Short Form Annual Return/Report of Small Employee Benefit Plan

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1 Form 55-SF Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Short Form Annual Return/Report of Small Employee Benefit Plan This form is required to be filed under sections 14 and 465 of the Employee Retirement Income Security Act of 1974 (ERISA), and sections 657(b) and 658(a) of the Internal Revenue Code (the Code). Complete all entries in accordance with the instructions to the Form 55-SF. Annual Report Identification Information For calendar plan year 215 or fiscal plan year beginning 1/1/215 a single-employer plan A This return/report is for: a one-participant plan and ending OMB Nos This Form is Open to Public Inspection a multiple-employer plan (not multiemployer) (Filers checking this box must attach a list of participating employer information in accordance with the form instructions) a foreign plan B This return/report is the first return/report the final return/report an amended return/report a short plan year return/report (less than 12 months) C Check box if filing under: Form 5558 automatic extension DFVC program special extension (enter description) Part II Basic Plan Information enter all requested information 1a Name of plan ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI 2a Plan sponsor s name (employer, if for a single-employer plan) Mailing address (include room, apt., suite no. and street, or P.O. Box) City or town, state or province, country, and ZIP or foreign postal code (if foreign, see instructions) ABCDEFGHI ABCDEFGH ABCDEFGHI ABCDEFGHI ABCDEFGHI I 444 N CAPITOL ST NW STE 221 WASHINGTON, DC b Three-digit plan number (PN) 1 1c Effective date of plan 1/1/27 2b Employer Identification Number YYYY-MM-DD (EIN) c Sponsor s telephone number d Business code (see instructions) b Administrator s EIN 3a Plan administrator s name and address Same as Plan Sponsor.ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI N CAPITOL ST NW STE c/o ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI WASHINGTON, ABCDEFGHI DC ABCDEFGHI 3c Administrator s telephone number ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDE ABCDEFGHI ABCDEFGHI ABCDE CITYEFGHI ABCDEFGHI AB ST I A 4 If the name and/or EIN of the plan sponsor has changed since the last return/report filed for this plan, enter the 4b EIN name, EIN, and the plan number from the last return/report. a Sponsor s name DEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI CDEFGHI 4c PN 12 5a Total number of participants at the beginning of the plan year... 5a b Total number of participants at the end of the plan year... 5b NATIONAL CONFERENCE ON PUBLIC EMPLOYEE RETIREMENT SYSTEMS c Number of participants with account balances as of the end of the plan year (defined benefit plans do not complete this item)... d(1) Total number of active participants at the beginning of the plan year... 4 d(2) Total number of active participants at the end of the plan year... 5d(2) 3 e Number of participants that terminated employment during the plan year with accrued benefits that were less than 1% vested... 5e Caution: A penalty for the late or incomplete filing of this return/report will be assessed unless reasonable cause is established. Under penalties of perjury and other penalties set forth in the instructions, I declare that I have examined this return/report, including, if applicable, a Schedule SB or Schedule MB completed and signed by an enrolled actuary, as well as the electronic version of this return/report, and to the best of my knowledge and belief, it is true, correct, and complete. SIGN HERE SIGN HERE Filed with authorized/valid electronic signature. 1/11/216 HANK KIM Signature of plan administrator Date Enter name of individual signing as plan administrator Signature of employer/plan sponsor Date Enter name of individual signing as employer or plan sponsor Preparer s telephone number Preparer s name (including firm name, if applicable) and address (include room or suite number ) ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI 12/31/215 For Paperwork Reduction Act Notice and OMB Control Numbers, see the instructions for Form 55-SF. Form 55-SF (215) v c 5d(1) 813 2

