Source: http://fsco.gov.on.ca/en/pensions/Forms/Documents/1161E.4.htm
Timestamp: 2019-08-19 18:49:15
Document Index: 662077285

Matched Legal Cases: ['art 1', 'art 2', 'art 3', 'art 4', 'art 5', 'arts 3', 'art 6']

1161E.4 - Form 8 - Investment Information Summary
Form 8 - Investment Information Summary
This is a SAMPLE form only. The IIS must be filed electronically through the Pension Services Portal (PSP).
Please see the instructions for completing this form, which is also available as an Excel spreadsheet.
Part 1 - Pension Plan Information
Registation number: (101)
Name of registered pension plan: (102)
From: (yyyy-mm-dd) (103)
To: (yyyy-mm-dd) (104)
Is this a designated plan? Y/N (105)
If the answer in line 105 is "Y", this form does not need to be prepared
Part 2 - Certification by Plan Administrator
As the administrator of the pension plan or its authorized delegate, I certify that the information contained in this Investment Information Summary is true, accurate and complete to the best of my knowledge and belief.
Dated this: (day) day of (month), (year). (201)
Full name of administrator (please print or type): (202)
Company name: (204)
Title/position: (203)
Address of administrator: (205)
Telephone number: (206)
Facsimile number: (207)
Email address: (208)
Investment Information Summary:
Plan registration number:
Plan fiscal year end:
Part 3 - Statement of Changes in Net Assets
INCREASE IN ASSETS (including receivables)
Increase due to investments:
Net gains (or losses) on investments:
Realized: Current year (A)/Previous Year (B) (301)
Unrealized:	Current year (A)/Previous Year (B) (302)
Investment income (interest, dividends, rents, etc.): Current year (A)/Previous Year (B) (303)
Total increase due to investments (Sum of lines 301 to 303): Current year (A)/Previous Year (B) (304)
Employer contributions (normal cost, special payments, etc.): Current year (A)/Previous Year (B) (311)
Member contributions: Current year (A)/Previous Year (B) (312)
Total contributions (Lines 311+312): Current year (A)/Previous Year (B) (320)
Transfers from other pension plans, LIRAs, LIFs and LRIFs: Current year (A)/Previous Year (B) (321)
Other sources of increase in assets (specify): (323)
Current year (A)/Previous Year (B) (322)
TOTAL INCREASE IN ASSETS (Lines 310+320+321+322): Current year (A)/Previous Year (B) (330)
DECREASE IN ASSETS (including payables)
Expenses related to managing investments: Current year (A)/Previous Year (B) (331)
Professional fees: Current year (A)/Previous Year (B) (332)
Other expenses (specify): 334
Current year (A)/Previous Year (B) (333)
Total plan expenses (Sum of lines 331 to 333): Current year (A)/Previous Year (B) (340)
Benefit payments: Current year (A)/Previous Year (B) (341)
Transfer to other pension plans, LIRAs, LIFs and LRIFs: Current year (A)/Previous Year (B) (351)
Other sources of decrease in assets (specify): (353)
Current year (A)/Previous Year (B) (352)
TOTAL DECREASE IN ASSETS (Lines 340+341+351+352): Current year (A)/Previous Year (B) (360)
CHANGE IN NET ASSETS(Lines 330-360): Current year (A)/Previous Year (B) (370)
NET ASSETS AT BEGINNING OF FISCAL YEAR: Current year (A)/Previous Year (B) (381)
NET ASSETS AT FISCAL YEAR END (Lines 370+381): Current year (A)/Previous Year (B) (390)
Part 4 - Statement of Net Assets
Demand deposits and cash on hand: Current year (A)/Previous Year (B) (401)
Insured contracts: Current year (A)/Previous Year (B) (402)
Short term notes and treasury bills: Current year (A)/Previous Year (B) (403)
Term deposits and guaranteed investment certificates: Current year (A)/Previous Year (B) (404)
Canadian bonds and debentures: Current year (A)/Previous Year (B) (405)
Non-Canadian bonds and debentures: Current year (A)/Previous Year (B) (406)
Mortgage loans: Current year (A)/Previous Year (B) (407)
Real estate debentures: Current year (A)/Previous Year (B) (408)
Canadian stocks: Current year (A)/Previous Year (B) (411)
Non-Canadian stocks: Current year (A)/Previous Year (B) (412)
Real estate: Current year (A)/Previous Year (B) (413)
Resource properties: Current year (A)/Previous Year (B) (414)
Venture capital: Current year (A)/Previous Year (B) (415)
Securities of real estate, resource and investment corporations: Current year (A)/Previous Year (B) (416)
Pooled/mutual/segregated funds:
Fixed-income funds: Current year (A)/Previous Year (B) (421)
Equity funds: Current year (A)/Previous Year (B) (422)
Balanced funds: Current year (A)/Previous Year (B) (423)
