of this explanation. 

Comments should include the name, 

EIN, and PN of the plan and be 

submitted to: Office of Enforcement, 

Employee Benefits Security 

Administration, U.S. Department of 

Labor, 200 Constitution Avenue, N.W., 

Washington, DC 20210. 

Signed 

Dated 

2009 Instructions for Schedule D (Form 

5500) DFE/Participating Plan 

Information 

General Instructions 

Purpose of Schedule 

When the Form 5500 Return/Report is 

filed for a plan or Direct Filing Entity 

(DFE) that invested or participated in 

any master trust investment accounts 

(MTIAs), 103–12 Investment Entities 

(103–12 IEs), common/collective trusts 

(CCTs) and/or pooled separate accounts 

(PSAs), Part I provides information 

about these entities. When the Form 

5500 Return/Report is filed for a DFE, 

Part II provides information about plans 

participating in the DFE. 

Who Must File 

Employee Benefit Plans: Schedule D 

(Form 5500), DFE/Participating Plan 

Information (Schedule D), must be 

attached to a Form 5500 filed for an 

employee benefit plan that participated 

or invested in one or more CCTs, PSAs, 

MTIAs, or 103–12 IEs at anytime during 

the plan year. 

Direct Filing Entities: Schedule D 

must be attached to a Form 5500 filed 

for a CCT, PSA, MTIA, 103–12 IE or 

Group Insurance Arrangement (GIA), as 

a Direct Filing Entity (i.e., when ‘‘a 

DFE’’ is checked on Part I, Line A of the 

Form 5500). For more information, see 

instructions for Direct Filing Entity 

(DFE) Filing Requirements. 

Check the Schedule D box on the 

Form 5500 (Part II, line 10b(5)) if a 

Schedule D is attached to the Form 

5500. As many repeating entries must be 

completed as necessary to report the 

required information. 

Specific Instructions 

Lines A, B, C, and D. The information 

must be the same as reported in Part II 

of the Form 5500 to which this 

Schedule D is attached. The plan name 

may be abbreviated. 

Do not use a social security number 

in line D in lieu of an EIN. The Schedule 

D and its attachments are open to public 

inspection, and the contents are public 

information and are subject to 

publication on the Internet. Because of 

privacy concerns, the inclusion of a 

social security number on this Schedule 

D or any of its attachments may result 

in the rejection of the filing. 

EINs may be obtained by applying for 

one on Form SS–4, Application for 

Employer Identification Number, as 

soon as possible. You can obtain Form 

SS–4 by calling 1–800–TAX–FORM (1–

800–829–3676) or at the IRS Web Site at 

http://www.irs.gov. The EBSA does not 

issue EINs. 

Part I—Information on Interests in 

MTIAs, CCTs, PSAs, and 103–12 IEs (To 

Be Completed by Plans and DFEs) 

Complete as many repeating entries as 

necessary to enter the information 

specified below for all MTIAs, CCTs, 

PSAs, and 103–12 IEs in which the plan 

or DFE filing the Form 5500 Return/ 

Report participated at any time during 

the plan or DFE year. 

Complete a separate item (elements 

(a) through (e)) for each MTIA, CCT, 

PSA, or 103–12 IE. 

Element (a). Enter the name of the 

MTIA, CCT, PSA, or 103–12 IE in which 

the plan or DFE filing the Form 5500 

Return/Report participated at any time 

during the plan or DFE year. 

Element (b). Enter the name of the 

sponsor of the MTIA, CCT, PSA, or 103–

12 IE named in (a). 

Element (c). Enter the nine-digit 

employer identification number (EIN) 

and three-digit plan/entity number (PN) 

for each MTIA, CCT, PSA, or 103–12 IE 

named in (a). This must be the same 

DFE EIN/PN as reported on lines 2b and 

1b of the Form 5500 filed for the DFE. 

If a Form 5500 was not filed for a CCT 

or PSA named in element (a), enter the 

EIN for the CCT or PSA and enter 000 

for the PN. Do not use a social security 

number in lieu of an EIN. The Schedule 

D and its attachments are open to public 

inspection, and the contents are public 

information and are subject to 

publication on the Internet. 

Because of privacy concerns, the 

inclusion of a social security number on 

this Schedule D or any of its 

attachments may result in the rejection 

of the filing. 

Element (d). Enter an M, C, P, or E, 

as appropriate, (see table below) to 

identify the type of entity (MTIA, CCT, 

PSA, or 103–12 IE). 

Type of entity Enter in (d) 

MTIA ..................................... M 

CCT ...................................... C 

PSA ....................................... P 

103–12 IE ............................. E 

Element (e). Enter the dollar value of 

the plan’s or DFE’s interest as of the end 

of the year. If the plan or DFE for which 

this Schedule D is filed had no interest 

in the MTIA, CCT, PSA, or 103–12 IE 

listed at the end of the year, enter ‘‘0’. 

Example for Part I: If a plan 

participates in an MTIA, the MTIA is 

named in element (a); the MTIA’s 

sponsor is named in element (b); the 

MTIA’s EIN and PN is entered in 

element (c) (such as: 12–3456789–001); 

an ‘‘M’’ is entered in element (d); and 

the dollar value of the plan’s interest in 

the MTIA as of the end of the plan year 

is entered in element (e). 

If the plan also participates in a CCT 

for which a Form 5500 was not filed, the 

CCT is named in another element (a); 

the name of the CCT sponsor is entered 

in element (b); the EIN for the CCT, 

followed by 000 is entered in element 

(c) (such as: 99–8765432–000); a ‘‘C’’ is 

entered in element (d); and the dollar 

value of the plan’s interest in the CCT 

is entered in element (e). 

If the plan also participates in a PSA 

for which a Form 5500 was filed, the 

PSA is named in a third element (a); the 

name of the PSA sponsor is entered in 

element (b); the PSA’s EIN and PN are 

entered in element (c) (such as: 98–

7655555–001); a ‘‘P’’ is entered in 

element (d); and the dollar value of the 

plan’s interest in the PSA is entered in 

element (e). 

Part II—Information on Participating 

Plans (To Be Completed Only by DFEs) 

Complete as many repeating entries as 

necessary to enter the information 

specified below for all plans that 

invested or participated in the DFE at 

any time during the DFE year. 

Complete a separate item (elements 

(a) through (c)) for each plan. 

Element (a). Enter the name of each 

plan that invested or participated in the 

DFE at any time during the DFE year. 

GIAs need not complete element (a). 

Element (b). Enter the sponsor of each 

investing or participating plan. This 

section must be completed by DFEs for 

all participating plans even if those 


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plans are filing the Form 5500–SF and 

not the Form 5500 and Schedule D. 

Element (c). Enter the nine-digit EIN 

and three-digit PN for each plan named 

in element (a). This is the EIN and PN 

entered on lines 2b and 1b of the plan’s 

Form 5500 or Form 5500–SF. GIAs 

should enter the EIN of the sponsor 

listed in element (b). Do not use a social 

security number in lieu of an EIN. The 

Schedule D and its attachments are 

open to public inspection, and the 

contents are public information and are 

subject to publication on the Internet. 

Because of privacy concerns, the 

inclusion of a social security number on 

this Schedule D or any of its 

attachments may result in the rejection 

of the filing. 

2009 Instructions for Schedule G (Form 

5500) Financial Transaction Schedules 

General Instructions 

Who Must File 

Schedule G (Form 5500), Financial 

Transaction Schedules (Schedule G), 

must be attached to a Form 5500 filed 

for a plan, MTIA, 103–12 IE, or GIA to 

report loans or fixed income obligations 

in default or determined to be 

uncollectible as of the end of the plan 

year, leases in default or classified as 

uncollectible, and nonexempt 

transactions. See Schedule H lines 4b, 

4c, and/or 4d. 

Check the Schedule G box on the 

Form 5500 (Part II, line 10b(6)) if a 

Schedule G is attached to the Form 

5500. As many entries must be 

completed as necessary to report the 

required information. 

The Schedule G consists of three 

parts. Part I of the Schedule G reports 

any loans or fixed income obligations in 

default or determined to be 

uncollectible as of the end of the plan 

year. Part II of the Schedule G reports 

any leases in default or classified as 

uncollectible. Part III of the Schedule G 

reports nonexempt transactions. 

Specific Instructions 

Lines A, B, C, and D. This information 

must be the same as reported in Part II 

of the Form 5500 to which this 

Schedule G is attached. The plan name 

may be abbreviated. 

Do not use a social security number 

in line D in lieu of an EIN. The Schedule 

G and its attachments are open to public 

inspection, and the contents are public 

information and are subject to 

publication on the Internet. Because of 

privacy concerns, the inclusion of a 

social security number on this Schedule 

G or any of its attachments may result 

in the rejection of the filing. 

EINs may be obtained by applying for 

one on Form SS–4, Application for 

Employer Identification Number, as 

soon as possible. You can obtain Form 

SS–4 by calling 1–800–TAX–FORM (1–

800–829–3676) or at the IRS Web Site at 

http://www.irs.gov. The EBSA does not 

issue EINs. 

Part I—Loans or Fixed Income 

Obligations in Default or Classified as 

Uncollectible 

List all loans or fixed income 

obligations in default or determined to 

be uncollectible as of the end of the plan 

year or the fiscal year of the GIA, MTIA, 

or 103–12 IE. Include: 

• Obligations where the required 

payments have not been made by the 

due date; 

• Fixed income obligations that have 

matured, but have not been paid, for 

which it has been determined that 

payment will not be made; and 

• Loans that were in default even if 

renegotiated later during the year. 

Note: Identify in element (a) each obligor 

known to be a party-in-interest to the plan. 

Provide, on a separate attachment, an 

explanation of what steps have been 

taken or will be taken to collect overdue 

amounts for each loan listed and label 

the attachment ‘‘Schedule G, Part I—

Overdue Loan Explanation.’’

The due date, payment amount, and 

conditions for determining default in 

the case of a note or loan are usually 

contained in the documents establishing 

the note or loan. A loan is in default 

when the borrower is unable to pay the 

obligation upon maturity. Obligations 

that require periodic repayment can 

default at any time. Generally loans and 

fixed income obligations are considered 

uncollectible when payment has not 

been made and there is little probability 

that payment will be made. A fixed 

income obligation has a fixed maturity 

date at a specified interest rate. 

Do not report in Part I participant 

loans under an individual account plan 

with investment experience segregated 

for each account, that are made in 

accordance with 29 CFR 2550.408b–1, 

and that are secured solely by a portion 

of the participant’s vested accrued 

benefit. Report all other participant 

loans in default or classified as 

uncollectible on Part I, and list each 

such loan individually. 

Part II—Leases in Default or Classified 

as Uncollectible 

List any leases in default or classified 

as uncollectible. A lease is an agreement 

conveying the right to use property, 

plant, or equipment for a stated period. 

A lease is in default when the required 

payment(s) has not been made. An 

uncollectible lease is one where the 

required payments have not been made 

and for which there is little probability 

that payment will be made. Provide, on 

a separate attachment, an explanation of 

what steps have been taken or will be 

taken to collect overdue amounts for 

each lease listed and label the 

attachment ‘‘Schedule G, Part II—

Overdue Lease Explanation.’’

Part III—Nonexempt Transactions 

All nonexempt party-in-interest 

transactions must be reported, 

regardless of whether disclosed in the 

accountant’s report, unless the 

nonexempt transaction is: 

1. Statutorily exempt under Part 4 of 

Title I of ERISA; 

2. Administratively exempt under 

ERISA section 408(a); 

3. Exempt under Code sections 

4975(c) or 4975(d); 

4. The holding of participant 

contributions in the employer’s general 

assets for a welfare plan that meets the 

conditions of ERISA Technical Release 

92–01; 

5. A transaction of a 103–12 IE with 

parties other than the plan; or 

6. A delinquent participant 

contribution reported on Schedule H, 

line 4a. 

Nonexempt transactions with a partyin-interest include any direct or 

indirect: 

A. Sale or exchange, or lease, of any 

property between the plan and a partyin-interest. 

B. Lending of money or other 

extension of credit between the plan 

and a party-in-interest. 

C. Furnishing of goods, services, or 

facilities between the plan and a partyin-interest. 

D. Transfer to, or use by or for the 

benefit of, a party-in-interest, of any 

income or assets of the plan. 

E. Acquisition, on behalf of the plan, 

of any employer security or employer 

real property in violation of ERISA 

section 407(a). 

F. Dealing with the assets of the plan 

for a fiduciary’s own interest or own 

account. 

G. Acting in a fiduciary’s individual 

or any other capacity in any transaction 

involving the plan on behalf of a party 

(or represent a party) whose interests are 

adverse to the interests of the plan or 

the interests of its participants or 

beneficiaries. 

H. Receipt of any consideration for his 

or her own personal account by a partyin-interest who is a fiduciary from any 

party dealing with the plan in 

connection with a transaction involving 

the income or assets of the plan. 


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For purposes of this form, party-ininterest is deemed to include a 

disqualified person. See Code section 

4975(e)(2). The term ‘‘party-in-interest’’

means, as to an employee benefit plan: 

A. Any fiduciary (including, but not 

limited to, any administrator, officer, 

trustee or custodian), counsel, or 

employee of the plan; 

B. A person providing services to the 

plan; 

C. An employer, any of whose 

employees are covered by the plan; 

D. An employee organization, any of 

whose members are covered by the plan; 

E. An owner, direct or indirect, of 

50% or more of: (1) The combined 

voting power of all classes of stock 

entitled to vote or the total value of 

shares of all classes of stock of a 

corporation, (2) the capital interest or 

the profits interest of a partnership, or 

(3) the beneficial interest of a trust or 

unincorporated enterprise that is an 

employer or an employee organization 

described in C or D; 

F. A relative of any individual 

described in A, B, C, or E; 

G. A corporation, partnership, or trust 

or estate of which (or in which) 50% or 

more of: 

(1) The combined voting power of all 

classes of stock entitled to vote or the 

total value of shares of all classes of 

stock of such corporation, (2) the capital 

interest or profits interest of such 

partnership, or (3) the beneficial interest 

of such trust or estate is owned directly 

or indirectly, or held by, persons 

described in A, B, C, D, or E; 

H. An employee, officer, director (or 

an individual having powers or 

responsibilities similar to those of 

officers or directors), or a 10% or more 

shareholder, directly or indirectly, of a 

person described in B, C, D, E, or G, or 

of the employee benefit plan; or 

I. A 10% or more (directly or 

indirectly in capital or profits) partner 

or joint venturer of a person described 

in B, C, D, E, or G. 

CAUTION: An unfunded, fully 

insured, or combination unfunded/ 

insured welfare plan with 100 or more 

participants exempt under 29 CFR 

2520.104–44 from completing Schedule 

H must still complete Schedule G, Part 

III, to report nonexempt transactions. 

If you are unsure whether a 

transaction is exempt or not, you should 

consult with either the plan’s 

independent qualified public 

accountant (IQPA) or legal counsel or 

both. 

You may indicate that an application 

for an administrative exemption is 

pending. 

If the plan is a qualified pension plan 

and a nonexempt prohibited transaction 

occurred with respect to a disqualified 

person, an IRS Form 5330, Return of 

Excise Taxes Related to Employee 

Benefit Plans, is required to be filed 

with the IRS to pay the excise tax on the 

transaction. 

TIP: The DOL Voluntary Fiduciary 

Correction Program (VFCP) describes 

how to apply, the specific transactions 

covered (which transactions include 

delinquent participant contributions to 

pension and welfare plans), and 

acceptable methods for correcting 

violations. In addition, applicants that 

satisfy both the VFCP requirements and 

the conditions of Prohibited Transaction 

Exemption (PTE) 2002–51 are eligible 

for immediate relief from payment of 

certain prohibited transaction excise 

taxes for certain corrected transactions, 

and are also relieved from the obligation 

to file the Form 5330 with the IRS. For 

more information, see 71 FR 20261 

(Apr. 19, 2006) and 71 FR 20135 (Apr. 

19, 2006). If the conditions of PTE 

2002–51 are satisfied, corrected 

transactions should be treated as exempt 

under Code section 4975(c) for the 

purposes of answering Schedule G, Part 

III. Information about the VFCP is also 

available on the Internet at http:// 

www.dol.gov/ebsa. 

2009 Instructions for Schedule H (Form 

5500) Financial Information 

General Instructions 

Who Must File 

Schedule H (Form 5500) must be 

attached to a Form 5500 filed for a 

pension benefit plan or a welfare benefit 

plan that covered 100 or more 

participants as of the beginning of the 

plan year and a Form 5500 filed for an 

MTIA, CCT, PSA, 103–12 IE, or GIA. 

See the instructions to the Form 5500 

for Direct Filing Entity (DFE) Filing 

Requirements. 

Exceptions: 

(1) Insured, unfunded, or a 

combination of unfunded/insured 

welfare plans and fully insured pension 

benefit plans that meet the requirements 

of 29 CFR 2520.104–44 are exempt from 

completing the Schedule H. 

(2) If a Schedule I was filed for the 

plan for the 2008 plan year and the plan 

covered fewer than 121 participants as 

of the beginning of the 2009 plan year, 

the Schedule I may be completed 

instead of a Schedule H. See What To 

File. If eligible, such a plan may file the 

Form 5500–SF instead of the Form 5500 

and its schedules, including the 

Schedule I. See Instructions for Form 

5500–SF. 

(3) Plans that file a Form 5500–SF for 

the 2009 plan year are not required to 

file a Schedule H for that year. 

Check the Schedule H box on the 

Form 5500 (Part II, line 10b(1)) if a 

Schedule H is attached to the Form 

5500. Do not attach both a Schedule H 

and a Schedule I to the same Form 5500. 

Specific Instructions 

Lines A, B, C, and D. This information 

must be the same as reported in Part II 

of the Form 5500 to which this 

Schedule H is attached. The plan name 

may be abbreviated. 

Do not use a social security number 

in line D in lieu of an EIN. The Schedule 

H and its attachments are open to public 

inspection, and the contents are public 

information and are subject to 

publication on the Internet. Because of 

privacy concerns, the inclusion of a 

social security number on this Schedule 

H or any of its attachments may result 

in the rejection of the filing. 

EINs may be obtained by applying for 

one on Form SS–4, Application for 

Employer Identification Number, as 

soon as possible. You can obtain Form 

SS–4 by calling 1–800–TAX–FORM (1–

800–829–3676) or at the IRS Web Site at 

http://www.irs.gov. The EBSA does not 

issue EINs. 

Note: The cash, modified cash, or accrual 

basis may be used for recognition of 

transactions in Parts I and II, as long as you 

use one method consistently. Round off all 

amounts reported on the Schedule H to the 

nearest dollar. Any other amounts are subject 

to rejection. Check all subtotals and totals 

carefully. 

If the assets of two or more plans are 

maintained in a fund or account that is 

not a DFE, a registered investment 

company, or the general account of an 

insurance company under an 

unallocated contract (see the 

instructions for lines 1c(9) through 

1c(14)), complete Parts I and II of the 

Schedule H by entering the plan’s 

allocable part of each line item. 

Exception: When completing Part II of 

the Schedule H for a plan or DFE that 

participates in a CCT or PSA for which 

a Form 5500 has not been filed, do not 

allocate the income of the CCT or PSA 

and expenses that were subtracted from 

the gross income of the CCT or PSA in 

determining their net investment gain 

(loss). Instead, enter the CCT or PSA net 

gain (loss) on line 2b(6) or (7) in 

accordance with the instructions for 

these lines. 

If assets of one plan are maintained in 

two or more trust funds, report the 

combined financial information in Parts 

I and II. 

Current value means fair market value 

where available. Otherwise, it means the 


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fair value as determined in good faith 

under the terms of the plan by a trustee 

or a named fiduciary, assuming an 

orderly liquidation at the time of the 

determination. See ERISA section 3(26). 

Note: For the 2009 plan year, plans that 

provide participant-directed brokerage 

accounts as an investment alternative (and 

have entered pension feature code ‘‘2R’’ on 

line 8a of the Form 5500) may report 

investments in assets made through 

participant-directed brokerage accounts 

either: 

1. As individual investments on the 

applicable asset and liability categories in 

Part I and the income and expense categories 

in Part II, or 

2. By including on line 1c(15) the total 

aggregate value of the assets and on line 2c 

the total aggregate investment income (loss) 

before expenses, provided the assets are not 

loans, partnership or joint-venture interests, 

real property, employer securities, or 

investments that could result in a loss in 

excess of the account balance of the 

participant or beneficiary who directed the 

transaction. Expenses charged to the 

accounts must be reported on the applicable 

expense line items. Participant-directed 

brokerage account assets reported in the 

aggregate on line 1c(15) should be treated as 

one asset held for investment for purposes of 

the line 4i schedules, except that investments 

in tangible personal property must continue 

to be reported as separate assets on the line 

4i schedules. 

In the event that investments made 

through a participant-directed brokerage 

account are loans, partnership or joint 

venture interests, real property, 

employer securities, or investments that 

could result in a loss in excess of the 

account balance of the participant or 

beneficiary who directed the 

transaction, such assets must be broken 

out and treated as separate assets on the 

applicable asset and liability categories 

in Part I, income and expense categories 

in Part II, and on the line 4i schedules. 

The remaining assets in the participantdirected brokerage account may be 

reported in the aggregate as set forth in 

paragraph 2 above. 

Columns (a) and (b). Enter the current 

value on each line as of the beginning 

and end of the plan year. 

Note: Amounts reported in column (a) 

must be the same as reported for the end of 

the plan year for corresponding line items of 

the return/report for the preceding plan year. 

Do not include contributions designated for 

the 2009 plan year in column (a). 

Line 1a. Total noninterest bearing 

cash includes, among other things, cash 

on hand or cash in a noninterest bearing 

checking account. 

Line 1b(1). Noncash basis filers must 

include contributions due the plan by 

the employer but not yet paid. Do not 

include other amounts due from the 

employer such as the reimbursement of 

an expense or the repayment of a loan. 

Line 1b(2). Noncash basis filers must 

include contributions withheld by the 

employer from participants and 

amounts due directly from participants 

that have not yet been received by the 

plan. Do not include the repayment of 

participant loans. 

Line 1b(3). Noncash basis filers must 

include amounts due to the plan that are 

not includable in lines 1b(1) or 1b(2). 

These amounts may include investment 

income earned but not yet received by 

the plan and other amounts due to the 

plan such as amounts due from the 

employer or another plan for expense 

reimbursement or from a participant for 

the repayment of an overpayment of 

benefits. 

Line 1c(1). Include all assets that earn 

interest in a financial institution 

account such as interest bearing 

checking accounts, passbook savings 

accounts, or money market accounts. 

Line 1c(2). Include securities issued 

or guaranteed by the U.S. Government 

or its designated agencies, such as U.S. 

Savings Bonds, Treasury bonds, 

Treasury bills, FNMA, and GNMA. 