2 Form 55-SF 215 Page 2 6a Were all of the plan s assets during the plan year invested in eligible assets? (See instructions.)... Yes No b Are you claiming a waiver of the annual examination and report of an independent qualified public accountant (IQPA) under 29 CFR ? (See instructions on waiver eligibility and conditions.)... If you answered No to either line 6a or line 6b, the plan cannot use Form 55-SF and must instead use Form 55. c If the plan is a defined benefit plan, is it covered under the PBGC insurance program (see ERISA section 421)?... Yes No Part III Financial Information Yes No Not determined 7 Plan Assets and Liabilities (a) Beginning of Year (b) End of Year a Total plan assets... 7a b Total plan liabilities... 7b c Net plan assets (subtract line 7b from line 7a)... 7c Income, Expenses, and Transfers for this Plan Year (a) Amount (b) Total a Contributions received or receivable from: 2 (1) Employers... 8a(1) (2) Participants... 8a(2) (3) Others (including rollovers)... 8a(3) b Other income (loss)... 8b c Total income (add lines 8a(1), 8a(2), 8a(3), and 8b)... 8c d Benefits paid (including direct rollovers and insurance premiums to provide benefits)... 8d e Certain deemed and/or corrective distributions (see instructions)... 8e f Administrative service providers (salaries, fees, commissions)... 8f g Other expenses... 8g h Total expenses (add lines 8d, 8e, 8f, and 8g)... 8h i Net income (loss) (subtract line 8h from line 8c)... 8i j Transfers to (from) the plan (see instructions)... Part IV Plan Characteristics 8j a If the plan provides pension benefits, enter the applicable pension feature codes from the List of Plan Characteristic Codes in the instructions: 1A B If the plan provides welfare benefits, enter the applicable welfare feature codes from the List of Plan Characteristic Codes in the instructions: Part V Compliance Questions 1 During the plan year: Yes No N/A Amount a Was there a failure to transmit to the plan any participant contributions within the time period described in 29 CFR ? (See instructions and DOL s Voluntary Fiduciary Correction Program)... 1a b Were there any nonexempt transactions with any party-in-interest? (Do not include transactions reported on line 1a.)... 1b c Was the plan covered by a fidelity bond?... 1c d Did the plan have a loss, whether or not reimbursed by the plan s fidelity bond, that was caused by fraud or dishonesty?... 1d e Were any fees or commissions paid to any brokers, agents, or other persons by an insurance carrier, insurance service, or other organization that provides some or all of the benefits under the plan? (See instructions.)... 1e f Has the plan failed to provide any benefit when due under the plan?... 1f g Did the plan have any participant loans? (If Yes, enter amount as of year end.)... 1g h If this is an individual account plan, was there a blackout period? (See instructions and 29 CFR )... 1h i If 1h was answered Yes, check the box if you either provided the required notice or one of the exceptions to providing the notice applied under 29 CFR i j Did the plan trust incur unrelated business taxable income?... 1j Part VI Pension Funding Compliance 11 Is this a defined benefit plan subject to minimum funding requirements? (If "Yes," see instructions and complete Schedule SB (Form 55) and line 11a below)... Yes No 11a Enter the unpaid minimum required contribution for all years from Schedule SB (Form 55) line Is this a defined contribution plan subject to the minimum funding requirements of section 412 of the Code or section 32 of ERISA?... Yes No 11a 5

3 Form 55-SF 215 Page 3-1 x (If "Yes," complete line 12a or lines 12b, 12c, 12d, and 12e below, as applicable.) a If a waiver of the minimum funding standard for a prior year is being amortized in this plan year, see instructions, and enter the date of the letter ruling granting the waiver.... Month Day Year If you completed line 12a, complete lines 3, 9, and 1 of Schedule MB (Form 55), and skip to line 13. b Enter the minimum required contribution for this plan year... 12b c Enter the amount contributed by the employer to the plan for this plan year... d Subtract the amount in line 12c from the amount in line 12b. Enter the result (enter a minus sign to the left of a 12d negative amount)... 12c YYYY-MM-DD e Will the minimum funding amount reported on line 12d be met by the funding deadline?... Yes No N/A Part VII Plan Terminations and Transfers of Assets 13a Has a resolution to terminate the plan been adopted in any plan year?... If Yes, enter the amount of any plan assets that reverted to the employer this year... b Were all the plan assets distributed to participants or beneficiaries, transferred to another plan, or brought under the control of the PBGC?... c If during this plan year, any assets or liabilities were transferred from this plan to another plan(s), identify the plan(s) to which assets or liabilities were transferred. (See instructions.) 13a Yes No Yes No 13c(1) Name of plan(s): 13c(2) EIN(s) 13c(3) PN(s) ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI Part VIII Trust Information 14a Name of trust ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI 14c Name of trustee or custodian b Trust s EIN 14d Trustee s or custodian s telephone number Part I IRS Compliance Questions 15a Is the plan a 41(k) plan?... Yes No 15b If Yes, how does the 41(k) plan satisfy the nondiscrimination requirements for employee deferrals and employer matching contributions (as applicable) under sections 41(k)(3) and 41(m)(2)?... Designbased safe harbor method 15c If the ADP/ACP test is used, did the 41(k) plan perform ADP/ACP testing for the plan year using the "current year Yes testing method" for nonhighly compensated employees (Treas. Reg sections 1.41(k)-2(a)(2)(ii) and 1.41(m)- 2(a)(2)(ii))?... 16a Ratio Check the box to indicate the method used by the plan to satisfy the coverage requirements under section 41(b):... percentage test 16b Does the plan satisfy the coverage and nondiscrimination tests of sections 41(b) and 41(a)(4) by combining Yes this plan with any other plans under the permissive aggregation rules?... ADP/ACP test No Average benefit test 17a Has the plan been timely amended for all required tax law changes?... Yes No N/A 17b Date the last plan amendment/restatement for the required tax law changes was adopted / /. Enter the applicable code (See instructions for tax law changes and codes). 17c If the plan sponsor is an adopter of a pre-approved master and prototype (M&P) or volume submitter plan that is subject to a favorable IRS opinion or advisory letter, enter the date of that favorable letter / / and the letter s serial number. 17d If the plan is an individually-designed plan and received a favorable determination letter from the IRS, enter the date of the plan s last favorable determination letter / /. 18 Is the Plan maintained in a U.S. territory (i.e., Puerto Rico (if no election under ERISA section 122(i)(2) has been made), American Samoa, Guam, the Commonwealth of the Northern Mariana Islands or the U.S. Virgin Islands)? Were in-service distributions made during the plan year?... Yes No If Yes, enter amount Were required minimum distributions made to 5% owners who have attained age 7 ½ (regardless of whether or not retired), as required under section 41(a)(9)?... Yes No No Yes No N/A

