Free 2007 Form 5500 Schedule B - Federal

Attention:
· Telephone requests for the 2007 Form 5500-series forms, schedules, and instructions will not be filled until October 16, 2007. · Requests for the 2007 Form 5500-series products can be made on the Internet (see below) beginning October 16, 2007. Requests made prior to that date will be filled with the 2006 version of the products. The product you are about to view is provided for information purposes and should not be reproduced on personal computer printers by individual taxpayers for filing. The Forms 5500 and 5500-EZ (and related schedules) are printed on special paper with dropout ink so they can be processed by the computerized processing system "EFAST." These forms and schedules may be obtained by calling 1-800TAX-FORM (1-800-829-3676). Be sure to order using the IRS form number. Note: You can also use the Internet link Forms and Publications by U.S. Mail to request a limited number of these forms and schedules. Check the Department of Labor's website at www.efast.dol.gov for additional information concerning the processing system, electronic filing, software, and "non-standard" filings. ________________________________________________

SCHEDULE B (Form 5500)
Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation

Actuarial Information
This schedule is required to be filed under section 104 of the Employee Retirement Income Security Act of 1974, referred to as ERISA, except when attached to Form 5500-EZ and, in all cases, under section 6059(a) of the Internal Revenue Code, referred to as the Code.


Official Use Only

OMB No. 1210-0110

2007
This Form is Open to Public Inspection (except when attached to Form 5500-EZ).

Attach to Form 5500 or 5500-EZ if applicable. See separate instructions.


Round off amounts to nearest dollar. Caution: A penalty of $1,000 will be assessed for late filing of this report unless reasonable cause is established.
B D

FO

Three-digit plan number

Employer Identification Number

C

Plan sponsor's name as shown on line 2a of Form 5500 or 5500-EZ

O

E

Type of plan: (1) Multiemployer (2) Single-employer (3)

T

Part I

Basic Information (To be completed by all plans)

E S

1a Enter the actuarial valuation date: b Assets: (1) Current value of assets .......................................................................................

MM / D D / Y Y Y Y

O N

LY

,D

O

Multiple-employer

N

F

U S

E

100 or fewer participants in prior plan year



R

A

Name of plan

FI LI N


For calendar plan year 2007 or fiscal plan year beginning


MM / D D / Y Y Y Y

and ending

MM / D D / Y Y Y Y

G





.00 .00

(2)

Actuarial value of assets for funding standard account ....................................

Statement by Enrolled Actuary (see instructions before signing):
To the best of my knowledge, the information supplied in this schedule and on the accompanying schedules, statements, and attachments, if any, is complete and accurate, and in my opinion each assumption, used in combination, represents my best estimate of anticipated experience under the plan. Furthermore, in the case of a plan other than a multiemployer plan, each assumption used (a) is reasonable (taking into account the experience of the plan and reasonable expectations) or (b) would, in the aggregate, result in a total contribution equivalent to that which would be determined if each such assumption were reasonable; in the case of a multiemployer plan, the assumptions used, in the aggregate, are reasonable (taking into account the experience of the plan and reasonable expectations).



N

Signature of actuary

A

L

P

U

R

P

O

S

IO

SIGN HERE
Type or print

Date

MM / D D / Y Y Y Y

Name of actuary Firm name

Address of the firm

FO

City

R

IN

FO

R

M

A

T

State
Telephone number (including area code)

Zip Code

G

Most recent enrollment number

If the actuary has not fully reflected any regulation or ruling promulgated under the statute in completing this schedule, check the box and see instructions ......................................................................................................................................................................
For Paperwork Reduction Act Notice and OMB Control Nos., see the inst. for Form 5500 or 5500-EZ. Cat. No. 13507E Schedule B (Form 5500) 2007

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F
v10.1

Schedule B (Form 5500) 2007

Page

2
Official Use Only

1c (1) (2)

Accrued liability for plans using immediate gain methods ................................ Information for plans using spread gain methods: (a) Unfunded liability for methods with bases .................................................. (b) (c) Accrued liability under entry age normal method ...................................... Normal cost under entry age normal method ............................................







.00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00

d Information on current liabilities of the plan: (1) (2) Amount excluded from current liability attributable to pre-participation service (see instructions) ......................................................... "RPA '94" information: (a) Current liability ............................................................................................. (b) (c) Expected increase in current liability due to benefits accruing during the plan year ....................................................... Current liability computed at highest allowable interest rate (see instructions) .................................................................... Expected release from "RPA '94" current liability for the plan year ..........

U S



FO



R

(3) Total Benefits

E

O

T

O

N

,D

(d)

R

P

(1)

For retired participants and beneficiaries receiving payments

O

S

(1) No. of Persons

(2) Vested Benefits

E S

(3) Expected plan disbursements for the plan year ................................................. 2 Operational information as of beginning of this plan year: a Current value of the assets (see instructions) ........................................................... b "RPA '94" current liability:

O N

LY

FI LI N


G
.