Line 1c(3). Include investment 

securities (other than employer 

securities defined below in 1d(1)) issued 

by a corporate entity at a stated interest 

rate repayable on a particular future 

date such as most bonds, debentures, 

convertible debentures, commercial 

paper and zero coupon bonds. Do not 

include debt securities of governmental 

units that should be reported on line 

1c(2) or 1c(15). 

‘‘Preferred’’ means any of the above 

securities that are publicly traded on a 

recognized securities exchange and the 

securities have a rating of ‘‘A’’ or above. 

If the securities are not ‘‘Preferred,’’ list 

them as ‘‘Other.’’

Line 1c(4)(A). Include stock issued by 

corporations (other than employer 

securities defined in 1d(1) below) which 

is accompanied by preferential rights 

such as the right to share in 

distributions of earnings at a higher rate 

or which has general priority over the 

common stock of the same entity. 

Include the value of warrants 

convertible into preferred stock. 

Line 1c(4)(B). Include any stock (other 

than employer securities defined in 

1d(1)) that represents regular ownership 

of the corporation and is not 

accompanied by preferential rights. 

Include the value of warrants 

convertible into common stock. 

Line 1c(5). Include the value of the 

plan’s participation in a partnership or 

joint venture if the underlying assets of 

the partnership or joint venture are not 

considered to be plan assets under 29 

CFR 2510.3–101. Do not include the 

value of a plan’s interest in a 

partnership or joint venture that is a 

103–12 Investment Entity (103–12 IE). 

Include the value of a 103–12 IE in line 

1c(12). 

Line 1c(6). Include the current value 

of both income and non-income 

producing real property owned by the 

plan. Do not include the value of 

property that is employer real property 

or property used in plan operations that 

must be reported on lines 1d and 1e, 

respectively. 

Line 1c(7). Enter the current value of 

all loans made by the plan, except 

participant loans reportable on line 

1c(8). Include the sum of the value of 

loans for construction, securities loans, 

commercial and/or residential mortgage 

loans that are not subject to Code 

section 72(p) (either by making or 

participating in the loans directly or by 

purchasing loans originated by a third 

party), and other miscellaneous loans. 

Line 1c(8). Enter the current value of 

all loans to participants including 

residential mortgage loans that are 

subject to Code section 72(p). Include 

the sum of the value of the unpaid 

principal balances, plus accrued but 

unpaid interest, if any, for participant 

loans made under an individual account 

plan with investment experience 

segregated for each account that are 

made in accordance with 29 CFR 

2550.408b-1 and secured solely by a 

portion of the participant’s vested 

accrued benefit. 

When applicable, combine this 

amount with the current value of any 

other participant loans. Do not include 

in column (b) a participant loan that has 

been deemed distributed during the 

plan year under the provisions of Code 

section 72(p) and Treasury Regulation 

section 1.72(p)–1, if both of the 

following circumstances apply: 

1. Under the plan, the participant loan 

is treated as a directed investment solely 

of the participant’s individual account; 

and 

2. As of the end of the plan year, the 

participant is not continuing repayment 

under the loan. 

If both of these circumstances apply, 

report the loan as a deemed distribution 

on line 2g. However, if either of these 

circumstances does not apply, the 

current value of the participant loan 

(including interest accruing thereon 

after the deemed distribution) must be 

included in column (b) without regard 

to the occurrence of a deemed 

distribution. 

Note: After a participant loan that has been 

deemed distributed is reported on line 2g, it 

is no longer to be reported as an asset on 


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Schedule H or Schedule I unless, in a later 

year, the participant resumes repayment 

under the loan. However, such a loan 

(including interest accruing thereon after the 

deemed distribution) that has not been repaid 

is still considered outstanding for purposes 

of applying Code section 72(p)(2)(A) to 

determine the maximum amount of 

subsequent loans. Also, the deemed 

distribution is not treated as an actual 

distribution for other purposes, such as the 

qualification requirements of Code section 

401, including, for example, the 

determination of top-heavy status under 

Code section 416 and the vesting 

requirements of Treasury Regulation section 

1.411(a)–7(d)(5). See Q&As 12 and 19 of 

Treasury Regulation section 1.72(p)–1. 

The entry on line 1c(8), column (b), of 

Schedule H (participant loans—end of 

year) or on line 1a, column (b), of 

Schedule I (plan assets—end of year) 

must include the current value of any 

participant loan that was reported as a 

deemed distribution on line 2g for any 

earlier year if the participant resumes 

repayment under the loan during the 

plan year. In addition, the amount to be 

entered on line 2g must be reduced by 

the amount of the participant loan that 

was reported as a deemed distribution 

on line 2g for the earlier year. 

Lines 1c(9), (10), (11), and (12). Enter 

the total current value of the plan’s or 

DFE’s interest in DFEs on the 

appropriate lines as of the beginning 

and end of the plan or DFE year. The 

value of the plan’s or DFE’s interest in 

each DFE at the end of the plan or DFE 

year must be reported on the Schedule 

D (Form 5500). 

CAUTION: The plan’s or DFE’s 

interest in common/collective trusts 

(CCTs) and pooled separate accounts 

(PSAs) for which a DFE Form 5500 has 

not been filed may not be included on 

lines 1c(9) or 1c(10). The plan’s or DFE’s 

interest in the underlying assets of such 

CCTs and PSAs must be allocated and 

reported in the appropriate categories 

on a line-by-line basis on Part I of the 

Schedule H. 

Note: For reporting purposes, a separate 

account that is not considered to be holding 

plan assets pursuant to 29 CFR 2510.3–

101(h)(1)(iii) does not constitute a PSA. 

Line 1c(14). Use the same method for 

determining the value of the insurance 

contracts reported here as you used for 

line 4 of Schedule A, or, if line 4 is not 

required, line 7 of Schedule A. 

Line 1c(15). Include all other 

investments not includable in lines 

1c(1) through (14), such as options, 

index futures, repurchase agreements, 

state and municipal securities, 

collectibles, and other personal 

property. 

Line 1d(1). An employer security is 

any security issued by an employer 

(including affiliates) of employees 

covered by the plan. These may include 

common stocks, preferred stocks, bonds, 

zero coupon bonds, debentures, 

convertible debentures, notes, and 

commercial paper. 

Line 1d(2). The term ‘‘employer real 

property’’ means real property (and 

related personal property) that is leased 

to an employer of employees covered by 

the plan, or to an affiliate of such 

employer. For purposes of determining 

the time at which a plan acquires 

employer real property for purposes of 

this line, such property shall be deemed 

to be acquired by the plan on the date 

on which the plan acquires the property 

or on the date on which the lease to the 

employer (or affiliate) is entered into, 

whichever is later. 

Line 1e. Include the current (not book) 

value of the buildings and other 

property used in the operation of the 

plan. Buildings or other property held 

as plan investments should be reported 

in lines 1c(6) and 1d(2). Do not include 

the value of future pension payments on 

lines 1g, h, i, j, or k. 

Line 1g. Noncash basis plans must 

include the total amount of benefit 

claims that have been processed and 

approved for payment by the plan. 

Include welfare plan ‘‘incurred but not 

reported’’ (IBNR) benefit claims on this 

line. 

Line 1h. Noncash basis plans must 

include the total amount of obligations 

owed by the plan which were incurred 

in the normal operations of the plan and 

have been approved for payment by the 

plan but have not been paid. 

Line 1i. ‘‘Acquisition indebtedness,’’

for debt-financed property other than 

real property, means the outstanding 

amount of the principal debt incurred: 

1. By the organization in acquiring or 

improving the property; 

2. Before the acquisition or 

improvement of the property if the debt 

was incurred only to acquire or improve 

the property; or 

3. After the acquisition or 

improvement of the property if the debt 

was incurred only to acquire or improve 

the property and was reasonably 

foreseeable at the time of such 

acquisition or improvement. For further 

explanation, see Code section 514(c). 

Line 1j. Noncash basis plans must 

include amounts owed for any liabilities 

that would not be classified as benefit 

claims payable, operating payables, or 

acquisition indebtedness. 

Line 1l. The entry in column (b) must 

equal the sum of the entry in column (a) 

plus lines 2k, 2l(1), and 2l(2). 

Line 2a. Include the total cash 

contributions received and/or (for 

accrual basis plans) due to be received. 

Note: Plans using the accrual basis of 

accounting should not include contributions 

designated for years before the 2009 plan 

year on line 2a. 

Line 2a(1)(B). For welfare plans, 

report all employee contributions, 

including all elective contributions 

under a cafeteria plan (Code section 

125). For pension benefit plans, 

participant contributions, for purposes 

of this item, also include elective 

contributions under a qualified cash or 

deferred arrangement (Code section 

401(k)). 

Line 2a(2). Use the current value, at 

date contributed, of securities or other 

noncash property. 

Line 2b(1)(A). Enter interest earned on 

interest-bearing cash, including earnings 

from sweep accounts, STIF accounts, 

money market accounts, certificates of 

deposit, etc. This is the interest earned 

on the investments reported on line 

1c(1). 

Line 2b(1)(B). Enter interest earned on 

U.S. Government Securities. This is the 

interest earned on the investments 

reported on line 1c(2). 

Line 2b(1)(C). Generally, this is the 

interest earned on securities that are 

reported on lines 1(c)(3)(A) and (B) and 

1d(1). 

Line 2b(2). Generally, the dividends 

are for investments reported on line 

1c(4)(A) and (B), 1(c)(13), and 1d(1). For 

accrual basis plans, include any 

dividends declared for stock held on the 

date of record, but not yet received as 

of the end of the plan year. 

Line 2b(3). Generally, rents represent 

the income earned on the real property 

that is reported in items 1c(6) and 1d(2). 

Enter rents as a ‘‘Net’’ figure. Net rents 

are determined by taking the total rent 

received and subtracting all expenses 

directly associated with the property. If 

the real property is jointly used as 

income producing property and for the 

operation of the plan, net that portion of 

the expenses attributable to the income 

producing portion of the property 

against the total rents received. 

Line 2b(4). Enter in column (b) the 

total of net gain (loss) on sale of assets. 

This equals the sum of the net realized 

gain (or loss) on each asset held at the 

beginning of the plan year which was 

sold or exchanged during the plan year, 

and on each asset that was both 

acquired and disposed of within the 

plan year. 

Note: As current value reporting is 

required for the Form 5500, assets are 

revalued to current value at the end of the 

plan year. For purposes of this form, the 


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increase or decrease in the value of assets 

since the beginning of the plan year (if held 

on the first day of the plan year) or their 

acquisition date (if purchased during the 

plan year) is reported in line 2b(5) below, 

with two exceptions: (1) The realized gain (or 

loss) on each asset that was disposed of 

during the plan year is reported in 2b(4) 

(NOT on line 2b(5)), and (2) the net 

investment gain (or loss) from CCTs, PSAs, 

MTIAs, 103–12 IEs, and registered 

investment companies is reported in lines 

2b(6) through (10). 

The sum of the realized gain (or loss) 

on assets sold or exchanged during the 

plan year is to be calculated as follows: 

1. Enter in 2b(4)(A), column (a), the 

sum of the amount received for these 

former assets; 

2. Enter in 2b(4)(B), column (a), the 

sum of the current value of these former 

assets as of the beginning of the plan 

year and the purchase price for assets 

both acquired and disposed of during 

the plan year; and 

3. Enter in 2b(4)(C), column (b), the 

result obtained when 2b(4)(B) is 

subtracted from 2b(4)(A). If entering a 

negative number, enter a minus sign ‘‘- 

’’ to the left of the number. 

Note: Bond write-offs must be reported as 

realized losses. 

Line 2b(5). Subtract the current value 

of assets at the beginning of the year 

plus the cost of any assets acquired 

during the plan year from the current 

value of assets at the end of the year to 

obtain this figure. If entering a negative 

number, enter a minus sign ‘‘¥’’ to the 

left of the number. Do not include the 

value of assets reportable in lines 2b(4) 

and 2b(6) through 2b(10). 

Lines 2b(6), (7), (8), and (9). Report all 

earnings, expenses, gains or losses, and 

unrealized appreciation or depreciation 

included in computing the net 

investment gain (or loss) from all CCTs, 

PSAs, MTIAs, and 103–12 IEs here. If 

some plan funds are held in any of these 

entities and other plan funds are held in 

other funding media, complete all 

applicable subitems of line 2 to report 

plan earnings and expenses relating to 

the other funding media. The net 

investment gain (or loss) allocated to the 

plan for the plan year from the plan’s 

investment in these entities is equal to: 

1. The sum of the current value of the 

plan’s interest in each entity at the end 

of the plan year, 

2. Minus the current value of the 

plan’s interest in each entity at the 

beginning of the plan year, 

3. Plus any amounts transferred out of 

each entity by the plan during the plan 

year, and 

4. Minus any amounts transferred into 

each entity by the plan during the plan 

year. 

Enter the net gain as a positive 

number or the net loss as a negative 

number. 

Note: Enter the combined net investment 

gain or loss from all CCTs and PSAs, 

regardless of whether a DFE Form 5500 was 

filed for the CCTs and PSAs. 

Line 2b(10). Enter net investment gain 

(loss) from registered investment 

companies here. Compute in the same 

manner as discussed above for lines 

2b(6) through (9). 

Line 2c. Include all other plan income 

earned that is not included in lines 2a 

or 2b. Do not include transfers to or 

from other plans reported in line 2l. 

Line 2e(1). Include the current value 

of all cash, securities, or other property 

at the date of distribution. Include all 

eligible rollover distributions as defined 

in Code section 401(a)(31)(C) paid at the 

participant’s election to an eligible 

retirement plan (including an IRA 

within the meaning of section 

401(a)(31)(D)). 

Line 2e(2). Include payments to 

insurance companies and similar 

organizations such as Blue Cross, Blue 

Shield, and health maintenance 

organizations for the provision of plan 

benefits (e.g., paid-up annuities, 

accident insurance, health insurance, 

vision care, dental coverage, stop-loss 

insurance whose claims are paid to the 

plan (or which is otherwise an asset of 

the plan)), etc. 

Line 2e(3). Include all payments made 

to other organizations or individuals 

providing benefits. Generally, these are 

individual providers of welfare benefits 

such as legal services, day care services, 

training, and apprenticeship services. 

Line 2f. Include on this line all 

distributions paid during the plan year 

of excess deferrals under Code section 

402(g)(2)(A)(ii), excess contributions 

under section 401(k)(8), and excess 

aggregate contributions under section 

401(m)(6). Include allocable income 

distributed. Also include on this line 

any elective deferrals and employee 

contributions distributed or returned to 

employees during the plan year in 

accordance with Treasury Regulation 

section 1.415–6(b)(6)(iv), as well as any 

attributable gains that were also 

distributed. 

Line 2g. Report on line 2g a 

participant loan that has been deemed 

distributed during the plan year under 

the provisions of Code section 72(p) and 

Treasury Regulation section 1.72(p)–1 

only if both of the following 

circumstances apply: 

1. Under the plan, the participant loan 

is treated as a directed investment solely 

of the participant’s individual account; 

and 

2. As of the end of the plan year, the 

participant is not continuing repayment 

under the loan. 

If either of these circumstances does 

not apply, a deemed distribution of a 

participant loan must not be reported on 

line 2g. Instead, the current value of the 

participant loan (including interest 

accruing thereon after the deemed 

distribution) must be included on line 

1c(8), column (b) (participant loans—

end of year), without regard to the 

occurrence of a deemed distribution. 

Note: The amount to be reported on line 2g 

of Schedule H or Schedule I must be reduced 

if, during the plan year, a participant resumes 

repayment under a participant loan reported 

as a deemed distribution on line 2g for any 

earlier year. The amount of the required 

reduction is the amount of the participant 

loan reported as a deemed distribution on 

line 2g for the earlier year. If entering a 

negative number, enter a minus sign ‘‘¥’’ to 

the left of the number. The current value of 

the participant loan must then be included in 

line 1c(8), column (b), of Schedule H 

(participant loans—end of year) or in line 1a, 

column (b), of Schedule I (plan assets—end 

of year). 

Although certain participant loans 

that are deemed distributed are to be 

reported on line 2g of the Schedule H 

or Schedule I, and are not to be reported 

on the Schedule H or Schedule I as an 

asset thereafter (unless the participant 

resumes repayment under the loan in a 

later year), they are still considered 

outstanding loans and are not treated as 

actual distributions for certain purposes. 

See Q&As 12 and 19 of Treasury 

Regulation section 1.72(p)–1. 

Line 2h. Interest expense is a 

monetary charge for the use of money 

borrowed by the plan. This amount 

should include the total of interest paid 

or to be paid (for accrual basis plans) 

during the plan year. 

Line 2i. Report all administrative 

expenses (by specified category) paid by 

or charged to the plan, including those 

that were not subtracted from the gross 

income of CCTs, PSAs, MTIAs, and 

103–12 IEs in determining their net 

investment gain(s) or loss(es). Expenses 

incurred in the general operations of the 

plan are classified as administrative 

expenses. 

Line 2i(1). Include the total fees paid 

(or in the case of accrual basis plans 

costs incurred during the plan year but 

not paid as of the end of the plan year) 

by the plan for outside accounting, 

actuarial, legal, and valuation/appraisal 

services. Include fees for the annual 

audit of the plan by an independent 

qualified public accountant (IQPA); for 

payroll audits; for accounting/ 

bookkeeping services; for actuarial 

services rendered to the plan; and to a 


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lawyer for rendering legal opinions, 

litigation, and advice (but not for 

providing legal services as a benefit to 

plan participants). Report here fees and 

expenses for corporate trustees and 

individual plan trustees, including 

reimbursement of expenses associated 

with trustees, such as lost time, 

seminars, travel, meetings, etc. Include 

the fee(s) for valuations or appraisals to 

determine the cost, quality, or value of 

an item such as real property, personal 

property (gemstones, coins, etc.), and for 

valuations of closely held securities for 

which there is no ready market. Do not 

include amounts paid to plan 

employees to perform bookkeeping/ 

accounting functions that should be 

included in line 2i(4). 

Line 2i(2). Enter the total fees paid (or 

in the case of accrual basis plans, costs 

incurred during the plan year but not 

paid as of the end of the plan year) to 

a contract administrator for performing 

administrative services for the plan. For 

purposes of the return/report, a contract 

administrator is any individual, 

partnership or corporation, responsible 

for managing the clerical operations 

(e.g., handling membership rosters, 

claims payments, maintaining books 

and records) of the plan on a contractual 

basis. Do not include salaried staff or 

employees of the plan or banks or 

insurance carriers. 

Line 2i(3). Enter the total fees paid (or 

in the case of accrual basis plans, costs 

incurred during the plan year but not 

paid as of the end of the plan year) to 

an individual, partnership or 

corporation (or other person) for advice 

to the plan relating to its investment 

portfolio. These may include fees paid 

to manage the plan’s investments, fees 

for specific advice on a particular 

investment, and fees for the evaluation 

of the plan’s investment performance. 

Line 2i(4). Other expenses are those 

that cannot be included in lines 2i(1) 

through 2i(3). These may include plan 

expenditures such as salaries and other 

compensation and allowances (e.g., 

payment of premiums to provide health 

insurance benefits to plan employees), 

expenses for office supplies and 

equipment, cars, telephone, postage, 

rent, expenses associated with the 

ownership of a building used in the 

operation of the plan, and all 

miscellaneous expenses. 

Line 2l. Include in these 

reconciliation figures the value of all 

transfers of assets or liabilities into or 

out of the plan resulting from, among 

other things, mergers and 

consolidations. A transfer of assets or 

liabilities occurs when there is a 

reduction of assets or liabilities with 

respect to one plan and the receipt of 

these assets or the assumption of these 

liabilities by another plan. A transfer is 

not a shifting of one plan’s assets or 

liabilities from one investment to 

another. A transfer is not a distribution 

of all or part of an individual 

participant’s account balance that is 

reportable on IRS Form 1099–R, 

Distributions From Pensions, Annuities, 

Retirement or Profit-Sharing Plans, 

IRAs, Insurance Contracts, etc., (see the 

instructions for line 2e). Transfers out at 

the end of the year should be reported 

as occurring during the plan year. 

Note: If this Schedule H is filed for a DFE, 

report the value of all asset transfers to the 

DFE, including those resulting from 

contributions to participating plans on line 

2l(1), and report the total value of all assets 

transferred out of the DFE, including assets 

withdrawn for disbursement as benefit 

payments by participating plans, on line 

2l(2). Contributions and benefit payments are 

considered to be made to/by the plan (not to/ 

by a DFE). 

Line 3. The administrator of an 

employee benefit plan who files a 

Schedule H generally must engage an 

IQPA pursuant to ERISA section 

103(a)(3)(A) and 29 CFR 2520.103–1(b). 

This requirement also applies to a Form 

5500 Return/Report filed for a 103–12 IE 

and for a GIA (see 29 CFR 2520.103–12 

and 29 CFR 2520.103–2). The IQPA’s 

report must be attached to the Form 

5500 Return/Report when a Schedule H 

is attached unless line 3d(1) or 3d(2) on 

the Schedule H is checked. 

29 CFR 2520.103–1(b) requires that 

any separate financial statements 

prepared in order for the IQPA to form 

the opinion and notes to these financial 

statements must be attached to the Form 

5500 Return/Report. Any separate 

statements must include the information 

required to be disclosed in Parts I and 

II of the Schedule H; however, they may 

be aggregated into categories in a 

manner other than that used on the 

Schedule H. The separate statements 

must consist of reproductions of Parts I 

and II or statements incorporating by 

references Parts I and II. See ERISA 

section 103(a)(3)(A), and the DOL 

regulations 29 CFR 2520.103–1(a)(2) and 

(b), 2520.103–2, and 2520.104–50. 

Note: Delinquent participant contributions 

reported on line 4a should be treated as part 

of the separate schedules referenced in 

ERISA section 103(a)(3)(A) and 29 CFR 

2520.103–1(b) and 2520.103–2(b) for 

purposes of preparing the IQPA’s opinion 

described on line 3 even though they are no 

longer required to be listed on Part III of the 

Schedule G. If the information contained on 

line 4a is not presented in accordance with 

regulatory requirements, i.e., when the IQPA 

concludes that the scheduled information 

required by Line 4a does not contain all the 

required information or contains information 

that is inaccurate or is inconsistent with the 

plan’s financial statements, the IQPA report 

must make the appropriate disclosures in 

accordance with generally accepted auditing 

standards. Delinquent participant 

contributions that are exempt because they 

satisfy the DOL voluntary fiduciary 

correction program (VFCP) requirements and 

the conditions of prohibited transaction 

exemption (PTE) 2002–51 do not need to be 

treated as part of the schedule of nonexempt 

party-in-interest transactions. 

