| SAR item
| Form 5500 large plan filer line items
| Form 5500 small plan filer line items
| Form 5500-SF filer line items
|
|---|
| A. PENSION PLAN:
| | | |
| 1. Funding arrangement | Form 5500-9a | Same | Not applicable.
|
| 2. Total plan expenses | Sch. H-2j | Sch. I-2j | Line 8h.
|
| 3. Administrative expenses | Sch. H-2i(5) | Sch. I-2h | Line 8f.
|
| 4. Benefits paid | Sch. H-2e(4) | Sch. I-2e | Line 8d.
|
| 5. Other expenses | Sch. H-Subtract the sum of 2e(4) & 2i(5) from 2j | Sch. I-2i | Line 8g.
|
| 6. Total participants | Form 5500-6f | Same | Line 5b.
|
| 7. Value of plan assets (net): | Sch. H-1l [Col. (b)] | Sch. I-1c [Col. (b)] | Line 7c [Col. (b)].
|
| a. End of plan year
| | | |
| b. Beginning of plan year | Sch. H-1l [Col. (a)] | Sch. I-1c [Col. (a)] | Line 7c [Col. (a)].
|
| 8. Change in net assets | Sch. H-Subtract 1l [Col. (a)] from 1l [Col. (b)] | Sch. I-Subtract 1c [Col. (a) from Col. (b)] | Line 7c-Subtract Col. (a) from Col. (b).
|
| 9. Total income | Sch. H-2d | Sch. I-2d | Line 8c.
|
| a. Employer contributions | Sch. H-2a(1)(A) & 2a(2) if applicable | Sch. I-2a(1) & 2b if applicable | Line 8a(1) if applicable.
|
| b. Employee contributions | Sch. H-2a(1)(B) & 2a(2) if applicable | Sch. I-2a(2) & 2b if applicable | Line 8a(2) & 8a(3) if applicable.
|
| c. Gains (losses) from sale of assets | Sch. H-2b(4)(C) | Not applicable | Not applicable.
|
| d. Earnings from investments | Sch. H-Subtract the sum of 2a(3), 2b(4)(C) and 2c from 2d | Sch. I-2c | Line 8b.
|
| 10. Total insurance premiums | Total of all Schs. A-6b | Total of all Schs. A-6b | Not applicable.
|
| 11. Unpaid minimum required contribution (S-E plans) or Funding deficiency (ME plans): | Sch. SB-39 | Same | Same.
|
| a. S-E Defined benefit plans
| | | |
| b. ME Defined benefit plans | Sch. MB-10 | Same | Not applicable.
|
| c. Defined contribution plans | Sch. R-6c, if more than zero | Same | Line 12d.
|
| B. WELFARE PLAN
| | | |
| 1. Name of insurance carrier | All Schs. A-1(a) | Same | Not applicable.
|
| 2. Total (experience rated and non-experienced rated) insurance premiums | All Schs. A-Sum of 9a(1) and 10a | Same | Not applicable.
|
| 3. Experience rated premiums | All Schs. A-9a(1) | Same | Not applicable.
|
| 4. Experience rated claims | All Schs. A-9b(4) | Same | Not applicable.
|
| 5. Value of plan assets (net): | Sch. H-1l [Col. (b)] | Sch. I-1c [Col. (b)] | Line 7c [Col. (b)].
|
| a. End of plan year
| | | |
| b. Beginning of plan year | Sch. H-1l [Col. (a)] | Sch. I-1c [Col. (a)] | Line 7c [Col. (a)].
|
| 6. Change in net assets | Sch. H-Subtract 1l [Col. (a)] from 1l [Col. (b)] | Sch. I-Subtract 1c [Col. (a)] from 1c [Col. (b)] | Line 7c-Subtract [Col. (a)] from 7c [Col. (b)].
|
| 7. Total income | Sch. H-2d | Sch. I-2d | Line 8c
|
| a. Employer contributions | Sch. H-2a(1)(A) & 2a(2) if applicable | Sch. I-2a(1) & 2b if applicable | Line 8a(1) if applicable.
|
| b. Employee contributions | Sch. H-2a(1)(B) & 2a(2) if applicable | Sch. I-2a(2) & 2b if applicable | Line 8a(2) if applicable.
|
| c. Gains (losses) from sale of assets | Sch. H-2b(4)(C) | Not applicable | Not applicable.
|
| d. Earnings from investments | Sch. H-Subtract the sum of 2a(3), 2b(4)(C) and 2c from 2d | Sch. I-2c | Line 8b.
|
| 8. Total plan expenses | Sch. H-2j | Sch. I-2j | Line 8h.
|
| 9. Administrative expenses | Sch. H-2i(5) | Sch. I-2h | Line 8f.
|
| 10. Benefits paid | Sch. H-2e(4) | Sch. I-2e | Line 8d.
|
| 11. Other expenses | Sch. H-Subtract the sum of 2e(4) & 2i(5) from 2j | Sch. I-2i | Line 8g. |