L

P

(2)

For terminated vested participants

U


(3)









.00 .00 .00 .00





.00 .00 .00 .00
%

For active participants

c If the percentage resulting from dividing line 2a by line 2b(4), column (3), is less than 70%, enter such percentage ....

FO

R

IN

FO



R

M

(4)

Total

A
0



T

IO

N

A



7

0

7

0

0

0

2

0

G

Schedule B (Form 5500) 2007 3 Contributions made to the plan for the plan year by employer(s) and employees: (a) Month-Day-Year (b) Amount paid by employer

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3
Official Use Only

(c) Amount paid by employees

MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y MM/ D D / Y Y Y Y








00 . 00 . 00 . 00 . 00 . 00







00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 .

O

,D

00 . 00 .

N

00 .

O

T

00 .

U S

00 .



FO

.

R

E



O N

LY

00 . 00 . 00 . 00 . 00 .

E S

P

U



R

P



S



O

4

Quarterly contributions and liquidity shortfall(s):

N

A

L

3

Totals ............................





FI LI N

(d) (h)

G




IO

R

M

A

a Plans other than multiemployer plans, enter funded current liability percentage for preceding year (see instructions) ... b If line 4a is less than 100%, see instructions, and complete the following amount fields as applicable: Liquidity shortfall as of end of Quarter of this plan year

.

%

T

FO

(1) 1st (2) 2nd 5 (a) (e)


(b) (f)




Entry age normal

.00 .00
(c)

(3) (4)

3rd 4th


Accrued benefit (unit credit) Individual aggregate


Aggregate

.00 .00

FO

R

Actuarial cost method used as the basis for this plan year's funding standard account computation: Attained age normal Frozen initial liability

IN

Individual level premium

(g)

Other (specify)



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0

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0

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3

0

H

Schedule B (Form 5500) 2007

Page

4
Official Use Only

5 i Has a change been made in funding method for this plan year? ....................................................... j If line i is "Yes," was the change made pursuant to Revenue Procedure 2000-40? ......................... k If line i is "Yes," and line j is "No" enter the date of the ruling letter (individual or class) approving the change in funding method ............................................................ 6

Yes Yes

No No

MM / D D / Y Y Y Y

G
Checklist of certain actuarial assumptions: a Interest rate for "RPA '94" current liability ......................................................................................................... b Weighted average retirement age ...................................................................................................................... e Valuation liability interest rate ......................... f Expense loading ................................................ g Annual withdrawal rates: (1) Age 25 ....................................................... (2) (3) Age 40 ....................................................... Age 55 .......................................................

O N

LY



.

,D

(2)

Females .....................................................

O

N

c Rates specified in insurance or annuity contracts .......................................... d Mortality table code for valuation purposes: (1) Males .........................................................

Yes

No

N/A

U S

Pre-retirement

E

Yes

FO

R

Post-retirement No N/A

O

T

FI LI N


N/A

.

%

N/A

N/A

%


Female
Rate Code

.

%



.

% % % % %
N/A

.

% % % % %
N/A

E S

Male

h Salary scale ......................................................

IO

i Estimated investment return on actuarial value of assets for year ending on the valuation date ................................................................................................... j Estimated investment return on current value of assets for year ending on the valuation date ...................................................................................................

N

. . . .


. . . .


A

L

P

URate Code R P O S

R

7

FO

New amortization bases established in the current plan year: (1) Type of Base (2) Initial Balance

M

. .


% %

A

T

(3)

Amortization Charge/Credit

R

IN


0 7


0 7


0 0

.00 .00 .00 .00 .00
0 4 0 I



.00 .00 .00 .00 .00

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Schedule B (Form 5500) 2007

Page

5
Official Use Only

8 Miscellaneous information: a If a waiver of a funding deficiency or an extension of an amortization period has been approved for this plan year, enter the date of the ruling letter granting the approval ........................ b If one or more alternative methods or rules (as listed in the instructions) were used for this plan year, enter the appropriate code in accordance with the instructions ...................................


MM / D D / Y Y Y Y

c Is the plan required to provide a Schedule of Active Participant Data? (see instructions) ............... If "Yes," attach schedule. 9 Funding standard account statement for this plan year: Charges to funding standard account: a Prior year funding deficiency, if any ............................................................................ b Employer's normal cost for plan year as of valuation date ....................................... Outstanding Balance c Amortization charges as of valuation date: (1) All bases except funding waivers Funding waivers

Yes

No

FI LI N


G


.00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00

O

T

(2)

($







.00 )

U S N
.00 .00

E

($







.00 )





d Interest as applicable on line 9a, 9b, and 9c ............................................................. e Additional interest charge due to late quarterly contributions, if applicable ............. f Adjusted additional funding charge from Part II, line 12q, if applicable ... N/A

O

,D

O N

LY

E S

g Total charges. Add lines 9a through 9f ....................................................................... Credits to funding standard account: h Prior year credit balance, if any ..................................................................................