If the required IQPA’s report is not 

attached to the Form 5500 Return/ 

Report, the filing is subject to rejection 

as incomplete and penalties may be 

assessed. 

Lines 3a(1) through 3a(4). These 

boxes identify the type of opinion 

offered by the accountant. 

Line 3a(1). Check if an unqualified 

opinion was issued. Generally, an 

unqualified opinion is issued when the 

IQPA concludes that the plan’s financial 

statements present fairly, in all material 

respects, the financial status of the plan 

as of the end of the period audited and 

the changes in its financial status for the 

period under audit in conformity with 

generally accepted accounting 

principles (GAAP) or an other 

comprehensive basis of accounting 

(OCBOA), e.g., cash basis. 

Line 3a(2). Check if a qualified 

opinion was issued. Generally, a 

qualified opinion is issued by an IQPA 

when the plan’s financial statements 

present fairly, in all material respects, 

the financial status of the plan as of the 

end of the audit period and the changes 

in its financial status for the period 

under audit in conformity with GAAP 

or OCBOA, except for the effects of one 

or more matters described in the 

opinion. 

Line 3a(3). Check if a disclaimer of 

opinion was issued. A disclaimer of 

opinion is issued when the IQPA does 

not express an opinion on the financial 

statements because he or she has not 

performed an audit sufficient in scope 

to enable him or her to form an opinion 

on the financial statements. 

Line 3a(4). Check if the plan received 

an adverse accountant’s opinion. 

Generally, an adverse opinion is issued 

by an IQPA when the plan’s financial 

statements do not present fairly, in all 

material respects, the financial status of 

the plan as of the end of the audit period 

and the changes in its financial status 

for the period under audit in conformity 

with GAAP or OCBOA. 

Line 3b. Check ‘‘Yes’’ if a box is 

checked on line 3a and the scope of the 

plan’s audit was limited pursuant to 

DOL regulations 29 CFR 2520.103–8 and 

2520.103–12(d) because the 


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examination and report of an IQPA did 

not extend to: (a) Statements or 

information regarding assets held by a 

bank, similar institution or insurance 

carrier that is regulated and supervised 

and subject to periodic examination by 

a state or federal agency provided that 

the statements or information are 

prepared by and certified to by the bank 

or similar institution or an insurance 

carrier, or (b) information included with 

the Form 5500 Return/Report filed for a 

103–12 IE. 

The term ‘‘similar institution’’ as used 

here does not extend to securities 

brokerage firms (see DOL Advisory 

Opinion 93–21A). See 29 CFR 

2520.103–8 and 2520.103–12(d). 

Note: These regulations do not exempt the 

plan administrator from engaging an IQPA or 

from attaching the IQPA’s report to the Form 

5500 Return/Report. If you check line 3b, you 

must also check the appropriate box on line 

3a to identify the type of opinion offered by 

the IQPA. 

Line 3c. Enter the name and EIN of the 

accountant (or accounting firm) in the 

space provided on line 3c. Do not use 

a social security number in lieu of an 

EIN. The Schedule H is open to public 

inspection, and the contents are public 

information and are subject to 

publication on the Internet. Because of 

privacy concerns, the inclusion of a 

social security number on this Schedule 

H may result in the rejection of the 

filing. 

Line 3d(1). Check this box only if the 

Schedule H is being filed for a CCT, 

PSA, or MTIA. 

Line 3d(2). Check this box if the plan 

has elected to defer attaching the IQPA’s 

opinion for the first of two (2) 

consecutive plan years, one of which is 

a short plan year of seven (7) months or 

fewer. The Form 5500 for the first of the 

two years must be complete and 

accurate, with all required schedules 

and attachments, except for the IQPA’s 

report, including an attachment 

explaining why one of the two plan 

years is of seven or fewer months 

duration and stating that the annual 

report for the immediately following 

plan year will include a report of an 

IQPA with respect to the financial 

statements and accompanying schedules 

for both of the two plan years. The Form 

5500 Return/Report for the second year 

must include: (a) Financial schedules 

and statements for both plan years; (b) 

a report of an IQPA with respect to the 

financial schedules and statements for 

each of the two plan years (regardless of 

the number of participants covered at 

the beginning of each plan year); and (c) 

a statement identifying any material 

differences between the unaudited 

financial information submitted with 

the first Form 5500 and the audited 

financial information submitted with 

the second Form 5500. See 29 CFR 

2520.104–50. 

Note: Do not check the box on line 3d(2) 

if the Form 5500 Return/Report is filed for a 

103–12 IE or a GIA. A deferral of the IQPA’s 

opinion is not permitted for a 103–12 IE or 

a GIA. If an E or G is entered on Form 5500, 

Part I, line A(4), an IQPA’s opinion must be 

attached to the Form 5500 Return/Report, 

and the type of opinion must be reported on 

Schedule H, line 3a. 

Lines 4a through 4n. Plans completing 

Schedule H must answer all these lines 

either ‘‘Yes’’ or ‘‘No.’’ If lines 4a through 

4h are ‘‘Yes’’ or line 4l is ‘‘Yes’’ an 

amount must be entered where 

indicated. 

Report investments in CCTs, PSAs, 

MTIAs, and 103–12 IEs, but not the 

investments made by these entities. 

Plans with all of their funds held in a 

master trust must check ‘‘No’’ on lines 

4b, 4c, 4i, and 4j. CCTs and PSAs do not 

complete Part IV. MTIAs, 103–12 IEs, 

and GIAs do not complete lines 4a, 4e, 

4f, 4g, 4h, 4k, 4m, or 4n. 103–12 IEs also 

do not complete lines 4j and 4l. MTIAs 

also do not complete line 4l. 

Line 4a. Amounts paid by a 

participant or beneficiary to an 

employer and/or withheld by an 

employer for contribution to the plan 

are participant contributions that 

become plan assets as of the earliest 

date on which such contributions can 

reasonably be segregated from the 

employer’s general assets (see 29 CFR 

2510.3–102). An employer holding these 

assets after that date commingled with 

its general assets will have engaged in 

a prohibited use of plan assets (see 

ERISA section 406). If such a 

nonexempt prohibited transaction 

occurred with respect to a disqualified 

person (see Code section 4975(e)(2)), file 

IRS Form 5330, Return of Excise Taxes 

Related to Employee Benefit Plans, with 

the IRS to pay any applicable excise tax 

on the transaction. 

Plans that check ‘‘Yes’’ must enter the 

aggregate amount of all late 

contributions for the year. The total 

amount of the delinquent contributions 

must be included on line 4a of the 

Schedule H or I, as applicable, for the 

year in which the contributions were 

delinquent and must be carried over and 

reported again on line 4a of the 

Schedule H or I, as applicable, for each 

subsequent year until the year after the 

violation has been fully corrected, 

which correction includes payment of 

the late contributions and 

reimbursement of the plan for lost 

earnings or profits. If no participant 

contributions were received or withheld 

by the employer during the plan year, 

answer ‘‘No.’’

Participant loan repayments paid to 

and/or withheld by an employer for 

purposes of transmittal to the plan that 

were not transmitted to the plan in a 

timely fashion must be reported either 

on line 4a in accordance with the 

reporting requirements that apply to 

delinquent participant contributions or 

on line 4d. See Advisory Opinion 2002–

02A, available at http://www.dol.gov/ 

ebsa. 

TIP: Delinquent participant 

contributions reported on line 4a must 

be treated as part of the separate 

schedules referenced in ERISA section 

103(a)(3)(A) and 29 CFR 2520.103–1(b) 

and 2520.103–2(b) for purposes of 

preparing the IQPA’s opinion described 

on line 3 even though they are no longer 

required to be listed on Part III of the 

Schedule G. If the information 

contained on line 4a is not presented in 

accordance with regulatory 

requirements, i.e., when the IQPA 

concludes that the scheduled 

information required by line 4a does not 

contain all the required information or 

contains information that is inaccurate 

or is inconsistent with the plan’s 

financial statements, the IQPA report 

must make the appropriate disclosures 

in accordance with generally accepted 

auditing standards. For more 

information, see EBSA’s Frequently 

Asked Questions About Reporting 

Delinquent Contributions on the Form 

5500, available on the Internet at 

http://www.dol.gov/ebsa. These 

Frequently Asked Questions clarify that 

plans have an obligation to include 

delinquent participant contributions on 

their financial statements and 

supplemental schedules and that the 

IQPA’s report covers such delinquent 

contributions even though they are no 

longer required to be included on Part 

III of the Schedule G. Although all 

delinquent participant contributions 

must be reported on line 4a, delinquent 

contributions for which the DOL VFCP 

requirements and the conditions of PTE 

2002–51 have been satisfied do not need 

to be treated as nonexempt party-ininterest transactions. 

The VFCP describes how to apply the 

specific transactions covered (which 

transactions include delinquent 

participant contributions to pension and 

welfare plans), and acceptable methods 

for correcting violations. In addition, 

applicants that satisfy both the VFCP 

requirements and the conditions of PTE 

2002–51 are eligible for immediate relief 

from payment of certain prohibited 

transaction excise taxes for certain 

corrected transactions, and are also 


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relieved from the obligation to file the 

IRS Form 5330 with the IRS. For more 

information, see 71 FR 20261 (Apr. 19, 

2006) and 71 FR 20135 (Apr. 19, 2006). 

All delinquent participant 

contributions must be reported on line 

4a even if violations have been 

corrected. Information about the VFCP 

is also available on the Internet at 

http://www.dol.gov/ebsa. 

Line 4a Schedule. Attach a Schedule 

of Delinquent Participant Contributions 

using the format below if you entered 

‘‘Yes.’’ If you choose to include 

participant loan repayments on line 4a, 

you must apply the same supplemental 

schedule and IQPA disclosure 

requirements to the loan repayments as 

applied to delinquent transmittals of 

participant contributions. 

SCHEDULE H LINE 4A.—SCHEDULE OF DELINQUENT PARTICIPATION CONTRIBUTIONS

Participant Contributions Transferred 

Late to Plan 

Total that Constitute Nonexempt Prohibited Transactions Total Fully Corrected 

Under VFCP and PTE 

2002–51 Contributions Not Corrected 

Contributions Corrected 

Outside VFCP 

Contributions Pending 

Correction in VFCP 

Check here if Late Participant Loan Repayments are included: b 

Line 4b. Plans that check ‘‘Yes’’ must 

enter the amount and complete Part I of 

Schedule G. The due date, payment 

amount and conditions for determining 

default of a note or loan are usually 

contained in the documents establishing 

the note or loan. A loan by the plan is 

in default when the borrower is unable 

to pay the obligation upon maturity. 

Obligations that require periodic 

repayment can default at any time. 

Generally, loans and fixed income 

obligations are considered uncollectible 

when payment has not been made and 

there is little probability that payment 

will be made. A fixed income obligation 

has a fixed maturity date at a specified 

interest rate. Do not include participant 

loans made under an individual account 

plan with investment experience 

segregated for each account that were 

made in accordance with 29 CFR 

2550.408b–1 and secured solely by a 

portion of the participant’s vested 

accrued benefit. 

Line 4c. Plans that check ‘‘Yes’’ must 

enter the amount and complete Part II 

of Schedule G. A lease is an agreement 

conveying the right to use property, 

plant, or equipment for a stated period. 

A lease is in default when the required 

payment(s) has not been made. An 

uncollectible lease is one where the 

required payments have not been made 

and for which there is little probability 

that payment will be made. 

Line 4d. Plans that check ‘‘Yes’’ must 

enter the amount and complete Part III 

of Schedule G. Check ‘‘Yes’’ if any 

nonexempt transaction with a party-ininterest occurred regardless of whether 

the transaction is disclosed in the 

IQPA’s report. Do not check ‘‘Yes’’ or 

complete Schedule G, Part III, with 

respect to transactions that are: (1) 

Statutorily exempt under Part 4 of Title 

I of ERISA; (2) administratively exempt 

under ERISA section 408(a); (3) exempt 

under Code sections 4975(c) or 4975(d); 

(4) the holding of participant 

contributions in the employer’s general 

assets for a welfare plan that meets the 

conditions of ERISA Technical Release 

92–01; (5) a transaction of a 103–12 IE 

with parties other than the plan; or (6) 

delinquent participant contributions 

reported on line 4a. 

Note: See the instructions for Part III of the 

Schedule G concerning non-exempt 

transactions and parties-in-interest. 

You may indicate that an application 

for an administrative exemption is 

pending. If you are unsure as to whether 

a transaction is exempt or not, you 

should consult with either the plan’s 

IQPA or legal counsel or both. 

TIP: Applicants that satisfy the VFCP 

requirements and the conditions of PTE 

2002–51 (see the instructions for line 

4a) are eligible for immediate relief from 

payment of certain prohibited 

transaction excise taxes for certain 

corrected transactions, and are also 

relieved from the obligation to file the 

IRS Form 5330 with the IRS. For more 

information, see 71 FR 20261 (Apr. 19, 

2006) and 71 FR 20135 (Apr. 19, 2006). 

When the conditions of PTE 2002–51 

have been satisfied, the corrected 

transactions should be treated as exempt 

under Code section 4975(c) for the 

purposes of answering line 4d. 

Line 4e. Plans that check ‘‘Yes’’ must 

enter the aggregate amount of fidelity 

bond coverage for all claims. Check 

‘‘Yes’’ only if the plan itself (as opposed 

to the plan sponsor or administrator) is 

a named insured under a fidelity bond 

from an approved surety covering plan 

officials and that protects the plan as 

described in 29 CFR Part 2580. 

Generally, every plan official of an 

employee benefit plan who ‘‘handles’’

funds or other property of such plan 

must be bonded. Generally, a person 

shall be deemed to be ‘‘handling’’ funds 

or other property of a plan, so as to 

require bonding, whenever his or her 

other duties or activities with respect to 

given funds are such that there is a risk 

that such funds could be lost in the 

event of fraud or dishonesty on the part 

of such person, acting either alone or in 

collusion with others. Section 412 of 

ERISA and 29 CFR Part 2580 describe 

the bonding requirements, including the 

definition of ‘‘handling’’ (29 CFR 

2580.412–6), the permissible forms of 

bonds (29 CFR 2580.412–10), the 

amount of the bond (29 CFR Part 2580, 

subpart C), and certain exemptions such 

as the exemption for unfunded plans, 

certain banks and insurance companies 

(ERISA section 412), and the exemption 

allowing plan officials to purchase 

bonds from surety companies 

authorized by the Secretary of the 

Treasury as acceptable reinsurers on 

Federal bonds (29 CFR 2580.412–23). 

Information concerning the list of 

approved sureties and reinsurers is 

available on the Internet at http:// 

www.fms.treas.gov/c570. 

NOTE: Plans are permitted under certain 

conditions to purchase fiduciary liability 

insurance with plan assets. These fiduciary 

liability insurance policies are not written 

specifically to protect the plan from losses 

due to dishonest acts and are not fidelity 

bonds reported in line 4e. 

Line 4f. Check ‘‘Yes’’ if the plan 

suffered or discovered any loss as a 

result of any dishonest or fraudulent 

act(s) even if the loss was reimbursed by 

the plan’s fidelity bond or from any 

other source. If ‘‘Yes’’ is checked enter 

the full amount of the loss. If the full 

amount of the loss has not yet been 

determined, provide an estimate as 

determined in good faith by a plan 

fiduciary. You must keep, in accordance 

with ERISA section 107, records 

showing how the estimate was 

determined. 

CAUTION: Willful failure to report is 

a criminal offense. See ERISA section 

501. 


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Lines 4g and 4h. Current value means 

fair market value where available. 

Otherwise, it means the fair value as 

determined in good faith under the 

terms of the plan by a trustee or a 

named fiduciary, assuming an orderly 

liquidation at the time of the 

determination. See ERISA section 3(26). 

An accurate assessment of fair market 

value is essential to a pension plan’s 

ability to comply with the requirements 

set forth in the Code (e.g., the exclusive 

benefit rule of Code section 401(a)(2), 

the limitations on benefits and 

contributions under Code section 415, 

and the minimum funding requirements 

under Code section 412) and must be 

determined annually. 

Examples of assets that may not have 

a readily determinable value on an 

established market (e.g., NYSE, AMEX, 

over the counter, etc.) include real 

estate, nonpublicly traded securities, 

shares in a limited partnership, and 

collectibles. Do not check ‘‘Yes’’ on line 

4g for mutual fund shares or insurance 

company investment contracts. Also do 

not check ‘‘Yes’’ on line 4g if the plan 

is a defined contribution plan and the 

only assets the plan holds that do not 

have a readily determinable value on an 

established market are: (1) Participant 

loans not in default or (2) assets over 

which the participant exercises control 

within the meaning of section 404(c) of 

ERISA. 

Although the current value of plan 

assets must be determined each year, 

there is no requirement that the assets 

(other than certain nonpublicly traded 

employer securities held in ESOPs) be 

valued every year by independent thirdparty appraisers. 

Enter in the amount column the fair 

market value of the assets referred to on 

line 4g whose value was not readily 

determinable on an established market 

and which were not valued by an 

independent third-party appraiser in the 

plan year. Generally, as it relates to 

these questions, an appraisal by an 

independent third party is an evaluation 

of the value of an asset prepared by an 

individual or firm who knows how to 

judge the value of such assets and does 

not have an ongoing relationship with 

the plan or plan fiduciaries except for 

preparing the appraisals. 

Line 4i. Check ‘‘Yes’’ if the plan had 

any assets held for investment purposes, 

and attach a schedule of assets held for 

investment purposes at end of year, a 

schedule of assets held for investment 

purposes that were both acquired and 

disposed of within the plan year, or 

both, as applicable. The schedules must 

use the format set forth below or a 

similar format. See 29 CFR 2520.103–11. 

Assets held for investment purposes 

shall include: 

• Any investment asset held by the 

plan on the last day of the plan year; 

and 

• Any investment asset purchased 

during the plan year and sold before the 

end of the plan year except: 

1. Debt obligations of the U.S. or any 

U.S. agency. 

2. Interests issued by a company 

registered under the Investment 

Company Act of 1940 (e.g., a mutual 

fund). 

3. Bank certificates of deposit with a 

maturity of one year or less. 

4. Commercial paper with a maturity 

of 9 months or less if it is valued in the 

highest rating category by at least two 

nationally recognized statistical rating 

services and is issued by a company 

required to file reports with the 

Securities and Exchange Commission 

under section 13 of the Securities 

Exchange Act of 1934. 

5. Participations in a bank common or 

collective trust. 

6. Participations in an insurance 

company pooled separate account. 

7. Securities purchased from a brokerdealer registered under the Securities 

Exchange Act of 1934 and either: (1) 

Listed on a national securities exchange 

and registered under section 6 of the 

Securities Exchange Act of 1934 or (2) 

quoted on NASDAQ. 

Assets held for investment purposes 

shall not include any investment that 

was not held by the plan on the last day 

of the plan year if that investment is 

reported in the annual report for that 

plan year in any of the following: 

1. The schedule of loans or fixed 

income obligations in default required 

by Schedule G, Part I; 

2. The schedule of leases in default or 

classified as uncollectible required by 

Schedule G, Part II; 

3. The schedule of non-exempt 

transactions required by Schedule G, 

Part III; or 

4. The schedule of reportable 

transactions required by Schedule H, 

line 4j. 

Line 4i schedules. The first schedule 

required to be attached is a schedule of 

all assets held for investment purposes 

at the end of the plan year, aggregated 

and identified by issue, maturity date, 

rate of interest, collateral, par or 

maturity value, cost and current value, 

and, in the case of a loan, the payment 

schedule. 

In column (a), place an asterisk (*) on 

the line of each identified person known 

to be a party-in-interest to the plan. In 

column (c), include any restriction on 

transferability of corporate securities. 

(Include lending of securities permitted 

under Prohibited Transactions 

Exemption 81–6.) 

This schedule must be clearly labeled 

‘‘Schedule H, line 4i—Schedule of 

Assets (Held At End of Year).’’

(a) 

(b) Identity of issue, borrower, lessor, or similar 

party 

(c) Description of investment including maturity 

date, rate of interest, collateral, par, or maturity 

value 

(d) Cost (e) Current value 

The second schedule required to be 

attached is a schedule of investment 

assets that were both acquired and 

disposed of within the plan year. This 

schedule must be clearly labeled 

‘‘Schedule H, line 4i—Schedule of 

Assets (Acquired and Disposed of 

Within Year).’’

(a) Identity of issue, borrower, lessor, or similar party 

(b) Description of investment including maturity date, rate of interest, collateral, par, or maturity 

value 

(c) Costs of acquisitions (d) Proceeds of dispositions 


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(a) Identity of issue, borrower, lessor, or similar party 

(b) Description of investment including maturity date, rate of interest, collateral, par, or maturity 

value 

(c) Costs of acquisitions (d) Proceeds of dispositions 

Notes: (1) Participant loans under an 

individual account plan with investment 

experience segregated for each account, that 

are made in accordance with 29 CFR 

2550.408b–1 and that are secured solely by 

a portion of the participant’s vested accrued 

benefit, may be aggregated for reporting 

purposes in item 4i. Under identity of 

borrower enter ‘‘Participant loans,’’ under 

rate of interest enter the lowest rate and the 

highest rate charged during the plan year 

(e.g., 8%–10%), under the cost and proceeds 

columns enter zero, and under current value 

enter the total amount of these loans. (2) 

Column (d) cost information for the Schedule 

of Assets (Held At End of Year) and the 

column (c) cost of acquisitions information 

for the Schedule of Assets (Acquired and 

Disposed of Within Year) may be omitted 

when reporting investments of an individual 

account plan that a participant or beneficiary 

directed with respect to assets allocated to 

his or her account (including a negative 

election authorized under the terms of the 

plan). Likewise, investments in Code section 

403(b)(1) annuity contracts and Code section 

403(b)(7) custodial accounts may also be 

omitted. (3) Participant-directed brokerage 

account assets reporting in the aggregate on 

line 1c(15) must be treated as one asset held 

for investment for purposes of the line 4i 

schedules, except investments in tangible 

personal property must continue to be 

reported as separate assets on the line 4i 

schedules. Investments in Code section 

403(b) annuity contracts and Code section 

403(b)(7) custodial accounts should also be 

treated as one asset held for investment for 

purposes on the line 4i schedules. 

Line 4j. Check ‘‘Yes’’ and attach to the 

Form 5500 the following schedule if the 

plan had any reportable transactions 

(see 29 CFR 2520.103–6 and the 

examples provided in the regulation). 

The schedule must use the format set 

forth below or a similar format. See 29 

CFR 2520.103–11. 