(specify) (426) Current year (A)/Previous Year (B) (424)
(specify) (427) Current year (A)/Previous Year (B) (425)
Total pooled/mutual/segregated funds (Sum of lines 421 to 425): Current year (A)/Previous Year (B) (430)
Investments in other asset categories not listed above: (specify) (442)
Current year (A)/Previous Year (B) (441)
TOTAL INVESTMENTS (Sum of lines401 to 408, 411 to 416, 430 and 441): Current year (A)/Previous Year (B) (460)
Employer contributions: Current year (A)/Previous Year (B) (461)
Member contributions: Current year (A)/Previous Year (B) (462)
Investment income receivable (interest, dividends, rents, etc.): Current year (A)/Previous Year (B) (463)
Other amounts receivable: (specify) (465)
Current year (A)/Previous Year (B) (464)
TOTAL ACCOUNTS RECEIVABLE (Sum of lines 461 to 464): Current year (A)/Previous Year (B) (470)
Accounts payable: Current year (A)/Previous Year (B) (471)
Other payable: (specify) (473)
Current year (A)/Previous Year (B) (472)
TOTAL ACCOUNTS PAYABLE (Sum of lines 471 to 472): Current year (A)/Previous Year (B) (480)
NET ASSETS AVAILABLE FOR BENEFITS (Lines 460+470-480): Current year (A)/Previous Year (B) (490)
Part 5 - Interrogatories
5.01	Is the information set out in Parts 3 and 4 of this Investment Information Summary consistent with the information set out in the pension plan's financial statements for the corresponding fiscal year that are required to be filed under section 76 of Regulation 909?
5.02	Were any of the assets of the pension fund held directly by the plan administrator, rather than an external custodian of the pension fund (such as a trust company or insurance company)?
5.03	Were any of the assets of the pension fund invested in derivative instruments, other than those held in pooled or mutual funds or segregated funds?
5.04	Were any of the assets of the pension fund invested in employer-issued securities, other than those held in pooled or mutual funds or segregated funds?
If so, enter the fair market value of such securities as of the fiscal year end: (501)
5.05	Were the assets of the pension fund invested in any master trust?
If so, indicate the name(s) of the master trust(s): (502)
5.06	Were all of the assets of the pension fund invested in a name on behalf of the pension plan in accordance with clause 6(1)(b) of the Federal Investment Regulations (FIR)?
5.07	Did the plan administrator maintain records identifying all of the investments of the pension fund in accordance with section 7 of the FIR?
5.08	Did the plan have a Statement of Investment Policies and Procedures (SIPP) meeting the requirements of section 7.1 of the FIR?
5.09	Was the SIPP reviewed and confirmed or amended by the plan administrator, having regard to all known factors of the plan's portfolio of investments and loans, during the plan fiscal year covered by this Investment Information Summary?
5.10	Did the plan administrator provide a copy of the most recent SIPP to the actuary to the plan?
5.11	Did the investments of the pension fund exceed the 10% quantitative limit described in section 9 of Schedule III of the FIR?
5.12	Did the investments of the pension fund comply with the 5%, 15% and 25% rules described in section 10 of Schedule III of the FIR?
5.13	Did the investments of the pension fund exceed the 30% quantitative limit described in section 11 of Schedule III of the FIR?
5.14	Did the investments of the pension fund comply with the 30% rules respecting real estate corporations, resource corporations and investment corporations described in sections 12 to 14 of Schedule III of the FIR?
5.15	Did the investments of the pension fund comply with the related party transaction rules described in sections 16 and 17 of Schedule III of the FIR?
5.16	Were all of the investments of the pension fund invested in accordance with the SIPP?
5.17	Has the situation described by any of questions 5.02 to 5.16 in this Part of the Investment Information Summary changed so that the answer to the relevant question(s) is different by the time this Investment Information Summary is filed?
If so, list the relevant question(s): (503)
5.18	On what date was the SIPP last amended, or if it has never been amended, first established? (504)
5.19	As described in the SIPP, what percentage of the assets of the pension fund were intended to be invested in the following broad asset categories:
Specify asset categories in the next column
Part 6 - Additional Explanations and Comments
Effective (2013-04-25)
FSCO 1161.4E