S

i Employer contributions. Total from column (b) of line 3 .............................................

L

P

j Amortization credits as of valuation date



($

U

R

Outstanding Balance

P

O







.00 )

T

IO

k Interest as applicable to end of plan year on lines 9h, 9i, and 9j ............................. l Full funding limitation (FFL) and credits (1) ERISA FFL (accrued liability FFL) ...................

N

A

(2) (3) m (1) (2)

"RPA '94" override (90% current liability FFL) .

R

M



A

FO



R

FO

FFL credit .............................................................................................................



.00 .00 .00 .00

n Total credits. Add lines 9h through 9k, 9l(3), 9m(1), and 9m(2) ................................

FO

Other credits ........................................................................................................

R

IN

Waived funding deficiency ...................................................................................

0

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0

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0

J

Schedule B (Form 5500) 2007

Page

6
Official Use Only

9o Credit balance: If line 9n is greater than line 9g, enter the difference ..................... p Funding deficiency: If line 9g is greater than line 9n, enter the difference .............. Reconciliation account: q Current year's accumulated reconciliation account: (1) (2) (3) Due to additional funding charges as of the beginning of the plan year ............... Due to additional interest charges as of the beginning of the plan year ............... Due to waived funding deficiencies: (a) (b) Reconciliation outstanding balance as of valuation date ...................................... Reconciliation amount. Line 9c(2) balance minus line 9q(3)(a) ...







.00 .00








.00 .00 .00 .00

T

U S

E

FO

R

FI LI N

Yes

G O N O


(4) 10

Total as of valuation date ...............................................................................

.00 .00
No

11

Has a change been made in the actuarial assumptions for the current plan year? If "Yes," see instructions.

U

R

Please see Who Must File in the Schedule B instructions to determine if you must complete Part II. 12 Additional required funding charge (see instructions): a Enter "Gateway %." Divide line 1b(2) by line 1d(2)(c) and multiply by 100. If line 12a is at least 90%, go to line 12q and enter -0-. If line 12a is less than 80%, go to line 12b. If line 12a is at least 80% (but less than 90%), see instructions and, if applicable, go to line 12q and enter -0-. Otherwise, go to line 12b .............................................

O

S

E S

O N

Part II

Additional Information for Certain Plans Other Than Multiemployer Plans

LY

,D

Contribution necessary to avoid an accumulated funding deficiency. Enter the amount in line 9p or the amount required under the alternative funding standard account if applicable ..............................................................................



.

P

%

L

P

b "RPA '94" current liability. Enter line 1d(2)(a) ............................................................. c Adjusted value of assets (see instructions) ................................................................

.00 .00

N

A

IO

d Funded current liability percentage. Divide line 12c by 12b and multiply by 100 ....

.

%

T

R

M

e Unfunded current liability. Subtract line 12c from line 12b ........................................ f Liability attributable to any unpredictable contingent event benefit ...........................

.00 .00 .00 .00 .00 .00 .00

g Outstanding balance of unfunded old liability ............................................................. h Unfunded new liability. Subtract the total of lines 12f and 12g from line 12e. Enter -0- if negative .....................................................................................................

FO

R

IN

FO

A

i Unfunded new liability amount

(



.

%

of line 12h ..................

)

j Unfunded old liability amount ...................................................................................... k Deficit reduction contribution. Add lines 12i, 12j, and 1d(2)(b) .................................

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6

0

K

Schedule B (Form 5500) 2007

Page

7
Official Use Only

12 l Net charges in funding standard account used to offset the deficit reduction contribution. Enter a negative number if less than zero ............................................ m Unpredictable contingent event amount: (1) Benefits paid during year attributable to unpredictable contingent event ....................... (2)







.00



.00

(3) (4)

Amortization of all unpredictable contingent event liabilities ............................... "RPA '94" additional amount (see instructions)

U S

(5) (6)







T

E







FO
.00 .00


R

Enter the product of lines 12m(1) and 12m(2) ..........................................







.00

FI LI N
.00 .00 .00 .00 .00


Unfunded current liability percentage. Subtract the percentage on line 12d from 100% ......................................................

.

%

E S

p Additional funding charge prior to adjustment: Enter the lesser of line 12n or 12o .............................................................................................................

O N

LY

o Contributions needed to increase current liability percentage to 100% (see instructions) ..........................................................................................................

,D

n Preliminary additional funding charge: Enter the excess of line 12k over line 12l (if any), plus line 12m(6), adjusted to end of year with interest ..................

O

N

O

Enter the greatest of lines 12m(3), 12m(4), or 12m(5) ......................................





FO

R

IN

FO

R

M

A

T

IO

N

A

L

0

P

U

q Adjusted additional funding charge.

(

R

0 %

.

P

O

S

of line 12p ............

)



7

0

7

0

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