A reportable transaction includes: 

1. A single transaction within the plan 

year in excess of 5% of the current value 

of the plan assets; 

2. Any series of transactions with or 

in conjunction with the same person, 

involving property other than securities, 

which amount in the aggregate within 

the plan year (regardless of the category 

of asset and the gain or loss on any 

transaction) to more than 5% of the 

current value of plan assets; 

3. Any transaction within the plan 

year involving securities of the same 

issue if within the plan year any series 

of transactions with respect to such 

securities amount in the aggregate to 

more than 5% of the current value of the 

plan assets; and 

4. Any transaction within the plan 

year with respect to securities with, or 

in conjunction with, a person if any 

prior or subsequent single transaction 

within the plan year with such person, 

with respect to securities, exceeds 5% of 

the current value of plan assets. 

The 5% figure is determined by 

comparing the current value of the 

transaction at the transaction date with 

the current value of the plan assets at 

the beginning of the plan year. If this is 

the initial plan year, you may use the 

current value of plan assets at the end 

of the plan year to determine the 5% 

figure. 

If the assets of two or more plans are 

maintained in one trust, except as 

provided below, the plan’s allocable 

portion of the transactions of the trust 

shall be combined with the other 

transactions of the plan, if any, to 

determine which transactions (or series 

of transactions) are reportable (5%) 

transactions. 

For investments in common/ 

collective trusts (CCTs), pooled separate 

accounts (PSAs), 103–12 IEs and 

registered investment companies, 

determine the 5% figure by comparing 

the transaction date value of the 

acquisition and/or disposition of units 

of participation or shares in the entity 

with the current value of the plan assets 

at the beginning of the plan year. If the 

Schedule H is attached to a Form 5500 

filed for a plan with all plan funds held 

in a master trust, check ‘‘No’’ on line 4j. 

Plans with assets in a master trust that 

have other transactions should 

determine the 5% figure by subtracting 

the current value of plan assets held in 

the master trust from the current value 

of all plan assets at the beginning of the 

plan year and check ‘‘Yes’’ or ‘‘No,’’ as 

appropriate. Do not include individual 

transactions of CCTs, PSAs, master trust 

investment accounts (MTIAs), 103–12 

IEs, and registered investment 

companies in which this plan or DFE 

invests. 

In the case of a purchase or sale of a 

security on the market, do not identify 

the person from whom purchased or to 

whom sold. 

Special rule for certain participantdirected transactions. Transactions 

under an individual account plan that a 

participant or beneficiary directed with 

respect to assets allocated to his or her 

account (including a negative election 

authorized under the terms of the plan) 

should not be treated for purposes of 

line 4j as reportable transactions. The 

current value of all assets of the plan, 

including these participant-directed 

transactions, should be included in 

determining the 5% figure for all other 

transactions. 

Line 4j schedule. The schedule 

required to be attached is a schedule of 

reportable transactions that must be 

clearly labeled ‘‘Schedule H, line 4j—

Schedule of Reportable Transactions.’’

(a) Identity 

of party involved 

(b) Description of 

asset (include interest rate and maturity 

in case of a loan) 

(c) Purchase 

price 

(d) Selling 

price 

(e) Lease 

rental 

(f) Expense incurred 

with transaction 

(g) Cost 

of asset 

(h) Current value of 

asset on transaction 

date 

(i) Net 

gain or 

(loss) 

Line 4k. Check ‘‘Yes’’ if all the plan 

assets (including insurance/annuity 

contracts) were distributed to the 

participants and beneficiaries, legally 

transferred to the control of another 


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plan, or brought under the control of the 

PBGC. 

Check ‘‘No’’ for a welfare benefit plan 

that is still liable to pay benefits for 

claims incurred before the termination 

date, but not yet paid. See 29 CFR 

2520.104b–2(g)(2)(ii). 

Line 4l. You must check ‘‘Yes’’ if any 

benefits due under the plan were not 

timely paid or not paid in full. Include 

in this amount the total of any 

outstanding amounts that were not paid 

when due in previous years that have 

continued to remain unpaid. 

Line 4m. Check ‘‘Yes’’ if there was a 

‘‘blackout period.’’ A blackout period is 

a temporary suspension of more than 

three consecutive business days during 

which participants or beneficiaries of a 

401(k) or other individual account 

pension plan were unable to, or were 

limited or restricted in their ability to, 

direct or diversify assets credited to 

their accounts, obtain loans from the 

plan, or obtain distributions from the 

plan. A ‘‘blackout period’’ generally 

does not include a temporary 

suspension of the right of participants 

and beneficiaries to direct or diversify 

assets credited to their accounts, obtain 

loans from the plan, or obtain 

distributions from the plan if the 

temporary suspension is: (1) Part of the 

regularly scheduled operations of the 

plan that has been disclosed to 

participants and beneficiaries; (2) due to 

a qualified domestic relations order 

(QDRO) or because of a pending 

determination as to whether a domestic 

relations order is a QDRO; (3) due to an 

action or a failure to take action by an 

individual participant or because of an 

action or claim by someone other than 

the plan regarding a participant’s 

individual account; or (4) by application 

of federal securities laws. For more 

information, see 29 CFR 2520.101–3 

(available at http://www.dol.gov/ebsa). 

Line 4n. If there was a blackout 

period, did you provide the required 

notice not less than 30 days nor more 

than 60 days in advance of restricting 

the rights of participants and 

beneficiaries to change their plan 

investments, obtain loans from the plan, 

or obtain distributions from the plan? If 

so, check ‘‘Yes.’’ See 29 CFR 2520.101–

3 for specific notice requirements and 

for exceptions from the notice 

requirement. Also, answer ‘‘Yes’’ if one 

of the exceptions to the notice 

requirement under 29 CFR 2520.101–3 

applies. 

Line 5a. Check ‘‘Yes’’ if a resolution 

to terminate the plan was adopted 

during this or any prior plan year, 

unless the termination was revoked and 

no assets reverted to the employer. If 

‘‘Yes’’ is checked, enter the amount of 

plan assets that reverted to the employer 

during the plan year in connection with 

the implementation of such termination. 

Enter ‘‘-0-’’ if no reversion occurred 

during the current plan year. 

CAUTION: A Form 5500 must be filed 

for each year the plan has assets, and, 

for a welfare benefit plan, if the plan is 

still liable to pay benefits for claims 

incurred before the termination date, 

but not yet paid. See 29 CFR 2520.104b–

2(g)(2)(ii). 

Line 5b. Enter information concerning 

assets and/or liabilities transferred from 

this plan to another plan(s) (including 

spinoffs) during the plan year. A 

transfer of assets or liabilities occurs 

when there is a reduction of assets or 

liabilities with respect to one plan and 

the receipt of these assets or the 

assumption of these liabilities by 

another plan. Enter the name, EIN, and 

PN of the transferee plan(s) involved on 

lines 5b(1), (2), and (3). If you need 

additional space, include an attachment 

with the information required for lines 

5b(1), (2), and (3) for each additional 

plan and label the attachment 

‘‘Schedule H, line 5b—Additional 

Plans.’’

Do not use a social security number 

in lieu of an EIN or include an 

attachment that contains visible social 

security numbers. The Schedule H is 

open to public inspection, and the 

contents are public information and are 

subject to publication on the Internet. 

Because of privacy concerns, the 

inclusion of a social security number on 

this Schedule H or the inclusion of a 

visible social security number on an 

attachment may result in the rejection of 

the filing. 

Note: A distribution of all or part of an 

individual participant’s account balance that 

is reportable on Form 1099–R should not be 

included on line 5b. Do not submit Form 

1099–R with the Form 5500. 

CAUTION: IRS Form 5310–A, Notice 

of Plan Merger or Consolidation, 

Spinoff, or Transfer of Plan Assets or 

Liabilities; Notice of Qualified Separate 

Lines of Business, must be filed at least 

30 days before any plan merger or 

consolidation or any transfer of plan 

assets or liabilities to another plan. 

There is a penalty for not filing Form 

5310–A on time. In addition, a transfer 

of benefit liabilities involving a plan 

covered by PBGC insurance may be 

reportable to the PBGC. See PBGC Form 

10, Post-Event Notice of Reportable 

Events, and Form 10-Advance, Advance 

Notice of Reportable Events. 

2009 Instructions for Schedule I 

(Form 5500) Financial Information—

Small Plan 

General Instructions 

Who Must File 

Schedule I (Form 5500), Financial 

Information—Small Plan, must be 

attached to a Form 5500 filed for 

pension benefit plans and welfare 

benefit plans that covered fewer than 

100 participants as of the beginning of 

the plan year and that are not eligible to 

file Form 5500–SF. 

Note: If a Schedule I was filed for the plan 

for the 2008 plan year and the plan covered 

fewer than 121 participants as of the 

beginning of the 2009 plan year, the 

Schedule I may be completed instead of a 

Schedule H. 

Exception: Certain insured, unfunded 

or combination unfunded/insured 

welfare plans are exempt from filing the 

Form 5500 and the Schedule I. In 

addition, certain fully insured pension 

benefit plans are exempt from 

completing the Schedule I. See the Form 

5500 instructions for Who Must File and 

Limited Pension Plan Reporting for 

more information. 

Check the Schedule I box on the Form 

5500 (Part II, line 10b(2)) if a Schedule 

I is attached to the Form 5500. Do not 

attach both a Schedule I and a Schedule 

H to the same Form 5500. 

Specific Instructions 

Lines A, B, C, and D. This information 

must be the same as reported in Part II 

of the Form 5500 to which this 

Schedule I is attached. The plan name 

may be abbreviated. 

Do not use a social security number 

in line D in lieu of an EIN. The Schedule 

I and its attachments are open to public 

inspection, and the contents are public 

information and are subject to 

publication on the Internet. Because of 

privacy concerns, the inclusion of a 

social security number on this Schedule 

I or any of its attachments may result in 

the rejection of the filing. 

EINs may be obtained by applying for 

one on Form SS–4, Application for 

Employer Identification Number, as 

soon as possible. You can obtain Form 

SS–4 by calling 1–800–TAX–FORM 

(1–800–829–3676) or at the IRS Web 

Site at www.irs.gov. The EBSA does not 

issue EINs. 

Note: Use the cash, modified cash, or 

accrual basis for recognition of transactions, 

as long as you use one method consistently. 

Round off all amounts reported on the 

Schedule I to the nearest dollar. Any other 

amounts are subject to rejection. Check all 

subtotals and totals carefully. 

If the assets of two or more plans are 

maintained in one fund, such as when 


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an employer has two plans funded 

through a single trust (except a DFE), 

complete Parts I and II by entering the 

plan’s allocable part of each line item. 

If assets of one plan are maintained in 

two or more trust funds, report the 

combined financial information in Part 

I. 

Current value means fair market value 

where available. Otherwise, it means the 

fair value as determined in good faith 

under the terms of the plan by a trustee 

or a named fiduciary, assuming an 

orderly liquidation at time of the 

determination. See ERISA section 3(26). 

Part I—Small Plan Financial 

Information 

Amounts reported on lines 1a, 1b, and 

1c for the beginning of the plan year 

must be the same as reported for the end 

of the plan year for corresponding lines 

on the return/report for the preceding 

plan year. 

Do not include contributions 

designated for the 2009 plan year in 

column (a). 

Line 1a. A plan with assets held in 

common/collective trusts (CCTs), 

pooled separate accounts (PSAs), master 

trust investment accounts (MTIAs), and/ 

or 103–12 IEs must also attach Schedule 

D. 

Use the same method for determining 

the value of the plan’s interest in an 

insurance company general account 

(unallocated contracts) that you used for 

line 4 of Schedule A, or, if line 4 is not 

required, line 7 of Schedule A. 

Note: Do not include in column (b) a 

participant loan that has been deemed 

distributed during the plan year under the 

provisions of Code section 72(p) and 

Treasury Regulation section 1.72(p)–1, if both 

of the following circumstances apply: 

1. Under the plan, the participant loan is 

treated as a directed investment solely of the 

participant’s individual account; and 

2. As of the end of the plan year, the 

participant is not continuing repayment 

under the loan. 

If the deemed distributed participant 

loan is included in column (a) and both 

of these circumstances apply, report the 

loan as a deemed distribution on line 

2g. However, if either of these 

circumstances does not apply, the 

current value of the participant loan 

(including interest accruing thereon 

after the deemed distribution) should be 

included in column (b) without regard 

to the occurrence of a deemed 

distribution. 

After a participant loan that has been 

deemed distributed is reported on line 

2g, it is no longer to be reported as an 

asset on Schedule H or Schedule I 

unless, in a later year, the participant 

resumes repayment under the loan. 

However, such a loan (including interest 

accruing thereon after the deemed 

distribution) that has not been repaid is 

still considered outstanding for 

purposes of applying Code section 

72(p)(2)(A) to determine the maximum 

amount of subsequent loans. Also, the 

deemed distribution is not treated as an 

actual distribution for other purposes, 

such as the qualification requirements 

of Code section 401, including, for 

example, the determination of top-heavy 

status under Code section 416 and the 

vesting requirements of Treasury 

Regulation section 1.411(a)–7(d)(5). See 

Q&As 12 and 19 of Treasury Regulation 

section 1.72(p)–1. 

The entry on line 1a, column (b), of 

Schedule I (plan assets—end of year) or 

on line 1c(8), column (b), of Schedule H 

(participant loans—end of year) must 

include the current value of any 

participant loan reported as a deemed 

distribution on line 2g for any earlier 

year if, during the plan year, the 

participant resumes repayment under 

the loan. In addition, the amount to be 

entered on line 2g must be reduced by 

the amount of the participant loan 

reported as a deemed distribution on 

line 2g for the earlier year. 

Line 1b. Enter the total liabilities at 

the beginning and end of the plan year. 

Liabilities to be entered here do not 

include the value of future pension 

payments to plan participants. However, 

the amount to be entered in line 1b for 

accrual basis filers includes, among 

other things: 

1. Benefit claims that have been 

processed and approved for payment by 

the plan but have not been paid 

(including all incurred but not reported 

welfare benefit claims); 

2. Accounts payable obligations owed 

by the plan that were incurred in the 

normal operations of the plan but have 

not been paid; and 

3. Other liabilities such as acquisition 

indebtedness and any other amount 

owed by the plan. 

Line 1c. Enter the net assets as of the 

beginning and end of the plan year. 

(Subtract line 1b from 1a). Line 1c, 

column (b) must equal the sum of line 

1c, column (a) plus lines 2j and 2k. 

Line 2a. Include the total cash 

contributions received and/or (for 

accrual basis plans) due to be received. 

Line 2a(1). Plans using the accrual 

basis of accounting must not include 

contributions designated for years 

before the 2009 plan year on line 2a(1). 

Line 2a(2). For welfare plans, report 

all employee contributions, including 

all elective contributions under a 

cafeteria plan (Code section 125). For 

pension benefit plans, participant 

contributions, for purposes of this item, 

also include elective contributions 

under a qualified cash or deferred 

arrangement (Code section 401(k)). 

Line 2b. Use the current value, at date 

contributed, of securities or other 

noncash property. 

Line 2c. Enter all other plan income 

for the plan year. Do not include 

transfers from other plans that are 

reported on line 2k. Other income 

received and/or receivable would 

include: 

1. Interest on investments (including 

money market accounts, sweep 

accounts, STIF accounts, etc.) 

2. Dividends. (Accrual basis plans 

should include dividends declared for 

all stock held by the plan even if the 

dividends have not been received as of 

the end of the plan year.) 

3. Rents from income-producing 

property owned by the plan. 

4. Royalties. 

5. Net gain or loss from the sale of 

assets. 

6. Other income, such as unrealized 

appreciation (depreciation) in plan 

assets. To compute this amount subtract 

the current value of all assets at the 

beginning of the year plus the cost of 

any assets acquired during the plan year 

from the current value of all assets at the 

end of the year minus assets disposed of 

during the plan year. 

Line 2d. Enter the total of all cash 

contributions (line 2a(1) through (3)), 

noncash contributions (line 2b), and 

other plan income (line 2c) during the 

plan year. If entering a negative number, 

enter a minus sign ‘‘¥’’ to the left of the 

number. 

Line 2e. Include: (1) Payments made 

(and for accrual basis filers payments 

due) to or on behalf of participants or 

beneficiaries in cash, securities, or other 

property (including rollovers of an 

individual’s accrued benefit or account 

balance). Include all eligible rollover 

distributions as defined in Code section 

401(a)(31)(D) paid at the participant’s 

election to an eligible retirement plan 

(including an IRA within the meaning of 

section 401(a)(31)(E)); (2) payments to 

insurance companies and similar 

organizations such as Blue Cross, Blue 

Shield, and health maintenance 

organizations for the provision of plan 

benefits (e.g., paid-up annuities, 

accident insurance, health insurance, 

vision care, dental coverage, etc.); and 

(3) payments made to other 

organizations or individuals providing 

benefits. 

Generally, these payments discussed 

in (3) are made to individual providers 

of welfare benefits such as legal 

services, day care services, and training 

and apprenticeship services. If 

securities or other property are 


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distributed to plan participants or 

beneficiaries, include the current value 

on the date of distribution. 

Line 2f. Include all distributions paid 

during the plan year of excess deferrals 

under Code section 402(g)(2)(A)(ii), 

excess contributions under section 

401(k)(8), and excess aggregate 

contributions under section 401(m)(6), 

allocable income distributed, and any 

elective deferrals and employee 

contributions distributed or returned to 

employees during the plan year in 

accordance with Treasury Regulation 

section 1.415–6(b)(6)(iv), as well as any 

attributable gains that were also 

distributed. 

Line 2g. Report on line 2g a 

participant loan included in line 1a, 

column (a) (participant loans—

beginning of year) and that has been 

deemed distributed during the plan year 

under the provisions of Code section 

72(p) and Treasury Regulation section 

1.72(p)–1 only if both of the following 

circumstances apply: 

1. Under the plan, the participant loan 

is treated as a directed investment solely 

of the participant’s individual account; 

and 

2. As of the end of the plan year, the 

participant is not continuing repayment 

under the loan. 

If either of these circumstances does 

not apply, a deemed distribution of a 

participant loan should not be reported 

on line 2g. Instead, the current value of 

the participant loan including interest 

accruing thereon after the deemed 

distribution) should be included on line 

1a, column (b) (plan assets—end of 

year), without regard to the occurrence 

of a deemed distribution. 

Note: The amount to be reported on line 2g 

of Schedule H or Schedule I must be reduced 

if, during the plan year, a participant resumes 

repayment under a participant loan reported 

as a deemed distribution on line 2g for any 

earlier year. The amount of the required 

reduction is the amount of the participant 

loan that was reported as a deemed 

distribution on line 2g for the earlier year. If 

entering a negative number, enter a minus 

sign ‘‘¥’’ to the left of the number. The 

current value of the participant loan must 

then be included in line 1c(8), column (b), of 

Schedule H (participant loans—end of year) 

or in line 1a, column (b), of Schedule I (plan 

assets—end of year). 

Although certain participant loans 

deemed distributed are to be reported 

on line 2g of the Schedule H or 

Schedule I, and are not to be reported 

on the Schedule H or Schedule I as an 

asset thereafter (unless the participant 

resumes repayment under the loan in a 

later year), they are still considered 

outstanding loans and are not treated as 

actual distributions for certain purposes. 

See Q&As 12 and 19 of Treasury 

Regulation section 1.72(p)–1. 

Line 2h. The amount to be reported 

for expenses involving administrative 

service providers (salaries, fees, and 

commissions) include the total fees paid 

(or in the case of accrual basis plans, 

costs incurred during the plan year but 

not paid as of the end of the plan year) 

by the plan for, among others: 

1. Salaries to employees of the plan; 

2. Fees and expenses for accounting, 

actuarial, legal, investment 

management, investment advice, and 

securities brokerage services; 

3. Contract administrator fees; 

4. Fees and expenses for individual 

plan trustees, including reimbursement 

for travel, seminars, and meeting 

expenses; and 

5. Fees and expenses paid for 

valuations and appraisals of real estate 

and closely held securities. 

Line 2i. Other expenses (paid and/or 

payable) include other administrative 

and miscellaneous expenses paid by or 

charged to the plan, including among 

others, office supplies and equipment, 

telephone, postage, rent and expenses 

associated with the ownership of a 

building used in operation of the plan. 

Line 2j. Enter the total of all benefits 

paid or due as reported on lines 2e, 2f, 

and 2g and all other plan expenses 

(lines 2h and 2i) during the year. 

Line 2l. Enter the net value of all 

assets transferred to and from the plan 

during the plan year including those 

resulting from mergers and spinoffs. A 

transfer of assets or liabilities occurs 

when there is a reduction of assets or 

liabilities with respect to one plan and 

the receipt of these assets or the 

assumption of these liabilities by 

another plan. Transfers out at the end of 

the year should be reported as occurring 

during the plan year. 

Note: A distribution of all or part of an 

individual participant’s account balance that 

is reportable on Form 1099–R, Distributions 

From Pensions, Annuities, Retirement or 

Profit-Sharing Plans, IRAs, Insurance 

Contracts, etc., should not be included on 

line 2l but must be included in benefit 

payments reported on line 2e. Do not submit 

IRS Form 1099–R with Form 5500. 

Lines 3a through 3g. You must check 

either ‘‘Yes’’ or ‘‘No’’ on each line to 

report whether the plan held any assets 

in the listed categories at any time 

during the plan year. If ‘‘Yes’’ is 

checked on any line, enter in the 

amount column for that line the current 

value of the assets held at the end of the 

plan year or ‘‘0’’ if no assets remain in 

the category at the end of the plan year. 

You should allocate the value of the 

plan’s interest in a commingled trust 

containing the assets of more than one 

plan on a line-by-line basis, except do 

not include on lines 3a through 3g the 

value of the plan’s interest in any CCT, 

PSA, MTIA, or 103–12 IE (see 

Instructions for definitions of CCT, PSA, 

MTIA, and 103–12 IE). 

Line 3a. Enter the value of the plan’s 

participation in a partnership or joint 

venture, unless the partnership or joint 

venture is a 103–12 IE. 

Line 3b. The term ‘‘employer real 

property’’ means real property (and 

related personal property) that is leased 

to an employer of employees covered by 

the plan, or to an affiliate of such 

employer. For purposes of determining 

the time at which a plan acquires 

employer real property for purposes of 

this line, such property shall be deemed 

to be acquired by the plan on the date 

on which the plan acquires the property 

or on the date on which the lease to the 

employer (or affiliate) is entered into, 

whichever is later. 

Line 3d. An employer security is any 

security issued by an employer 

(including affiliates) of employees 

covered by the plan. These may include 

common stocks, preferred stocks, bonds, 

zero coupon bonds, debentures, 

convertible debentures, notes, and 

commercial paper. 

Line 3e. Enter the current value of all 

loans to participants including 

residential mortgage loans that are 

subject to Code section 72(p). Include 

the sum of the value of the unpaid 

principal balances, plus accrued but 

unpaid interest, if any, for participant 

loans made under an individual account 

plan with investment experience 

segregated for each account that are 

made in accordance with 29 CFR 

2550.408b–1 and secured solely by a 

portion of the participant’s vested 

accrued benefit. When applicable, 

combine this amount with the current 

value of any other participant loans. Do 

not include any amount of a participant 

loan deemed distributed during the plan 

year under the provisions of Code 

section 72(p) and Treasury Regulation 

section 1.72(p)–1, if both of the 

following circumstances apply: 

1. Under the plan, the participant loan 

is treated as a directed investment solely 

of the participant’s individual account; 

and 

2. As of the end of the plan year, the 

participant is not continuing repayment 

under the loan. 

If both of these circumstances apply, 

report the loan as a deemed distribution 

on line 2g. However, if either of these 

circumstances does not apply, the 

current value of the participant loan 

(including interest accruing thereon 

after the deemed distribution) should be 


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included on line 3e without regard to 

the occurrence of a deemed distribution. 

Note: After participant loans have been 

deemed distributed and reported on line 2g 

of the Schedule I or H, they are no longer 

required to be reported as assets on the 

Schedule I or H. However, such loans 

(including interest accruing thereon after the 

deemed distribution) that have not been 

repaid are still considered outstanding for 

purposes of applying Code section 

72(p)(2)(A) to determine the maximum 

amount of subsequent loans. Also, the 

deemed distribution is not treated as an 

actual distribution for other purposes, such 

as the qualification requirements of Code 

section 401, including, for example, the 

determination of top-heavy status under 

Code section 416 and the vesting 

requirements of Treasury Regulation section 

1.411(a)–7(d)(5). See Q&As 12 and 19 of 

Treasury Regulation section 1.72(p)–1. 

Line 3f. Enter the current value of all 

loans made by the plan, except 

participant loans reportable on line 3e. 

Include the sum of the value of loans for 

construction, securities loans, 

commercial and/or residential mortgage 

loans that are not subject to Code 

section 72(p) (either by making or 

participating in the loans directly or by 

purchasing loans originated by a third 

party), and other miscellaneous loans. 

Line 3g. Include all property that has 

concrete existence and is capable of 

being processed, such as goods, wares, 

merchandise, furniture, machines, 

equipment, animals, automobiles, etc. 

This includes collectibles, such as 

works of art, rugs, antiques, metals, 

gems, stamps, coins, alcoholic 

beverages, musical instruments, and 

historical objects (documents, clothes, 

etc.). Do not include the value of a 

plan’s interest in property reported on 

lines 3a through 3f, or intangible 

property, such as patents, copyrights, 

goodwill, franchises, notes, mortgages, 

stocks, claims, interests, or other 

property that embodies intellectual or 

legal rights. 

Part II—Compliance Questions 

Answer all lines either ‘‘Yes’’ or 

‘‘No,’’ and if lines 4a through 4i are 

‘‘Yes’’ or line 4l is ‘‘Yes,’’ an amount 

must be entered. If you check ‘‘No’’ on 

line 4k you must attach the report of an 

independent qualified public 

accountant (IQPA) or a statement that 

the plan is eligible and elects to defer 

attaching the IQPA’s opinion pursuant 

to 29 CFR 2520.104–50 in connection 

with a short plan year of seven months 

or less. Plans with all of their funds held 

in a master trust should check ‘‘No’’ on 

Schedule I, lines 4b, c, and i. 

Line 4a. Amounts paid by a 

participant or beneficiary to an 

employer and/or withheld by an 

employer for contribution to the plan 

are participant contributions that 

become plan assets as of the earliest 

date on which such contributions can 

reasonably be segregated from the 

employer’s general assets (see 29 CFR 

2510.3–102). An employer holding these 

assets after that date commingled with 

its general assets will have engaged in 

a prohibited use of plan assets (see 

ERISA section 406). If such a 

nonexempt prohibited transaction 

occurred with respect to a disqualified 

person (see Code section 4975(e)(2)), file 

Form 5330, Return of Excise Taxes 

Related to Employee Benefit Plans, with 

the IRS to pay any applicable excise tax 

on the transaction. 

Plans that check ‘‘Yes’’ must enter the 

aggregate amount of all late 

contributions for the year. The total 

amount of the delinquent contributions 

must be included on line 4a of the 

Schedule H or I, as applicable, for the 

year in which the contributions were 

delinquent and must be carried over and 

reported again on line 4a of the 

Schedule H or I, as applicable, for each 

subsequent year until the year after the 

violation has been fully corrected, 

which correction includes payment of 

the late contributions and 

reimbursement of the plan for lost 

earnings or profits. If no participant 

contributions were received or withheld 

by the employer during the plan year, 

answer ‘‘No.’’

Participant loan repayments paid to 

and/or withheld by an employer for 

purposes of transmittal to the plan that 

were not transmitted to the plan in a 

timely fashion must be reported either 

on line 4a in accordance with the 

reporting requirements that apply to 

delinquent participant contributions or 

on line 4d. See Advisory Opinion 2002–

02A, available at http://www.dol.gov/ 

ebsa. 

TIP: For those Schedule I filers 

required to submit an IQPA report, 

delinquent participant contributions 

reported on line 4a must be treated as 

part of the separate schedules 

referenced in ERISA section 103(a)(3)(A) 

and 29 CFR 2520.103–1(b) and 

2520.103–2(b) for purposes of preparing 

the IQPA’s opinion even though they 

are no longer required to be listed on 

Part III of the Schedule G. If the 

information contained on line 4a is not 

presented in accordance with regulatory 

requirements, i.e., when the IQPA 

concludes that the scheduled 

information required by line 4a does not 

contain all the required information or 

contains information that is inaccurate 

or is inconsistent with the plan’s 

financial statements, the IQPA report 

must make the appropriate disclosures 

in accordance with generally accepted 

auditing standards. For more 

information, see EBSA’s Frequently 

Asked Questions About Reporting 

Delinquent Contributions on the Form 

5500, available on the Internet at 

http://www.dol.gov/ebsa. These 

Frequently Asked Questions clarify that 

plans have an obligation to include 

delinquent participant contributions on 

their financial statements and 

supplemental schedules and that the 

IQPA’s report covers such delinquent 

contributions even though they are no 

longer required to be included on Part 

III of the Schedule G. Although all 

delinquent participant contributions 

must be reported on line 4a, delinquent 

contributions for which the DOL 

Voluntary Fiduciary Correction Program 

(VFCP) requirements and the conditions 

of Prohibited Transaction Exemption 

(PTE) 2002–51 have been satisfied do 

not need to be treated as nonexempt 

party-in-interest transactions. 

The VFCP describes how to apply, the 

specific transactions covered (which 

transactions include delinquent 

participant contributions to pension and 

welfare plans), and acceptable methods 

for correcting violations. In addition, 

applicants that satisfy both the VFCP 

requirements and the conditions of PTE 

2002–51 are eligible for immediate relief 

from payment of certain prohibited 

transaction excise taxes for certain 

corrected transactions, and are also 

relieved from the obligation to file the 

IRS Form 5330 with the IRS. For more 

information, see 71 FR 20261 (Apr. 19, 

2006) and 71 FR 20135 (Apr. 19, 2006). 

All delinquent participant contributions 

must be reported on line 4a even if 

violations have been corrected. 

Information about the VFCP is also 

available on the Internet at http:// 

www.dol.gov/ebsa. 

Line 4a Schedule. Attach a Schedule 

of Delinquent Participant Contributions 

using the format below if you entered 

‘‘Yes’’ on Line 4a and you are checking 

‘‘No’’ on Line 4k because you are not 

claiming the audit waiver for the plan. 

If you choose to include participant loan 

repayments on Line 4a, you must apply 

the same supplemental schedule and 

IQPA disclosure requirements to the 

loan repayments as apply to delinquent 

transmittals of participant contributions. 


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SCHEDULE I LINE 4A.—SCHEDULE OF DELINQUENT PARTICIPANT CONTRIBUTIONS

Participant contributions transferred late to 

plan 

Total that constitute nonexempt prohibited transactions 

Total fully corrected 

under VFCP and PTE 

2002–51 Contributions not 

corrected 

Contributions 

corrected outside 

VFCP 

Contributions pending 

correction in VFCP 

Note here if Late Participant Loan Repayments are included: b 

Line 4b. Plans that check ‘‘Yes’’ must 

enter the amount. The due date, 

payment amount and conditions for 

determining default of a note or loan are 

usually contained in the documents 

establishing the note or loan. A loan by 

the plan is in default when the borrower 

is unable to pay the obligation upon 

maturity. Obligations that require 

periodic repayment can default at any 

time. Generally, loans and fixed income 

obligations are considered uncollectible 

when payment has not been made and 

there is little probability that payment 

will be made. A fixed income obligation 

has a fixed maturity date at a specified 

interest rate. Do not include participant 

loans made under an individual account 

plan with investment experience 

segregated for each account that were 

made in accordance with 29 CFR 

2550.408b–1 and secured solely by a 

portion of the participant’s vested 

accrued benefit. 

Line 4c. Plans that check ‘‘Yes’’ must 

enter the amount. A lease is an 

agreement conveying the right to use 

property, plant or equipment for a stated 

period. A lease is in default when the 

required payment(s) has not been made. 

An uncollectible lease is one where the 

required payments have not been made 

and for which there is little probability 

that payment will be made. 

Line 4d. Plans that check ‘‘Yes’’ must 

enter the amount. Check ‘‘Yes’’ if any 

nonexempt transaction with a party-ininterest occurred regardless of whether 

the transaction is disclosed in the 

IQPA’s report. Do not check ‘‘Yes’’ with 

respect to transactions that are: (1) 

Statutorily exempt under Part 4 of Title 

I of ERISA; (2) administratively exempt 

under ERISA section 408(a); (3) exempt 

under Code sections 4975(c) or 4975(d); 

(4) the holding of participant 

contributions in the employer’s general 

assets for a welfare plan that meets the 

conditions of ERISA Technical Release 

92–01; (5) a transaction of a 103–12 IE 

with parties other than the plan; or (6) 

delinquent participant contributions 

reported on line 4a. You may indicate 

that an application for an administrative 

exemption is pending. If you are unsure 

whether a transaction is exempt or not, 

you should consult with either a 

qualified public accountant, legal 

counsel, or both. If the plan is a 

qualified pension plan and a nonexempt 

prohibited transaction occurred with 

respect to a disqualified person, an IRS 

Form 5330 should be filed with the IRS 

to pay the excise tax on the transaction. 

TIP: Applicants that satisfy the VFCP 

requirements and the conditions of PTE 

2002–51 (see the instructions for line 

4a) are eligible for immediate relief from 

payment of certain prohibited 

transaction excise taxes for certain 

corrected transactions, and are also 

relieved from the obligation to file the 

Form 5330 with the IRS. For more 

information, see 71 FR 20261 (Apr. 19, 

2006) and 71 FR 20135 (Apr. 19, 2006). 

When the conditions of PTE 2002–51 

have been satisfied, the corrected 

transactions should be treated as exempt 

under Code section 4975(c) for the 

purposes of answering line 4d. 

Party-in-Interest. For purposes of this 

form, party-in-interest is deemed to 

include a disqualified person. See Code 

section 4975(e)(2). The term ‘‘party-ininterest’’ means, as to an employee 

benefit plan: 

A. Any fiduciary (including, but not 

limited to, any administrator, officer, 

trustee or custodian), counsel, or 

employee of the plan; 

B. A person providing services to the 

plan; 

C. An employer, any of whose 

employees are covered by the plan; 

D. An employee organization, any of 

whose members are covered by the plan; 

E. An owner, direct or indirect, of 

50% or more of: (1) The combined 

voting power of all classes of stock 

entitled to vote or the total value of 

shares of all classes of stock of a 

corporation, (2) the capital interest or 

the profits interest of a partnership, or 

(3) the beneficial interest of a trust or 

unincorporated enterprise that is an 

employer or an employee organization 

described in C or D; 

F. A relative of any individual 

described in A, B, C, or E; 

G. A corporation, partnership, or trust 

or estate of which (or in which) 50% or 

more of: (1) The combined voting power 

of all classes of stock entitled to vote or 

the total value of shares of all classes of 

stock of such corporation, (2) the capital 

interest or profits interest of such 

partnership, or (3) the beneficial interest 

of such trust or estate is owned directly 

or indirectly, or held by, persons 

described in A, B, C, D, or E; 

H. An employee, officer, director (or 

an individual having powers or 

responsibilities similar to those of 

officers or directors), or a 10% or more 

shareholder, directly or indirectly, of a 

person described in B, C, D, E, or G, or 

of the employee benefit plan; or 

I. A 10% or more (directly or 

indirectly in capital or profits) partner 

or joint venturer of a person described 

in B, C, D, E, or G. 

Nonexempt transactions with a partyin-interest include any direct or 

indirect: 

A. Sale or exchange, or lease, of any 

property between the plan and a partyin-interest. 

B. Lending of money or other 

extension of credit between the plan 

and a party-in-interest. 

C. Furnishing of goods, services, or 

facilities between the plan and a partyin-interest. 

D. Transfer to, or use by or for the 

benefit of, a party-in-interest, of any 

income or assets of the plan. 

E. Acquisition, on behalf of the plan, 

of any employer security or employer 

real property in violation of ERISA 

section 407(a). 

F. Dealing with the assets of the plan 

for a fiduciary’s own interest or own 

account. 

G. Acting in a fiduciary’s individual 

or any other capacity in any transaction 

involving the plan on behalf of a party 

(or represent a party) whose interests are 

adverse to the interests of the plan or 

the interests of its participants or 

beneficiaries. 

H. Receipt of any consideration for his 

or her own personal account by a partyin-interest who is a fiduciary from any 

party dealing with the plan in 

connection with a transaction involving 

the income or assets of the plan. 

Line 4e. Plans that check ‘‘Yes’’ must 

enter the aggregate amount of fidelity 

bond coverage for all claims. Check 

‘‘Yes’’ only if the plan itself (as opposed 


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to the plan sponsor or administrator) is 

a named insured under a fidelity bond 

from an approved surety covering plan 

officials and that protects the plan as 

described in 29 CFR part 2580. 

Generally, every plan official of an 

employee benefit plan who ‘‘handles’’

funds or other property of such plan 

must be bonded. Generally, a person 

shall be deemed to be ‘‘handling’’ funds 

or other property of a plan, so as to 

require bonding, whenever his or her 

other duties or activities with respect to 

given funds are such that there is a risk 

that such funds could be lost in the 

event of fraud or dishonesty on the part 

of such person, acting either alone or in 

collusion with others. Section 412 of 

ERISA and 29 CFR part 2580 describe 

the bonding requirements, including the 

definition of ‘‘handling’’ (29 CFR 

2580.412–6), the permissible forms of 

bonds (29 CFR 2580.412–10), the 

amount of the bond (29 CFR part 2580, 

subpart C), and certain exemptions such 

as the exemption for unfunded plans, 

certain banks and insurance companies 

(ERISA section 412), and the exemption 

allowing plan officials to purchase 

bonds from surety companies 

authorized by the Secretary of the 

Treasury as acceptable reinsurers on 

Federal bonds (29 CFR 2580.412–23). 

Information concerning the list of 

approved sureties and reinsurers is 

available on the Internet at http:// 

www.fms.treas.gov/c570. 

Note: Plans are permitted under certain 

conditions to purchase fiduciary liability 

insurance with plan assets. These fiduciary 

liability insurance policies are not written 

specifically to protect the plan from losses 

due to dishonest acts and are not fidelity 

bonds reported in line 4e. 

Line 4f. Check ‘‘Yes’’ if the plan 

suffered or discovered any loss as a 

result of any dishonest or fraudulent 

act(s) even if the loss was reimbursed by 

the plan’s fidelity bond or from any 

other source. If ‘‘Yes’’ is checked enter 

the full amount of the loss. If the full 

amount of the loss has not yet been 

determined, provide an estimate as 

determined in good faith by a plan 

fiduciary. You must keep, in accordance 

with ERISA section 107, records 

showing how the estimate was 

determined. 

CAUTION: Willful failure to report is 

a criminal offense. See ERISA section 

501. 

Lines 4g and 4h. Current value means 

fair market value where available. 

Otherwise, it means the fair value as 

determined in good faith under the 

terms of the plan by a trustee or a 

named fiduciary, assuming an orderly 

liquidation at time of the determination. 

See ERISA section 3(26). 

An accurate assessment of fair market 

value is essential to a pension plan’s 

ability to comply with the requirements 

set forth in the Code (e.g., the exclusive 

benefit rule of Code section 401(a)(2), 

the limitations on benefits and 

contributions under Code section 415, 

and the minimum funding requirements 

under Code section 412) and must be 

determined annually. 

Examples of assets that may not have 

a readily determinable value on an 

established market (e.g., NYSE, AMEX, 

over the counter, etc.) include real 

estate, nonpublicly traded securities, 

shares in a limited partnership, and 

collectibles. Do not check ‘‘Yes’’ on line 

4g for mutual fund shares or insurance 

company investment contracts. Also do 

not check ‘‘Yes’’ on line 4g if the plan 

is a defined contribution plan and the 

only assets the plan holds, that do not 

have a readily determinable value on an 

established market are: (1) Participant 

loans not in default, or (2) assets over 

which the participant exercises control 

within the meaning of section 404(c) of 

ERISA. 

Although the current value of plan 

assets must be determined each year, 

there is no requirement that the assets 

(other than certain nonpublicly traded 

employer securities held in ESOPs) be 

valued every year by independent thirdparty appraisers. 

Enter in the amount column the fair 

market value of the assets referred to on 

line 4g whose value was not readily 

determinable on an established market 

and which were not valued by an 

independent third-party appraiser in the 

plan year. Generally, as it relates to 

these questions, an appraisal by an 

independent third party is an evaluation 

of the value of an asset prepared by an 

individual or firm who knows how to 

judge the value of such assets and does 

not have an ongoing relationship with 

the plan or plan fiduciaries except for 

preparing the appraisals. 

Line 4i. Include as a single security all 

securities of the same issue. An example 

of a single issue is a certificate of 

deposit issued by the XYZ Bank on July 

1, 2008, which matures on June 30, 

2009, and yields 5.5%. For the purposes 

of line 4i, do not check ‘‘Yes’’ for 

securities issued by the U.S. 

Government or its agencies. Also, do not 

check ‘‘Yes’’ for securities held as a 

result of participant-directed 

transactions. 

Line 4j. Check ‘‘Yes’’ if all the plan 

assets (including insurance/annuity 

contracts) were distributed to the 

participants and beneficiaries, legally 

transferred to the control of another 

plan, or brought under the control of the 

PBGC. 

Check ‘‘No’’ for a welfare benefit plan 

that is still liable to pay benefits for 

claims that were incurred before the 

termination date, but not yet paid. See 

29 CFR 2520.104b–2(g)(2)(ii). 

Line 4k. Check ‘‘Yes’’ if you are 

claiming a waiver of the annual 

examination and report of an 

independent qualified public 

accountant (IQPA) under 29 CFR 

2520.104–46. You are eligible to claim 

the waiver if the Schedule I is being 

filed for: 

1. A small welfare plan, or 

2. A small pension plan for a plan 

year that began on or after April 18, 

2001, that complies with the conditions 

of 29 CFR 2520.104–46 summarized 

below. 

Check ‘‘No’’ and attach the report of 

the IQPA meeting the requirements of 

29 CFR 2520.103–1(b) if you are not 

claiming the waiver. Also check ‘‘No,’’

and attach the required IQPA reports or 

the required explanatory statement if 

you are relying on 29 CFR 2520.104–50 

in connection with a short plan year of 

seven months or less. At the top of any 

attached 2520.104–50 statement, enter 

‘‘2520.104–50 Statement, Schedule I, 

Line 4k.’’

For more information on the 

requirements for deferring an IQPA 

report pursuant to 29 CFR 2520.104–50 

in connection with a short plan year of 

seven months or less and the contents 

of the required explanatory statement, 

see the instructions for Schedule H, line 

3d(2) or call the EFAST Help Line at 

[number to be provided]. 

Note: For plans that check ‘‘No,’’ the IQPA 

report must make the appropriate disclosures 

in accordance with generally accepted 

auditing standards if the information 

reported on line 4a is not presented in 

accordance with regulatory requirements. 

The following summarizes the 

conditions of 29 CFR 2520.104–46 that 

must be met for a small pension plan 

with a plan year beginning on or after 

April 18, 2001, to be eligible for the 

waiver. For more information regarding 

these requirements, see the EBSA’s 

Frequently Asked Questions On The 

Small Pension Plan Audit Waiver 

Regulation and 29 CFR 2520.104–46, 

which are available at http:// 

www.dol.gov/ebsa, or call the EFAST 

Help Line at [number to be provided]. 

Condition 1: At least 95 percent of 

plan assets are ‘‘qualifying plan assets’’

as of the end of the preceding plan year, 

or any person who handles assets of the 

plan that do not constitute qualifying 

plan assets is bonded in accordance 

with the requirements of ERISA section 

412 (see the instructions for line 4e), 

except that the amount of the bond shall 


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not be less than the value of such nonqualifying assets. 

The determination of the ‘‘percent of 

plan assets’’ as of the end of the 

preceding plan year and the amount of 

any required bond must be made at the 

beginning of the plan’s reporting year 

for which the waiver is being claimed. 

For purposes of this line, you will have 

satisfied the requirement to make these 

determinations at the beginning of the 

plan reporting year for which the waiver 

is being claimed if they are made as 

soon after the date when such year 

begins as the necessary information 

from the preceding reporting year can 

practically be ascertained. See 29 CFR 

2580.412–11, 14 and 19 for additional 

guidance on these determinations, and 

29 CFR 2580.412–15 for procedures to 

be used for estimating these amounts if 

there is no preceding plan year. 

The term ‘‘qualifying plan assets,’’ for 

purposes of this line, means: 

1. Any assets held by any of the 

following regulated financial 

institutions: 

a. A bank or similar financial 

institution as defined in 29 CFR 

2550.408b–4(c); 

b. An insurance company qualified to 

do business under the laws of a state; 

c. An organization registered as a 

broker-dealer under the Securities 

Exchange Act of 1934; or 

d. Any other organization authorized 

to act as a trustee for individual 

retirement accounts under Code section 

408. 

2. Shares issued by an investment 

company registered under the 

Investment Company Act of 1940 (e.g., 

mutual funds); 

3. Investment and annuity contracts 

issued by any insurance company 

qualified to do business under the laws 

of a state; 

4. In the case of an individual account 

plan, any assets in the individual 

account of a participant or beneficiary 

over which the participant or 

beneficiary has the opportunity to 

exercise control and with respect to 

which the participant or beneficiary is 

furnished, at least annually, a statement 

from a regulated financial institution 

referred to above describing the assets 

held or issued by the institution and the 

amount of such assets; 

5. Qualifying employer securities, as 

defined in ERISA section 407(d)(5); and 

6. Participant loans meeting the 

requirements of ERISA section 

408(b)(1). 

Condition 2: The administrator must 

include in the summary annual report 

(SAR) or, in the case of plans subject to 

section 101(f) of the Act, the annual 

funding notice (described in 

§ 2520.101–5), furnished to participants 

and beneficiaries in accordance with 29 

CFR 2520.104b–10: 

1. The name of each regulated 

financial institution holding or issuing 

qualifying plan assets and the amount of 

such assets reported by the institution 

as of the end of the plan year (this SAR 

disclosure requirement does not apply 

to qualifying employer securities, 

participant loans and individual 

account assets described in paragraphs 

4, 5 and 6 above); 

2. The name of the surety company 

issuing the fidelity bond, if the plan has 

more than 5% of its assets in nonqualifying plan assets; 

3. A notice that participants and 

beneficiaries may, upon request and 

without charge, examine or receive from 

the plan evidence of the required bond 

and copies of statements from the 

regulated financial institutions 

describing the qualifying plan assets; 

and 

4. A notice that participants and 

beneficiaries should contact the EBSA 

Regional Office if they are unable to 

examine or obtain copies of the 

regulated financial institution 

statements or evidence of the required 

bond, if applicable. 

A Model Notice that plans can use to 

satisfy the enhanced SAR (or Annual 

Funding Notice) disclosure 

requirements to be eligible for the audit 

waiver is available as an Appendix to 29 

CFR 2520.104–46. 

Condition 3: In addition, in response 

to a request from any participant or 

beneficiary, the administrator, without 

charge to the participant or beneficiary, 

must make available for examination, or 

upon request furnish copies of, each 

regulated financial institution statement 

and evidence of any required bond. 

Examples. Plan A, which has a plan 

year that began on or after April 18, 

2001, had total assets of $600,000 as of 

the end of the 2000 plan year that 

included: Investments in various bank, 

insurance company and mutual fund 

products of $520,000; investments in 

qualifying employer securities of 

$40,000; participant loans (meeting the 

requirements of ERISA section 

408(b)(1)), totaling $20,000; and a 

$20,000 investment in a real estate 

limited partnership. Because the only 

asset of the plan that did not constitute 

a ‘‘qualifying plan asset’’ is the $20,000 

real estate limited partnership 

investment and that investment 

represents less than 5% of the plan’s 

total assets, no fidelity bond is required 

as a condition for the plan to be eligible 

for the waiver for the 2001 plan year. 

Plan B is identical to Plan A except 

that of Plan B’s total assets of $600,000 

as of the end of the 2000 plan year, 

$558,000 constitutes ‘‘qualifying plan 

assets’’ and $42,000 constitutes nonqualifying plan assets. Because 7%—

more than 5%—of Plan B’s assets do not 

constitute ‘‘qualifying plan assets,’’ Plan 

B, as a condition to be eligible for the 

waiver for the 2001 plan year, must 

ensure that it has a fidelity bond in an 

amount equal to at least $42,000 

covering persons handling its nonqualifying plan assets. Inasmuch as 

compliance with ERISA section 412 

generally requires the amount of the 

bond be not less than 10% of the 

amount of all the plan’s funds or other 

property handled, the bond acquired for 

section 412 purposes may be adequate 

to cover the non-qualifying plan assets 

without an increase (i.e., if the amount 

of the bond determined to be needed for 

the relevant persons for section 412 

purposes is at least $42,000). As 

demonstrated by the foregoing example, 

where a plan has more than 5% of its 

assets in non-qualifying plan assets, the 

required bond is for the total amount of 

the non-qualifying plan assets, not just 

the amount in excess of 5%. 

If you need further information 

regarding these requirements, see 29 

CFR 2520.104–46 which is available at 

http://www.dol.gov/ebsa or call the 

EFAST Help Line at [number to be 

provided]. 

Line 4l. You must check ‘‘Yes’’ if any 

benefits due under the plan were not 

timely paid or not paid in full. Include 

in this amount the total of any 

outstanding amounts that were not paid 

when due in previous years that have 

continued to remain unpaid. 

Line 4m. Check ‘‘Yes’’ if there was a 

‘‘blackout period.’’ A blackout period is 

a temporary suspension of more than 

three consecutive business days during 

which participants or beneficiaries of a 

401(k) or other individual account 

pension plan were unable to, or were 

limited or restricted in their ability to, 

direct or diversify assets credited to 

their accounts, obtain loans from the 

plan, or obtain distributions from the 

plan. A ‘‘blackout period’’ generally 

does not include a temporary 

suspension of the right of participants 

and beneficiaries to direct or diversify 

assets credited to their accounts, obtain 

loans from the plan, or obtain 

distributions from the plan if the 

temporary suspension is: (1) Part of the 

regularly scheduled operations of the 

plan that has been disclosed to 

participants and beneficiaries; (2) due to 

a qualified domestic relations order 

(QDRO) or because of a pending 

determination as to whether a domestic 

relations order is a QDRO; (3) due to an 

action or a failure to take action by an 


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individual participant or because of an 

action or claim by someone other than 

the plan regarding a participant’s 

individual account; or (4) by application 

of federal securities laws. For more 

information, see 29 CFR 2520.101–3 

(available at http://www.dol.gov/ebsa). 

Line 4n. If there was a blackout 

period, did you provide the required 

notice not less than 30 days nor more 

than 60 days in advance of restricting 

the rights of participants and 

beneficiaries to change their plan 

investments, obtain loans from the plan, 

or obtain distributions from the plan? If 

so, check ‘‘Yes.’’ See 29 CFR 2520.101–

3 for specific notice requirements and 

for exceptions from the notice 

requirement. Also, answer ‘‘Yes’’ if one 

of the exceptions to the notice 

requirement under 29 CFR 2520.101–3 

applies. 

Line 5a. Check ‘‘Yes’’ if a resolution 

to terminate the plan was adopted 

during this or any prior plan year, 

unless the termination was revoked and 

no assets reverted to the employer. If 

‘‘Yes’’ is checked, enter the amount of 

plan assets that reverted to the employer 

during the plan year in connection with 

the implementation of such termination. 

Enter ‘‘-0-’’ if no reversion occurred 

during the current plan year. 

CAUTION: A Form 5500 must be filed 

for each year the plan has assets, and, 

for a welfare benefit plan, if the plan is 

still liable to pay benefits for claims that 

were incurred before the termination 

date, but not yet paid. See 29 CFR 

2520.104b–2(g)(2)(ii). 

Line 5b. Enter information concerning 

assets and/or liabilities transferred from 

this plan to another plan(s) (including 

spinoffs) during the plan year. A 

transfer of assets or liabilities occurs 

when there is a reduction of assets or 

liabilities with respect to one plan and 

the receipt of these assets or the 

assumption of these liabilities by 

another plan. Enter the name, EIN, and 

PN of the transferee plan(s) involved on 

lines 5b(1), b(2) and b(3). If you need 

additional space, include an attachment 

with the information required for 5b(1), 

(2), and (3) for each additional plan and 

label the attachment, ‘‘Schedule I, line 

5b—Additional Plans.’’

Do not use a social security number 

in lieu of an EIN or include an 

attachment that contains visible social 

security numbers. The Schedule I and 

its attachments are open to public 

inspection, and the contents are public 

information and are subject to 

publication on the Internet. Because of 

privacy concerns, the inclusion of a 

social security number on this Schedule 

I or the inclusion of a visible social 

security number on an attachment may 

result in the rejection of the filing. 

Note: A distribution of all or part of an 

individual participant’s account balance that 

is reportable on IRS Form 1099–R should not 

be included on line 5b. Do not submit IRS 

Form 1099–R with the Form 5500. 

CAUTION: IRS Form 5310–A, Notice 

of Plan Merger or Consolidation, 

Spinoff, or Transfer of Plan Assets or 

Liabilities; Notice of Qualified Separate 

Lines of Business, must be filed at least 

30 days before any plan merger or 

consolidation or any transfer of plan 

assets or liabilities to another plan. 

There is a penalty for not filing IRS 

Form 5310–A on time. In addition, a 

transfer of benefit liabilities involving a 

plan covered by PBGC insurance may be 

reportable to the PBGC. See PBGC Form 

10, Post-Event Notice of Reportable 

Events, and PBGC Form 10—Advance, 

Advance Notice of Reportable Events. 

2009 Instructions for Schedule R (Form 

5500) Retirement Plan Information 

General Instructions 

Purpose of Schedule 

Schedule R (Form 5500), Retirement 

Plan Information, reports certain 

information on plan distributions, 

funding, and the adoption of 

amendments increasing the value of 

benefits in a defined benefit pension 

plan, as well as certain information on 

ESOPs and multiemployer defined 

benefit plans. 

Who Must File 

Schedule R must be attached to a 

Form 5500 filed for both tax qualified 

and nonqualified pension benefit plans. 

The parts of the Schedule R that must 

be completed depend on whether the 

plan is subject to the minimum funding 

standards of Code section 412 or ERISA 

section 302 and the type of plan. See 

line item requirements under ‘‘Specific 

Instructions’’ for more details. 

Exceptions: (1) Schedule R should not 

be completed when the Form 5500 

Return/Report is filed for a pension plan 

that uses, as the sole funding vehicle for 

providing benefits, individual 

retirement accounts or annuities (as 

described in Code section 408). See the 

Form 5500 instructions for Limited 

Pension Plan Reporting for more 

information. 

(2) Schedule R also should not be 

completed if each of the following 

conditions is met: 

• The plan is not a defined benefit 

plan or otherwise subject to the 

minimum funding standards of Code 

section 412 or ERISA section 302. 

• No plan benefits that would be 

reportable on line 1 of Part I of this 

Schedule R were distributed during the 

plan year. See the instructions for Part 

I, line 1, below. 

• No benefits, as described in the 

instructions for Part I, line 2, below, 

were paid during the plan year other 

than by the plan sponsor or plan 

administrator. (This condition is not 

met if benefits were paid by the trust or 

any other payor(s) which are reportable 

on IRS Form 1099–R, Distributions 

From Pensions, Annuities, Retirement 

or Profit-Sharing Plans, IRAs, Insurance 

Contracts, etc, using an EIN other than 

that of the plan sponsor or plan 

administrator reported on line 2b or 3b 

of Form 5500.) 

• Unless the plan is a profit-sharing, 

ESOP or stock bonus plan, no plan 

benefits of living or deceased 

participants were distributed during the 

plan year in the form of a single sum 

distribution. See the instructions for 

Part I, line 3, below. 

• The plan is not an ESOP. 

• The plan is not a multiemployer 

defined benefit plan. 

Check the Schedule R box on the 

Form 5500 (Part II, line 10a(1)) if a 

Schedule R is attached to the Form 

5500. 

Specific Instructions 

Lines A, B, C, and D. This information 

must be the same as reported in Part II 

of the Form 5500 to which this 

Schedule R is attached. The plan name 

may be abbreviated. 

Do not use a Social Security number 

in line D in lieu of an EIN. The Schedule 

R and its attachments are open to public 

inspection, and the contents are public 

information and are subject to 

publication on the Internet. Because of 

privacy concerns, the inclusion of a 

Social Security number on this 

Schedule R or any of its attachments 

may result in the rejection of the filing. 

EINs may be obtained by applying for 

one on IRS Form SS–4, Application for 

Employer Identification Number, as 

soon as possible. You can obtain an IRS 

Form SS–4 by calling 1–800–TAX–

FORM (1–800–829–3676) or at the IRS 

Web Site at http://www.irs.gov. The 

EBSA does not issue EINs. 

Part I—Distributions 

‘‘Distribution’’ includes only 

payments of benefits during the plan 

year, in cash, in kind, by purchase for 

the distributee of an annuity contract 

from an insurance company, or by 

distribution of life insurance contracts. 

It does not include corrective 

distributions of excess deferrals, excess 

contributions, or excess aggregate 

contributions, or the income allocable to 

any of these amounts. It also does not 


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include the distribution of elective 

deferrals or the return of employee 

contributions to correct excess annual 

additions under Code section 415, or the 

gains attributable to these amounts. 

Finally, it does not include a loan 

treated as a distribution under Code 

section 72(p); however, it does include 

a distribution of a plan loan offset 

amount as defined in section 1.402(c)–

2, Q&A 9(b). 

‘‘Participant’’ for purposes of 

Schedule R means any present of former 

employee who at any time during the 

plan year had an accrued benefit 

(account balance in a defined 

contribution plan) in the plan. 

Line 1. Enter the total value of all 

distributions made during the year 

(regardless of when the distribution 

began) in any form other than cash, 

annuity contracts issued by an 

insurance company, distribution of life 

insurance contracts, marketable 

securities, within the meaning of Code 

section 731(c)(2), or plan loan offset 

amounts. Do not include eligible 

rollover distributions paid directly to 

eligible retirement plans in a direct 

rollover under Code section 401(a)(31) 

unless such direct rollovers include 

property other than that enumerated in 

the preceding sentence. 

Line 2. Enter the EIN(s) of any 

payor(s) (other than the plan sponsor or 

plan administrator on line 2b or 3b of 

the Form 5500) who paid benefits 

reportable on IRS Form 1099–R on 

behalf of the plan to participants or 

beneficiaries during the plan year. This 

is the EIN that appears on the IRS Forms 

1099–R that are issued to report the 

payments. Include the EIN of the trust 

if different than that of the sponsor or 

plan administrator. If more than two 

payors made such payments during the 

year, enter the EINs of the two payors 

who paid the greatest dollar amounts 

during the year, in cash or in kind, that 

are reportable on IRS Form 1099–R, 

regardless of when the payment began, 

but take into account payments from an 

insurance company under an annuity 

only in the year the contract was 

purchased. 

Line 3. Enter the number of living or 

deceased participants whose benefits 

under the plan were distributed during 

the plan year in the form of a single sum 

distribution. For this purpose, a 

distribution of a participant’s benefits 

will not fail to be a single sum 

distribution merely because, after the 

date of the distribution, the plan makes 

a supplemental distribution as a result 

of earnings or other adjustments made 

after the date of the single sum 

distribution. Also include any 

participants whose benefits were 

distributed in the form of a direct 

rollover to the trustee or custodian of a 

qualified plan or individual retirement 

account. 

Part II—Funding Information 

Complete Part II only if the plan is 

subject to the minimum funding 

requirements of Code section 412 or 

ERISA section 302. 

All qualified defined benefit and 

defined contribution plans are subject to 

the minimum funding requirements of 

Code section 412 unless they are 

described in the exceptions listed under 

section 412(e)(2). These exceptions 

include profit-sharing or stock bonus 

plans, insurance contract plans 

described in section 412(e)(3), and 

certain plans to which no employer 

contributions are made. 

Nonqualified employee pension 

benefit plans are subject to the 

minimum funding requirements of 

ERISA section 302 unless specifically 

exempted under ERISA sections 4(a) or 

301(a). 

The employer or plan administrator of 

a single-employer or multiple-employer 

defined benefit plan that is subject to 

the minimum funding requirements 

must file the Schedule SB as an 

attachment to Form 5500. Schedule MB 

is filed for multiemployer defined 

benefit plans and certain money 

purchase defined contribution plans 

(whether they are single or 

multiemployer plans). However, 

Schedule MB is not required to be filed 

for a money purchase defined 

contribution plan that is subject to the 

minimum funding requirements unless 

the plan is currently amortizing a 

waiver of the minimum funding 

requirements. 

Line 4. Check ‘‘Yes’’ if, for purposes 

of computing the minimum funding 

requirements for the plan year, the plan 

administrator is making an election 

intended to satisfy the requirements of 

Code section 412(d)(2) or ERISA section 

302(d)(2). Under Code section 412(d)(2) 

and ERISA section 302(d)(2), a plan 

administrator may elect to have any 

amendment, adopted after the close of 

the plan year for which it applies, 

treated as having been made on the first 

day of the plan year if all of the 

following requirements are met: 

1. The requirement is adopted no later 

than two and one-half months after the 

close of such plan year (two years for a 

multiemployer plan); 

2. The amendment does not reduce 

the accrued benefit of any participant 

determined as of the beginning of such 

plan year; and 

3. The amendment does not reduce 

the accrued benefit of any participant 

determined as of the adoption of the 

amendment unless the plan 

administrator notified the Secretary of 

the Treasury of the amendment and the 

Secretary either approved the 

amendment or failed to disapprove the 

amendment within 90 days after the 

date the notice was filed. 

See Temporary Regulations section 

11.412(c)–7(b) for details on when and 

how to make the election and what 

information to include on the statement 

of election, which must be filed with the 

Form 5500 Return/Report. 

Line 5. If a money purchase defined 

contribution plan (including a target 

benefit plan) has received a waiver of 

the minimum funding standard, and the 

waiver is currently being amortized, 

complete lines 3, 9, and 10 of Schedule 

MB. See instructions for Schedule MB. 

Attach Schedule MB to Form 5500. The 

Schedule MB does not need to be signed 

by an enrolled actuary for a money 

purchase defined contribution plan. 

Line 6a. The minimum required 

contribution for a money purchase 

defined contribution plan for a plan 

year is the amount required to be 

contributed for the year under the 

formula set forth in the plan document. 

If there is an accumulated funding 

deficiency for a prior year that has not 

been waived, that amount should also 

be included as part of the contribution 

required for the current year. 

Line 6b. Include all contributions for 

the plan year made not later than 81⁄2

months after the end of the plan year. 

Show only contributions actually made 

to the plan by the date the form is filed. 

For example, do not include receivable 

contributions for this purpose. 

Line 6c. If the minimum required 

contribution exceeds the contributions 

for the plan year made not later than 81⁄2

months after the end of the plan year, 

the excess is an accumulated funding 

deficiency for the plan year. File IRS 

Form 5330, Return of Excise Taxes 

Related to Employee Benefit Plans, with 

the IRS to pay the excise tax on the 

deficiency. There is a penalty for not 

filing IRS Form 5330 on time. 

Line 7. Will the minimum required 

contribution remaining in 6c be made 

no later than 81⁄2 months after the end 

of the plan year? If ‘‘Yes,’’ and 

contributions are actually made by this 

date, then there will be no reportable 

deficiency and IRS Form 5330 will not 

need to be filed. 

Line 8. A revenue procedure 

providing for automatic approval for a 

change in funding method for a plan 

year generally does not apply unless the 

plan administrator or an authorized 

representative of the plan sponsor 

explicitly agrees to the change. If a 


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change in funding method made 

pursuant to such a revenue procedure 

(or class ruling letter) is to be applicable 

for the current plan year, this line 

generally must be checked ‘‘Yes.’’ In 

certain situations, however, the 

requirement that the plan administrator 

or an authorized representative of the 

plan sponsor agree to the change in 

funding method will be satisfied if the 

plan administrator or an authorized 

representative of the plan sponsor is 

made aware of the change. In these 

situations, this line must be checked 

‘‘N/A.’’ See section 6.01(2) of Rev. Proc. 

2000–40, 2000–42 I.R.B. 357. 

Part III—Amendments 

Line 9. 

• Check ‘‘No’’ if no amendments were 

adopted during this plan year that 

increased or decreased the value of 

benefits. 

• Check ‘‘Increase’’ if an amendment 

was adopted during the plan year that 

increased the value of benefits in any 

way. This includes an amendment 

providing for an increase in the amount 

of benefits or rate of accrual, more 

generous lump sum factors, COLAs, 

more rapid vesting, additional payment 

forms, and/or earlier eligibility for some 

benefits. 

• Check ‘‘Decrease’’ if an amendment 

was adopted during the plan year that 

decreased the value of benefits in any 

way. This includes a decrease in future 

accruals, closure of the plan to new 

employees, and accruals being frozen 

for some or all participants. 

• If the amendments that were 

adopted increased the value of some 

benefits but decreased the value of 

others, check ‘‘Both.’’

Part IV—ESOP Information 

Line 11b. A loan is a ‘‘back-to-back 

loan’’ if the following requirements are 

satisfied: 

1. The loan from the employer 

corporation to the ESOP qualifies as an 

exempt loan under DOL regulations at 

29 CFR 2550.408b–3 and under 

Treasury Regulation sections 54.4975–7 

and 54.4975–11; and 

2. The repayment terms of the loan 

from the sponsoring corporation to the 

ESOP are substantially similar to the 

repayment terms of the loan from the 

commercial lender to the sponsoring 

employer. 

Part V—Additional Employer 

Information for Multiemployer Defined 

Benefit Pension Plans 

Line 13. Line 13 should be completed 

only by multiemployer defined benefit 

pension plans that are subject to the 

minimum funding standards (see Code 

section 412 and Part 3 of Title I of 

ERISA). Enter the information on Lines 

13a through 13e for any employer that 

contributed more than five (5) percent of 

the plan’s total contributions for the 

2009 plan year. The employers should 

be listed in descending order according 

to the dollar amount of their 

contributions to the plan. Complete as 

many entries as are necessary to list all 

employers that contributed more than 

five (5) percent of the plan’s 

contributions. 

Line 13a. Enter the name of the 

contributing employer to the plan. 

Line 13b. Enter the EIN number of the 

contributing employer to the plan. Do 

not enter a social security number in 

lieu of an EIN. The Form 5500 is open 

to public inspection, and the contents 

are public information and are subject to 

publication on the Internet. Because of 

privacy concerns, the inclusion of a 

social security number on this line may 

result in the rejection of the filing. 

EINs may be obtained by applying for 

one on IRS Form SS–4, Application for 

Employer Identification Number. You 

can obtain an IRS Form SS–4 by calling 

1–800–TAX–FORM (1–800–829–3676) 

or at the IRS Web Site at http:// 

www.irs.gov. The EBSA does not issue 

EINs. 

Line 13c. Dollar Amount Contributed. 

Enter the total dollar amount 

contributed to the plan by the employer 

for all covered workers in all locations 

for the plan year. Do not include the 

portion of an aggregated contribution 

that is for another plan, such as a 

welfare benefit plan, a defined 

contribution pension plan or another 

defined benefit pension plan. 

Line 13d. Collective Bargaining 

Agreement Expiration Date. Enter the 

date on which the employer’s collective 

bargaining agreement expires. If the 

employer has more than one collective 

bargaining agreement requiring 

contributions to the plan, check the box 

and include, as an attachment, a 

summary of each applicable expiration 

date. 

Line 13e. Contribution Rate 

Information. Enter the information in 

(e)(1) and (e)(2). If the employer uses 

different contribution rates for different 

classifications of employees or different 

places of business, check the box and 

instead of completing items (e)(1) and 

(e)(2), include, as an attachment, a list 

of each applicable contribution rate 

with a description of the rate, providing 

the information in (e)(1) and (e)(2); skip 

line 13(e)(1) and 13(e)(2). 

Line 13(e)(1). Contribution Rate 

(dollars and cents). Enter the employer’s 

contribution rate per contribution base 

unit (e.g., if the contribution rate is 

$xx.xx per covered hour worked, enter 

$xx.xx). If the employer’s contribution 

rate changed during the plan year, enter 

the last contribution rate in effect for the 

plan year. 

Line 13e(2). Base Unit Measure. Check 

the contribution base unit on which the 

contribution rate is based. If the 

contribution rate is not measured on an 

hourly, weekly, or unit-of-production 

basis, check ‘‘other’’ and indicate the 

basis of measurement. 

Lines 14–17—[RESERVED] 

Part VI—Additional Information for 

Single-Employer and Multiemployer 

Defined Benefit Pension Plans 

Lines 18 and 19—[RESERVED] 

LIST OF PLAN CHARACTERISTIC CODES FOR FORM 5500 LINES 8A AND 8B

Code 

Defined Benefit Pension Features 

1A ................. Benefits are primarily pay related. 

1B ................. Benefits are primarily flat dollar (includes dollars per year of service). 

1C ................. Cash balance or similar plan—Plan has a ‘‘cash balance’’ formula. For this purpose, a ‘‘cash balance’’ formula is a benefit formula in a defined benefit plan by whatever name (e.g., personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum 

distribution amount (e.g., 10 percent of final average pay times years of service, or the amount of the employee’s hypothetical 

account balance). 

1D ................. Floor offset plan—Plan benefits are subject to offset for retirement benefits provided by an employer-sponsored defined contribution plan. 


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LIST OF PLAN CHARACTERISTIC CODES FOR FORM 5500 LINES 8A AND 8B—Continued 

Code 

1E ................. Code section 401(h) arrangement—Plan contains separate accounts under Code section 401(h) to provide employee health 

benefits. 

1F ................. Code section 414(k) arrangement—Benefits are based partly on the balance of the separate account of the participant (also include appropriate defined contribution pension feature codes). 

1G ................ Covered by PBGC—Plan is covered under the PBGC insurance program (see ERISA section 4021). 

1H ................. Plan covered by PBGC that was terminated and closed out for PBGC purposes—Before the end of the plan year (or a prior plan 

year), (1) the plan terminated in a standard (or distress) termination and completed the distribution of plan assets in satisfaction of all benefit liabilities (or all ERISA Title IV benefits for distress termination); or (2) a trustee was appointed for a terminated plan pursuant to ERISA section 4042. 

1I .................. Frozen Plan—As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether 

because of service or compensation). 

Defined Contribution Pension Features 

2A ................. Age/Service Weighted or New Comparability or Similar Plan—Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New Comparability or Similar Plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation 

rate on compensation above a specified threshold, and the threshold or additional rate exceeds the maximum threshold or 

rate allowed under the permitted disparity rules of Code section 401(l). 

2B ................. Target benefit plan. 

2C ................. Money purchase (other than target benefit). 

2D ................. Offset plan—Plan benefits are subject to offset for retirement benefits provided in another plan or arrangement of the employer. 

2E ................. Profit-sharing. 

2F ................. ERISA section 404(c) plan—This plan, or any part of it, is intended to meet the conditions of 29 CFR 2550.404c–1. 

2G ................ Total participant-directed account plan—Participants have the opportunity to direct the investment of all the assets allocated to 

their individual accounts, regardless of whether 29 CFR 2550.404c–1 is intended to be met. 

2H ................. Partial participant directed account plan—Participants have the opportunity to direct the investment of a portion of the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c–1 is intended to be met. 

2I .................. Stock bonus. 

2J ................. Code section 401(k) feature—A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these 

amounts in cash. 

2K ................. Code section 401(m) arrangement—Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contributions to the plan. Not applicable if plan is 401(k)

plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7), or 408 arrangements/accounts 

annuities. 

2L ................. Code section 403(b)(1) arrangement. 

2M ................ Code section 403(b)(7) accounts. 

2N ................. Code section 408 accounts and annuities—See Limited Pension Plan Reporting instructions for pension plan utilizing individual 

Code section 408(b) retirement accounts or annuities as the funding vehicle for providing benefits. 

2O ................ ESOP other than a leveraged ESOP. 

2P ................. Leveraged ESOP—An ESOP that acquires employer securities with borrowed money or other debt-financing techniques. 

2Q ................ The employer maintaining this ESOP is an S corporation. 

2R ................. Participant-directed brokerage accounts provided as an investment option under the plan. 

2S ................. Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll. 

2T ................. Total or partial participant-directed account plan—plan uses default investment account for participants who fail to direct assets 

in their account. 

Other Pension Benefit Features 

3B ................. Plan covering Self-Employed Individuals. 

3C ................. Plan not intended to be qualified—A plan not intended to be qualified under Code sections 401, 403, or 408. 

3D ................. Master plan—A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable 

opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use 

of all adopting employers. 

3E ................. Prototype plan—A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable 

opinion or notification letter; and under which a separate funding medium (for example, a separate trust or custodial account) 

is established for each participating employer. 

3F ................. Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year. 

3H ................. Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)). 

3I .................. Plan requiring that all or part of employer contributions be invested and held, at least for a limited period, in employer securities. 

3J ................. U.S.-based plan that covers residents of Puerto Rico and is qualified under both Code section 401 and section 8565 of Puerto 

Rico Code. 

Welfare Benefit Features 

4A ................. Health (other than vision or dental). 

4B ................. Life Insurance. 

4C ................. Supplemental unemployment. 

4D ................. Dental. 

4E ................. Vision. 

4F ................. Temporary disability (accident and sickness). 


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LIST OF PLAN CHARACTERISTIC CODES FOR FORM 5500 LINES 8A AND 8B—Continued 

Code 

4G ................ Prepaid legal. 

4H ................. Long-term disability. 

4I .................. Severance pay. 

4J ................. Apprenticeship and training. 

4K ................. Scholarship (funded). 

4L ................. Death benefits (include travel accident but not life insurance). 

4P ................. Taft-Hartley Financial Assistance for Employee Housing Expenses. 

4Q ................ Other. 

4R ................. Unfunded, fully insured, or combination unfunded/fully insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104–20. 

4S ................. Unfunded, fully insured, or combination unfunded/fully insured welfare plan that stopped filing Form 5500s in an earlier plan year 

pursuant to 29 CFR 2520.104–20. 

4T ................. 10 or more employer plan under Code section 419A(f)(6). 

4U ................. Collectively bargained welfare benefit arrangement under Code section 419A(f)(5). 

ERISA Compliance Quick Checklist 

Compliance with the Employee 

Retirement Income Security Act (ERISA) 

begins with knowing the rules. Plan 

administrators and other plan officials 

can use this checklist as a quick 

diagnostic tool for assessing a plan’s 

compliance with certain important 

ERISA rules; it is not a complete 

description of all ERISA’s rules and it is 

not a substitute for a comprehensive 

compliance review. Use of this checklist 

is voluntary, and it is not to be filed 

with your Form 5500. 

If you answer ‘‘No’’ to any of the 

questions below, you should review 

your plan’s operations because you may 

not be in full compliance with ERISA’s 

requirements. 

1. Have you provided plan 

participants with a summary plan 

description, summaries of any material 

modifications of the plan, and annual 

summary financial reports? 

2. Do you maintain copies of plan 

documents at the principal office of the 

plan administrator for examination by 

participants and beneficiaries? 

3. Do you respond to written 

participant inquires for copies of plan 

documents and information within 30 

days? 

4. Does your plan include written 

procedures for making benefit claims 

and appealing denied claims, and are 

you complying with those procedures? 

5. Is your plan covered by a fidelity 

bond against losses due to fraud or 

dishonesty? 

6. Are the plan’s investments 

diversified so as to minimize the risk of 

large losses? 

7. If the plan permits participants to 

select the investments in their plan 

accounts, has the plan provided them 

with enough information to make 

informed decisions? 

8. Has a plan official determined that 

the investments are prudent and solely 

in the interest of the plan’s participants 

and beneficiaries, and evaluated the 

risks associated with plan investments 

before making the investments? 

9. Did the employer or other plan 

sponsor send participant contributions 

to the plan on a timely basis? 

10. Did the plan pay participant 

benefits on time and in the correct 

amounts? 

11. Did the plan give participants and 

beneficiaries 30 days advance notice 

before imposing a ‘‘blackout period’’ of 

at least three consecutive business days 

during which participants or 

beneficiaries of a 401(k) or other 

individual account pension plan were 

unable to change their plan investments, 

obtain loans from the plan, or obtain 

distributions from the plan? 

If you answer ‘‘Yes’’ to any of the 

questions below, you should review 

your plan’s operations because you may 

not be in full compliance with ERISA’s 

requirements. 

1. Has the plan engaged in any 

financial transactions with persons 

related to the plan or any plan official? 

(For example, has the plan made a loan 

to or participated in an investment with 

the employer?) 

2. Has the plan official used the assets 

of the plan for his/her own interest? 

3. Have plan assets been used to pay 

expenses that were not authorized in the 

plan document, were not necessary to 

the proper administration of the plan, or 

were more than reasonable in amount? 

If you need help answering these 

questions or want additional guidance 

about ERISA requirements, a plan 

official should contact the U.S. 

Department of Labor Employee Benefits 

Security Administration office in your 

region or consult with the plan’s legal 

counsel or professional employee 

benefit advisor. 

QUICK REFERENCE CHART OF FORM 5500 SCHEDULES AND ATTACHMENTS 1

[This chart provides only general guidance—please see specific Form 5500 instructions for complete filing requirements.] 

Large Pension Plan Small Pension Plan Large Welfare Plan Small Welfare Plan DFE 

Form 5500 .................. Must complete .......... Must complete 3 ........ Must complete 2 ........ Must complete 2 3 ...... Must complete. 

Schedule A (Insurance 

Information).

Must complete if plan 

has insurance contracts.

Must complete if plan 

has insurance contracts.

Must complete if plan 

has insurance contracts.

Must complete if plan 

has insurance contracts.

Must complete if 

MTIA, 103–12 IE, 

or GIA has insurance contracts. 

Schedule MB (Actuarial Information).Must complete if 

multi-employer defined benefit plan 

or money purchase 

plan subject to minimum funding 

standards 4.

Must complete if 

multi-employer defined benefit plan 

or money purchase 

plan subject to minimum funding 

standards 4.

Not required .............. Not required .............. Not required. 


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QUICK REFERENCE CHART OF FORM 5500 SCHEDULES AND ATTACHMENTS 1—Continued 

[This chart provides only general guidance—please see specific Form 5500 instructions for complete filing requirements.] 

Large Pension Plan Small Pension Plan Large Welfare Plan Small Welfare Plan DFE 

Schedule SB (Actuarial Information).Must complete if single-employer or 

multiple-employer 

defined benefit plan.

Must complete if single-employer or 

multiple-employer 

defined benefit plan.

Not required .............. Not required .............. Not required. 

Schedule C Service 

Provider Information.

Must complete if service provider was 

paid $5,000 or 

more and/or an accountant or actuary 

was terminated.

Not required .............. Must complete if service provider was 

paid $5,000 or 

more and/or an accountant or actuary 

was terminated.

Not required .............. MTIAs, GIAs, and 

103–12 IEs must 

complete Part I if 

service provider 

paid $5,000 or 

more. GIAs and 

103–12 IEs must 

complete Part II if 

accountant was terminated. 

Schedule D DFE/Participating Plan Information.Must complete Part I 

if plan participated 

in a CCT, PSA, 

MTIA, or 103–12 IE.

Must complete Part I 

if plan participated 

in a CCT, PSA, 

MTIA, or 103–12 IE.

Must complete Part I 

if plan participated 

in a CCT, PSA, 

MTIA, or 103–12 IE.

Must complete Part I 

if plan participated 

in a CCT, PSA, 

MTIA, or 103–12 IE.

All DFEs must complete Part II, and 

DFEs that invest in 

a CCT, PSA, or 

103–12 IE must 

also complete Part 

I. 

Schedule G (Financial 

Schedules).

Must complete if 

Schedule H, lines 

4b, 4c, or ad are 

‘‘yes’’.

Not required .............. Must complete if 

Schedule H, lines 

4b, 4c, or 4d are 

‘‘Yes’’ 2.

Not required .............. Must complete if 

Schedule H, lines 

4b, 4c, or 4d for a 

GIA, MTIA or 103–

12 IE are ‘‘Yes.’’

Schedule H (Financial 

Information).

Must complete 5 ........ Not required .............. Must complete 2 5 ...... Not required .............. All DFEs must complete Parts I, II, and 

III. MTIAs, GIAs 

and 103–12 IEs 

must also complete 

Part IV.5

Schedule I (Small Plan 

Financial Information).

Not required .............. Must complete 3 ........ Not required .............. Must complete 3 ........ Not required. 

Schedule R (Pension 

Plan Information).

Must complete 6 ........ Must complete 3 6 ...... Not required .............. Not required .............. Not required. 

Accountant’s Report ... Must attach ............... Not required .............. Must attach ............... Not required .............. Must attach for a GIA 

or 103–12 IE. 

1This chart provides only general guidance. Not all rules and requirements are reflected. Refer to specific Form 5500 instructions for complete 

information on filing requirements (e.g., Who Must File and What to File). For example, a pension plan is exempt from filing any schedules if the 

plan uses Code section 408 individual retirement accounts as the sole funding vehicle for providing benefits. See Limited Pension Plan Reporting. 2 Unfunded, fully insured and combination unfunded/fully insured welfare plans covering fewer than 100 participants at the beginning of the 

plan year that meet the requirements of 29 CFR 2520.104–20 are exempt from filing an annual report. (See Who Must File). Such a plan with 

100 or more participants must file an annual report, but is exempt under 29 CFR 2520.104–44 from the accountant’s report requirement and 

completing Schedule H, but MUST complete Schedule G, Part III, to report any nonexempt transactions. See What To File. 3Small pension benefit plans and small welfare plans not exempt from filing an annual return/report may be eligible to file the Form 5500–SF. 

(See Who May File of the instructions for the Form 5500–SF). 4 Certain money purchase defined contribution plans are required to complete Schedule MB in accordance with the instructions. Also see instructions for line 5 of Schedule R and line 12a of 5500–SF. 5Schedules of assets and reportable (5%) transactions also must be filed with the Form 5500 if Schedule H, line 4i or 4j is ‘‘Yes.’’ 6A pension plan is exempt from filing Schedule R if each of the following conditions is met: 

• The plan is not a defined benefit plan or otherwise subject to the minimum funding standards of Code section 412 or ERISA section 302. 

• No plan benefits that would be reportable on line 1 of Part I of this Schedule R were distributed during the plan year. See the instructions for 

Part I, line 1, below. 

• No benefits, as described in the instructions for Part I, line 2, below, were paid during the plan year other than by the plan sponsor or plan 

administrator. (This condition is not met if benefits were paid by the trust or any other payor(s) which are reportable on IRS Form 1099–R, Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc., using an EIN other than that of the plan 

sponsor or plan administrator reported on line 2b or 3b of Form 5500.) 

• Unless the plan is a profit-sharing, ESOP or stock bonus plan, no plan benefits of living or deceased participants were distributed during the 

plan year in the form of a single sum distribution. See the instructions for Part I, line 3, below. 

• The plan is not an ESOP. 

• The plan is not a multiemployer defined benefit plan. 

OMB CONTROL NUMBERS

Agency OMB No. 

Employee Benefits Security 

Administration ................... 1210–0110 

1210–0089 

OMB CONTROL NUMBERS—Continued 

Agency OMB No. 

Internal Revenue Service ..... 1545–1610 

OMB CONTROL NUMBERS—Continued 

Agency OMB No. 

Pension Benefit Guaranty 

Corporation ....................... 1212–0057 


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25The codes will be updated periodically from 

one Form year to another to reflect changes in the 

North American Industry Classification System. 

See, e.g., North American Industry Classification 

System—Update for 2007, 70 FR 12390 (Mar. 11, 

2005). 

Paperwork Reduction Act Notice 

We ask for the information on this 

form to carry out the law as specified in 

ERISA and in Code sections 6058(a) and 

6059(a). You are required to give us the 

information. We need it to determine 

whether the plan is operating according 

to the law. 

You are not required to provide the 

information requested on a form that is 

subject to the Paperwork Reduction Act 

unless the form displays a valid OMB 

control number. Books and records 

relating to a form or its instructions 

must be retained as long as their 

contents may become material in the 

administration of the Internal Revenue 

Code or are required to be maintained 

pursuant to Title I or IV of ERISA. The 

Form 5500 return/reports are open to 

public inspection and are subject to 

publication on the Internet. 

The time needed to complete and file 

the forms listed below reflects the 

combined requirements of the Internal 

Revenue Service, Department of Labor, 

and Pension Benefit Guaranty 

Corporation. These times will vary 

depending on individual circumstances. 

The estimated average times are: 

Pension plans Welfare plans 

Large Small Large Small 

Form 5500 ......................... 1 hr., 54 min ...................... 1 hr., 19 min ...................... 1 hr., 45 min ...................... 1 hr., 14 min 

Schedule A ........................ 2 hr., 52 min ...................... 2 hr., 51 min ...................... 3 hr., 39 min ...................... 2 hr., 43 min. 

Schedule SB ...................... 6 hr., 38 min ...................... 6 hr., 49 min ...................... N/A .................................... N/A. 

Schedule MB ..................... 7 hr., 52 min ...................... 4 hr., 14 min ...................... N/A .................................... N/A. 

Schedule C ........................ 3 hr., 4 min ........................ N/A .................................... 3 hr., 38 min ...................... N/A. 

Schedule D ........................ 1 hr., 39 min ...................... 20 min ............................... 1 hr., 52 min ...................... 20 min. 

Schedule G ........................ 11 hr., 29 min .................... N/A .................................... 11 hr .................................. N/A. 

Schedule H ........................ 7 hr., 42 min ...................... N/A .................................... 8hr., 35 min ....................... N/A. 

Schedule I ......................... N/A .................................... 2 hr., 5 min ........................ N/A .................................... 1 hr., 55 min. 

Schedule R ........................ 1 hr., 43 min ...................... 1 hr., 5 min ........................ N/A .................................... N/A. 

If you have comments concerning the 

accuracy of these time estimates or 

suggestions for making these forms 

simpler, we would be happy to hear 

from you. You can write to the Internal 

Revenue Service, Tax Products 

Coordinating Committee, 

SE:W:CAR:MP:T:T:SP, 1111 

Constitution Ave., NW., IR–6526, 

Washington, DC 20224. DO NOT send 

any of these forms or schedules to this 

address. The forms and schedules must 

be filed electronically. See How to 

File—Electronic Filing Requirement. 

Forms 5500, 5500–SF, and 5500–EZ 

Codes for Principal Business Activity 

This list of principal business 

activities and their associated codes is 

designed to classify an enterprise by the 

type of activity in which it is engaged. 

These principal activity codes are based 

on the North American Industry 

Classification System.25

Agriculture, Forestry, Fishing and 

Hunting 

Crop Production 

111100 Oilseed & Grain Farming 

111210 Vegetable & Melon Farming 

(including potatoes & yams) 

111300 Fruit & Tree Nut Farming 

111400 Greenhouse, Nursery, & 

Floriculture Production 

111900 Other Crop Farming (including 

tobacco, cotton, sugarcane, hay, 

peanut, sugar beet, & all other crop 

farming) 

Animal Production 

112111 Beef Cattle Ranching & 

Farming 

112112 Cattle Feedlots 

112120 Dairy Cattle & Milk Production 

112210 Hog & Pig Farming 

112300 Poultry & Egg Production 

112400 Sheep & Goat Farming 

112510 Animal Aquaculture 

(including shellfish & finfish farms & 

hatcheries) 

112900 Other Animal Production 

Forestry and Logging 

113110 Timber Tract Operations 

113210 Forest Nurseries & Gathering 

of Forest Products 

113310 Logging 

Fishing, Hunting and Trapping 

114110 Fishing 

114210 Hunting & Trapping 

Support Activities for Agriculture and 

Forestry 

115110 Support Activities for Crop 

Production (including cotton ginning, 

soil preparation, planting, & 

cultivating) 

115210 Support Activities for Animal 

Production 

115310 Support Activities For Forestry 

Mining 

211110 Oil & Gas Extraction 

212110 Coal Mining 

212200 Metal Ore Mining 

212310 Stone Mining & Quarrying 

212320 Sand, Gravel, Clay, & Ceramic 

& Refractory Minerals Mining & 

Quarrying 

212390 Other Nonmetallic Mineral 

Mining & Quarrying 

213110 Support Activities for Mining 

Utilities 

221100 Electric Power Generation, 

Transmission & Distribution 

221210 Natural Gas Distribution 

221300 Water, Sewage, & Other 

Systems 

221500 Combination Gas & Electric 

Construction 

Construction of Buildings 

236110 Residential Building 

Construction 

236200 Nonresidential Building 

Construction Heavy and Civil 

Engineering Construction 

237100 Utility System Construction 

237210 Land Subdivision 

237310 Highway, Street, & Bridge 

Construction 

237990 Other Heavy & Civil 

Engineering Construction Specialty 

Trade Contractors 

238100 Foundation, Structure, & 

Building Exterior Contractors 

(including framing carpentry, 

masonry, glass, roofing, & siding) 

238210 Electrical Contractors 

238220 Plumbing, Heating, & AirConditioning Contractors 

238290 Other Building Equipment 

Contractors 

238300 Building Finishing Contractors 

(including drywall, insulation, 

painting, wallcovering, flooring, tile, 

& finish carpentry) 

238900 Other Specialty Trade 

Contractors (including site 

preparation) 


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Beverage and Tobacco Product 

Manufacturing 

312110 Soft Drink & Ice Mfg 

312120 Breweries 

312130 Wineries 

312140 Distilleries 

312200 Tobacco 

Manufacturing 

Textile Mills and Textile Product Mills 

313000 Textile Mills 

314000 Textile Product Mills 

Apparel Manufacturing 

315100 Apparel Knitting Mills 

315210 Cut & Sew Apparel Contractors 

315220 Men’s & Boys’ Cut & Sew 

Apparel Mfg 

315230 Women’s & Girls’ Cut & Sew 

Apparel Mfg 

315290 Other Cut & Sew Apparel Mfg 

315990 Apparel Accessories & Other 

Apparel Mfg 

Leather and Allied Product 

Manufacturing 

316110 Leather & Hide Tanning & 

Finishing 

316210 Footwear Mfg (including 

rubber & plastics) 

316990 Other Leather & Allied Product 

Mfg 

Wood Product Manufacturing 

321110 Sawmills & Wood Preservation 

321210 Veneer, Plywood, & 

Engineered Wood Product Mfg 

21900 Other Wood Product Mfg 

Paper Manufacturing 

322100 Pulp, Paper, & Paperboard 

Mills 

322200 Converted Paper Product Mfg 

Printing and Related Support Activities 

323100 Printing & Related Support 

Activities 

Petroleum and Coal Products 

Manufacturing 

324110 Petroleum Refineries 

(including integrated) 

324120 Asphalt Paving, Roofing, & 

Saturated Materials Mfg 

324190 Other Petroleum & Coal 

Products Mfg 

Chemical Manufacturing 

325100 Basic Chemical Mfg 

325200 Resin, Synthetic Rubber, & 

Artificial & Synthetic Fibers & 

Filaments Mfg 

325300 Pesticide, Fertilizer, & Other 

Agricultural Chemical Mfg 

325410 Pharmaceutical & Medicine 

Mfg 

325500 Paint, Coating, & Adhesive Mfg 

325600 Soap, Cleaning Compound, & 

Toilet Preparation Mfg 

325900 Other Chemical Product & 

Preparation Mfg 

Plastics and Rubber Products 

Manufacturing 

326100 Plastics Product Mfg 

326200 Rubber Product Mfg 

Nonmetallic Mineral Product 

Manufacturing 

327100 Clay Product & Refractory Mfg 

327210 Glass & Glass Product Mfg 

327300 Cement & Concrete Product 

Mfg 

327400 Lime & Gypsum Product Mfg 

327900 Other Nonmetallic Mineral 

Product Mfg 

Primary Metal Manufacturing 

331110 Iron & Steel Mills & Ferroalloy 

Mfg 

331200 Steel Product Mfg from 

Purchased Steel 

331310 Alumina & Aluminum 

Production & Processing 

331400 Nonferrous Metal (except 

Aluminum) Production & Processing 

331500 Foundries Fabricated Metal 

Product Manufacturing 

332110 Forging & Stamping 

332210 Cutlery & Handtool Mfg 

332300 Architectural & Structural 

Metals Mfg 

332400 Boiler, Tank, & Shipping 

Container Mfg 

332510 Hardware Mfg 

332610 Spring & Wire Product Mfg 

332700 Machine Shops; Turned 

Product; & Screw, Nut, & Bolt Mfg 

332810 Coating, Engraving, Heat 

Treating, & Allied Activities 

332900 Other Fabricated Metal 

Product Mfg 

Machinery Manufacturing 

333100 Agriculture, Construction, & 

Mining Machinery Mfg 

333200 Industrial Machinery Mfg 

333310 Commercial & Service Industry 

Machinery Mfg 

333410 Ventilation, Heating, AirConditioning, & Commercial 

Refrigeration Equipment Mfg 

333510 Metalworking Machinery Mfg 

333610 Engine, Turbine & Power 

Transmission Equipment Mfg 

333900 Other General Purpose 

Machinery Mfg Computer and 

Electronic Product Manufacturing 

334110 Computer & Peripheral 

Equipment Mfg 

334200 Communications Equipment 

Mfg 

334310 Audio & Video Equipment Mfg 

334410 Semiconductor & Other 

Electronic Component Mfg 

334500 Navigational, Measuring, 

Electromedical, & Control Instruments 

Mfg 

334610 Manufacturing & Reproducing 

Magnetic & Optical Media 

Electrical Equipment, Appliance, and 

Component Manufacturing 

335100 Electric Lighting Equipment 

Mfg 

335200 Household Appliance Mfg 

335310 Electrical Equipment Mfg 

335900 Other Electrical Equipment & 

Component Mfg 

Transportation Equipment 

Manufacturing 

336100 Motor Vehicle Mfg 

336210 Motor Vehicle Body & Trailer 

Mfg 

336300 Motor Vehicle Parts Mfg 

336410 Aerospace Product & Parts Mfg 

336510 Railroad Rolling Stock Mfg 

336610 Ship & Boat Building 

336990 Other Transportation 

Equipment Mfg 

Furniture and Related Product 

Manufacturing 

337000 Furniture & Related Product 

Mfg 

Miscellaneous Manufacturing 

339110 Medical Equipment & Supplies 

Mfg 

339900 Other Miscellaneous Mfg 

Wholesale Trade Merchant 

Wholesalers, Durable Goods 

423100 Motor Vehicle & Motor Vehicle 

Parts & Supplies 

423200 Furniture & Home Furnishings 

423300 Lumber & Other Construction 

Materials 

423400 Professional & Commercial 

Equipment & Supplies 

423500 Metals & Minerals (except 

Petroleum) 

423600 Electrical & Electronic Goods 

423700 Hardware, Plumbing & Heating 

Equipment & Supplies 

423800 Machinery, Equipment, & 

Supplies 

423910 Sporting & Recreational Goods 

& Supplies 

423920 Toy & Hobby Goods & 

Supplies 

423930 Recyclable Materials 

423940 Jewelry, Watches, Precious 

Stones, & Precious Metals 

423990 Other Miscellaneous Durable 

Goods 

Merchant Wholesalers, Nondurable 

Goods 

424100 Paper & Paper Products 

424210 Drugs & Druggists’ Sundries 

424300 Apparel, Piece Goods, & 

Notions 

424400 Grocery & Related Products 

424500 Farm Product Raw Materials 

424600 Chemical & Allied Products 


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424700 Petroleum & Petroleum 

Products 

424800 Beer, Wine, & Distilled 

Alcoholic Beverages 

424910 Farm Supplies 

424920 Books, Periodicals, & 

Newspapers 

424930 Flower, Nursery Stock, & 

Florists’ Supplies 

424940 Tobacco & Tobacco Products 

424950 Paint, Varnish, & Supplies 

424990 Other Miscellaneous 

Nondurable Goods 

Wholesale Electronic Markets and 

Agents and Brokers 

425110 Business to Business 

Electronic Markets 

425120 Wholesale Trade Agents & 

Brokers 

Retail Trade 

Motor Vehicle and Parts Dealers 

441110 New Car Dealers 

441120 Used Car Dealers 

441210 Recreational Vehicle Dealers 

441221 Motorcycle Dealers 

441222 Boat Dealers 

441229 All Other Motor Vehicle 

Dealers 

441300 Automotive Parts, Accessories, 

& Tire Stores 

Furniture and Home Furnishings Stores 

442110 Furniture Stores 

442210 Floor Covering Stores 

442291 Window Treatment Stores 

442299 All Other Home Furnishings 

Stores 

Electronics and Appliance Stores 

443111 Household Appliance Stores 

443112 Radio, Television, & Other 

Electronics Stores 

443120 Computer & Software Stores 

443130 Camera & Photographic 

Supplies Stores 

Building Material and Garden 

Equipment and Supplies Dealers 

444110 Home Centers 

444120 Paint & Wallpaper Stores 

444130 Hardware Stores 

444190 Other Building Material 

Dealers 

444200 Lawn & Garden Equipment & 

Supplies Stores 

Food and Beverage Stores 

445110 Supermarkets and Other 

Grocery (except Convenience) Stores 

445120 Convenience Stores 

445210 Meat Markets 

445220 Fish & Seafood Markets 

445230 Fruit & Vegetable Markets 

445291 Baked Goods Stores 

445292 Confectionery & Nut Stores 

445299 All Other Specialty Food 

Stores 

445310 Beer, Wine, & Liquor Stores 

Health and Personal Care Stores 

446110 Pharmacies & Drug Stores 

446120 Cosmetics, Beauty Supplies, & 

Perfume Stores 

446130 Optical Goods Stores 

446190 Other Health & Personal Care 

Stores 

Gasoline Stations 

447100 Gasoline Stations (including 

convenience stores with gas) 

Clothing and Clothing Accessories 

Stores 

448110 Men’s Clothing Stores 

448120 Women’s Clothing Stores 

448130 Children’s & Infants’ Clothing 

Stores 

448140 Family Clothing Stores 

448150 Clothing Accessories Stores 

448190 Other Clothing Stores 

448210 Shoe Stores 

448310 Jewelry Stores 

448320 Luggage & Leather Goods 

Stores 

Sporting Goods, Hobby, Book, and 

Music Stores 

451110 Sporting Goods Stores 

451120 Hobby, Toy, & Game Stores 

451130 Sewing, Needlework, & Piece 

Goods Stores 

451140 Musical Instrument & Supplies 

Stores 

451211 Book Stores 

451212 News Dealers & Newsstands 

451220 Prerecorded Tape, Compact 

Disc, & Record Stores 

General Merchandise Stores 

452110 Department Stores 

452900 Other General Merchandise 

Stores 

Miscellaneous Store Retailers 

453110 Florists 

453210 Office Supplies & Stationery 

Stores 

453220 Gift, Novelty, & Souvenir 

Stores 

453310 Used Merchandise Stores 

453910 Pet & Pet Supplies Stores 

453920 Art Dealers 

453930 Manufactured (Mobile) Home 

Dealers 

453990 All Other Miscellaneous Store 

Retailers (including tobacco, candle, & 

trophy shops) 

Nonstore Retailers 

454110 Electronic Shopping & MailOrder Houses 

454210 Vending Machine Operators 

454311 Heating Oil Dealers 

454312 Liquefied Petroleum Gas 

(bottled gas) Dealers 

454319 Other Fuel Dealers 

454390 Other Direct Selling 

Establishments (including door-todoor retailing, frozen food plan 

providers, party plan merchandisers, 

& coffee-break service providers) 

Transportation and Warehousing Air, 

Rail, and Water Transportation 

481000 Air Transportation 

482110 Rail Transportation 

483000 Water 

Transportation 

Truck Transportation 

484110 General Freight Trucking, 

Local 

484120 General Freight Trucking, 

Long-distance 

484200 Specialized Freight Trucking 

Transit and Ground Passenger 

Transportation 

485110 Urban Transit Systems 

485210 Interurban & Rural Bus 

Transportation 

485310 Taxi Service 

485320 Limousine Service 

485410 School & Employee Bus 

Transportation 

485510 Charter Bus Industry 

485990 Other Transit & Ground 

Passenger Transportation 

Pipeline Transportation 

486000 Pipeline Transportation Scenic 

& Sightseeing Transportation 

487000 Scenic & Sightseeing 

Transportation Support Activities for 

Transportation 

488100 Support Activities for Air 

Transportation 

488210 Support Activities for Rail 

Transportation 

488300 Support Activities for Water 

Transportation 

488410 Motor Vehicle Towing 

488490 Other Support Activities for 

Road Transportation 

488510 Freight Transportation 

Arrangement 

488990 Other Support Activities for 

Transportation Couriers and 

Messengers 

492110 Couriers 

492210 Local Messengers & Local 

Delivery 

Warehousing and Storage 

493100 Warehousing & Storage (except 

lessors of miniwarehouses & selfstorage units) 

Information Publishing Industries 

(except Internet) 

511110 Newspaper Publishers 

511120 Periodical Publishers 

511130 Book Publishers 

511140 Directory & Mailing List 

Publishers 


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511190 Other Publishers 

511210 Software Publishers Motion 

Picture and Sound Recording 

Industries 

512100 Motion Picture & Video 

Industries (except video rental) 

512200 Sound Recording Industries 

Broadcasting (except Internet) 

515100 Radio & Television 

Broadcasting 

515210 Cable & Other Subscription 

Programming 

Internet Publishing and Broadcasting 

516110 Internet Publishing & 

Broadcasting Telecommunications 

517000 Telecommunications 

(including paging, cellular, satellite, 

cable & other program distribution, 

resellers, & other telecommunications) 

Internet Service Providers, Web Search 

Portals, and Data Processing Services 

518111 Internet Service Providers 

518112 Web Search Portals 

518210 Data Processing, Hosting, & 

Related Services Other Information 

Services 

519100 Other Information Services 

(including news syndicates & 

libraries) 

Finance and Insurance Depository 

Credit Intermediation 

522110 Commercial Banking 

522120 Savings Institutions 

522130 Credit Unions 

522190 Other Depository Credit 

Intermediation 

Nondepository Credit Intermediation 

522210 Credit Card Issuing 

522220 Sales Financing 

522291 Consumer Lending 

522292 Real Estate Credit (including 

mortgage bankers & originators) 

522293 International Trade Financing 

522294 Secondary Market Financing 

522298 All Other Nondepository 

Credit Intermediation Activities 

Related to Credit Intermediation 

522300 Activities Related to Credit 

Intermediation (including loan 

brokers, check clearing, & money 

transmitting) 

Securities, Commodity Contracts, and 

Other Financial Investments and 

Related Activities 

523110 Investment Banking & 

Securities Dealing 

523120 Securities Brokerage 

523130 Commodity Contracts Dealing 

523140 Commodity Contracts 

Brokerage 

523210 Securities & Commodity 

Exchanges 

523900 Other Financial Investment 

Activities (including portfolio 

management & investment advice) 

Insurance Carriers and Related 

Activities 

524140 Direct Life, Health, & Medical 

Insurance & Reinsurance Carriers 

524150 Direct Insurance & 

Reinsurance (except Life, Health & 

Medical) Carriers 

524210 Insurance Agencies & 

Brokerages 

524290 Other Insurance Related 

Activities (including third-party 

administration of insurance and 

pension funds) 

Funds, Trusts, and Other Financial 

Vehicles 

525100 Insurance & Employee Benefit 

Funds 

525910 Open-End Investment Funds 

(Form 1120–RIC) 

525920 Trusts, Estates, & Agency 

Accounts 

525930 Real Estate Investment Trusts 

(Form 1120–REIT) 

525990 Other Financial Vehicles 

(including mortgage REITs & closedend investment funds) 

‘‘Offices of Bank Holding Companies’’

and ‘‘Offices of Other Holding 

Companies’’ are located under 

Management of Companies (Holding 

Companies). 

Real Estate and Rental and Leasing 

Real Estate 

531110 Lessors of Residential 

Buildings & Dwellings (including 

equity REITs) 

531114 Cooperative Housing 

(including equity REITs) 

531120 Lessors of Nonresidential 

Buildings (except Miniwarehouses) 

(including equity REITs) 

531130 Lessors of Miniwarehouses & 

Self-Storage Units (including equity 

REITs) 

531190 Lessors of Other Real Estate 

Property (including equity REITs) 

531210 Offices of Real Estate Agents & 

Brokers 

531310 Real Estate Property Managers 

531320 Offices of Real Estate 

Appraisers 

531390 Other Activities Related to 

Real Estate 

Rental and Leasing Services 

532100 Automotive Equipment Rental 

& Leasing 

532210 Consumer Electronics & 

Appliances Rental 

532220 Formal Wear & Costume 

Rental 

532230 Video Tape & Disc Rental 

532290 Other Consumer Goods Rental 

532310 General Rental Centers 

532400 Commercial & Industrial 

Machinery & Equipment Rental & 

Leasing 

Lessors of Nonfinancial Intangible 

Assets (except copyrighted works) 

533110 Lessors of Nonfinancial 

Intangible Assets (except copyrighted 

works) 

Professional, Scientific, and Technical 

Services Legal Services 

541110 Offices of Lawyers 

541190 Other Legal Services 

Accounting, Tax Preparation, 

Bookkeeping, and Payroll Services 

541211 Offices of Certified Public 

Accountants 

541213 Tax Preparation Services 

541214 Payroll Services 

541219 Other Accounting Services 

Architectural, Engineering, and 

Related Services 

541310 Architectural Services 

541320 Landscape Architecture 

Services 

541330 Engineering Services 

541340 Drafting Services 

541350 Building Inspection Services 

541360 Geophysical Surveying & 

Mapping Services 

541370 Surveying & Mapping (except 

Geophysical) Services 

541380 Testing Laboratories 

Specialized Design Services 

541400 Specialized Design Services 

(including interior, industrial, 

graphic, & fashion design) 

Computer Systems Design and Related 

Services 

541511 Custom Computer 

Programming Services 

541512 Computer Systems Design 

Services 

541513 Computer Facilities 

Management Services 

541519 Other Computer Related 

Services 

Other Professional, Scientific, and 

Technical Services 

541600 Management, Scientific, & 

Technical Consulting Services 

541700 Scientific Research & 

Development Services 

541800 Advertising & Related Services 

541910 Marketing Research & Public 

Opinion Polling 

541920 Photographic Services 

541930 Translation & Interpretation 

Services 

541940 Veterinary Services 

541990 All Other Professional, 

Scientific, & Technical Services 

Management of Companies (Holding 

Companies) 

551111 Offices of Bank Holding 

Companies 

551112 Offices of Other Holding 

Companies 


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Administrative and Support and Waste 

Management and Remediation Services 

Administrative and Support Services 

561110 Office Administrative Services 

561210 Facilities Support Services 

561300 Employment Services 

561410 Document Preparation 

Services 

561420 Telephone Call Centers 

561430 Business Service Centers 

(including private mail centers & copy 

shops) 

561440 Collection Agencies 

561450 Credit Bureaus 

561490 Other Business Support 

Services (including repossession 

services, court reporting, & stenotype 

services) 

561500 Travel Arrangement & 

Reservation Services 

561600 Investigation & Security 

Services 

561710 Exterminating & Pest Control 

Services 

561720 Janitorial Services 

561730 Landscaping Services 

561740 Carpet & Upholstery Cleaning 

Services 

561790 Other Services to Buildings & 

Dwellings 

561900 Other Support Services 

(including packaging & labeling 

services, & convention & trade show 

organizers) 

Waste Management and Remediation 

Services 

562000 Waste Management & 

Remediation Service 

Educational Services 

611000 Educational Services 

(including schools, colleges, & 

universities) 

Health Care and Social Assistance 

Offices of Physicians and Dentists 

621111 Offices of Physicians (except 

mental health specialists) 

621112 Offices of Physicians, Mental 

Health Specialists 

621210 Offices of Dentists Offices of 

Other Health Practitioners 

621310 Offices of Chiropractors 

621320 Offices of Optometrists 

621330 Offices of Mental Health 

Practitioners (except Physicians) 

621340 Offices of Physical, 

Occupational & Speech Therapists, & 

Audiologists 

621391 Offices of Podiatrists 

621399 Offices of All Other 

Miscellaneous Health Practitioners 

Outpatient Care Centers 

621410 Family Planning Centers 

621420 Outpatient Mental Health & 

Substance Abuse Centers 

621491 HMO Medical Centers 

621492 Kidney Dialysis Centers 

621493 Freestanding Ambulatory 

Surgical & Emergency Centers 

621498 All Other Outpatient Care 

Centers Medical and Diagnostic 

Laboratories 

621510 Medical & Diagnostic 

Laboratories Home Health Care 

Services 

621610 Home Health Care Services 

Other Ambulatory Health Care 

Services 

621900 Other Ambulatory Health Care 

Services (including ambulance 

services & blood & organ banks) 

Hospitals 

622000 Hospitals Nursing and 

Residential Care Facilities 

623000 Nursing & Residential Care 

Facilities Social Assistance 

624100 Individual & Family Services 

624200 Community Food & Housing, & 

Emergency & Other Relief Services 

624310 Vocational Rehabilitation 

Services 

624410 Child Day Care Services 

Arts, Entertainment, and Recreation 

Performing Arts, Spectator Sports, and 

Related Industries 

711100 Performing Arts Companies 

711210 Spectator Sports (including 

sports clubs & racetracks) 

711300 Promoters of Performing Arts, 

Sports, & Similar Events 

711410 Agents & Managers for Artists, 

Athletes, Entertainers, & Other Public 

Figures 

711510 Independent Artists, Writers, & 

Performers Museums, Historical Sites, 

and Similar Institutions 

712100 Museums, Historical Sites, & 

Similar Institutions Amusement, 

Gambling, and Recreation Industries 

713100 Amusement Parks & Arcades 

713200 Gambling Industries 

713900 Other Amusement & 

Recreation Industries (including golf 

courses, skiing facilities, marinas, 

fitness centers, & bowling centers) 

Accommodation and Food Services 

Accommodation 

721110 Hotels (except Casino Hotels) 

& Motels 

721120 Casino Hotels 

721191 Bed & Breakfast Inns 

721199 All Other Traveler 

Accommodation 

721210 RV (Recreational Vehicle) 

Parks & Recreational Camps 

721310 Rooming & Boarding Houses 

Food Services and Drinking Places 

722110 Full-Service Restaurants 

722210 Limited-Service Eating Places 

722300 Special Food Services 

(including food service contractors & 

caterers) 

722410 Drinking Places (Alcoholic 

Beverages) 

Other Services 

Repair and Maintenance 

811110 Automotive Mechanical & 

Electrical Repair & Maintenance 

811120 Automotive Body, Paint, 

Interior & Glass Repair 

811190 Other Automotive Repair & 

Maintenance (including oil change & 

lubrication shops & car washes) 

811210 Electronic & Precision 

Equipment Repair & Maintenance 

811310 Commercial & Industrial 

Machinery & Equipment (except 

Automotive & Electronic) Repair & 

Maintenance 

811410 Home & Garden Equipment & 

Appliance Repair & Maintenance 

811420 Reupholstery & Furniture 

Repair 

811430 Footwear & Leather Goods 

Repair 

811490 Other Personal & Household 

Goods Repair & Maintenance 

Personal and Laundry Services 

812111 Barber Shops 

812112 Beauty Salons 

812113 Nail Salons 

812190 Other Personal Care Services 

(including diet & weight reducing 

centers) 

812210 Funeral Homes & Funeral 

Services 

812220 Cemeteries & Crematories 

812310 Coin-Operated Laundries & 

Drycleaners 

812320 Drycleaning & Laundry 

Services (except Coin-Operated) 

812330 Linen & Uniform Supply 

812910 Pet Care (except Veterinary) 

Services 

812920 Photofinishing 

812930 Parking Lots & Garages 

812990 All Other Personal Services 

Religious, Grantmaking, Civic, 

Professional, and Similar Organizations 

813000 Religious, Grantmaking, Civic, 

Professional, & Similar Organizations 

(including condominium and 

homeowners associations) 

813930 Labor Unions and Similar 

Labor Organizations 

921000 Governmental Instrumentality 

or Agency 

Statutory Authority 

Accordingly, pursuant to the 

authority in sections 101, 103, 104, 109, 

110, and 4065 of ERISA and section 

6058 of the Code, the Form 5500 Annual 

Return/Report and the instructions 

thereto are amended as set forth herein, 

including the addition of the proposed 

Short Form 5500 and the replacement of 

the Schedule B with Schedules SB and 

MB. 


sroberts on PROD1PC70 with NOTICES
Federal Register / Vol. 72, No. 221 / Friday, November 16, 2007 / Notices 64857 

Signed at Washington, DC, this 30th day of 

October 2007. 

Bradford P. Campbell, 

Assistant Secretary, Employee Benefits 

Security Administration, U.S. Department of 

Labor. 

Joseph Grant, 

Director, Employee Plans, Tax Exempt and 

Government Entities Division, Internal 

Revenue Service. 

Charles E.F. Millard, 

Interim Director, Pension Benefit Guaranty 

Corporation. 

[FR Doc. 07–5521 Filed 11–15–07; 8:45 am] 

BILLING CODE 4510–29–P 


sroberts on PROD1PC70 with NOTICES