4 SCHEDULE SB (Form 55) Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Single-Employer Defined Benefit Plan Actuarial Information This schedule is required to be filed under section 14 of the Employee Retirement Income Security Act of 1974 (ERISA) and section 659 of the Internal Revenue Code (the Code). Pension Benefit Guaranty Corporation File as an attachment to Form 55 or 55-SF. For calendar plan year 215 or fiscal plan year beginning 1/1/215 and ending Round off amounts to nearest dollar. Caution: A penalty of $1, will be assessed for late filing of this report unless reasonable cause is established. A Name of plan B Three-digit ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI C Plan sponsor s name as shown on line 2a of Form 55 or 55-SF ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI D OMB No This Form is Open to Public Inspection plan number (PN) 2 1 Employer Identification Number (EIN) E Type of plan: Single Multiple-A Multiple-B F Prior year plan size: 1 or fewer 11-5 More than 5 Part I Basic Information 1 Enter the valuation date: Month 1 Day 1 Year Assets: a Market value... 2a b Actuarial value... 2b Funding target/participant count breakdown (1) Number of participants a For retired participants and beneficiaries receiving payment... (2) Vested Funding Target (3) Total Funding Target b For terminated vested participants... c For active participants... d Total If the plan is in at-risk status, check the box and complete lines (a) and (b)... a Funding target disregarding prescribed at-risk assumptions... 4a b Funding target reflecting at-risk assumptions, but disregarding transition rule for plans that have been in at-risk status for fewer than five consecutive years and disregarding loading factor... 4b Effective interest rate % Target normal cost Statement by Enrolled Actuary To the best of my knowledge, the information supplied in this schedule and accompanying schedules, statements and attachments, if any, is complete and accurate. Each prescribed assumption was applied in accordance with applicable law and regulations. In my opinion, each other assumption is reasonable (taking into account the experience of the plan and reasonable expectations) and such other assumptions, in combination, offer my best estimate of anticipated experience under the plan. SIGN HERE Signature of actuary ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDE PANRONG IAO Type or print name of actuary 7/5/216 Date Most recent enrollment number YYYY-MM-DD ABCDEFGHI ACO/DCS ABCDEFGHI ABCDEFGHI ABCDE Firm name PO BO 1967 ABCDEFGHI ABCDEFGHI ABCDE WOODSTOCK, GA ABCDEFGHI ABCDEFGHI ABCDE UK Address of the firm 12/31/ Telephone number (including area code) 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 Numbers, see the instructions for Form 55 or 55-SF. Schedule SB (Form 55) 215 v

5 Schedule SB (Form 55) 215 Page 2-1 x 1 Part II Beginning of Year Carryover and Prefunding Balances 7 Balance at beginning of prior year after applicable adjustments (line 13 from prior year)... (a) Carryover balance (b) Prefunding balance Portion elected for use to offset prior year s funding requirement (line 35 from prior year) Amount remaining (line 7 minus line 8) Interest on line 9 using prior year s actual return of 2.96% Prior year s excess contributions to be added to prefunding balance: a Present value of excess contributions (line 38a from prior year) b(1) Interest on the excess, if any, of line 38a over line 38b from prior year Schedule SB, using prior year's effective interest rate of 6.98%... b(2) Interest on line 38b from prior year Schedule SB, using prior year's actual return... c Total available at beginning of current plan year to add to prefunding balance d Portion of (c) to be added to prefunding balance Other reductions in balances due to elections or deemed elections Balance at beginning of current year (line 9 + line 1 + line 11d line 12) Part III Funding Percentages 14 Funding target attainment percentage % Adjusted funding target attainment percentage % Prior year s funding percentage for purposes of determining whether carryover/prefunding balances may be used to reduce current year s funding requirement % 17 If the current value of the assets of the plan is less than 7 percent of the funding target, enter such percentage % Part IV Contributions and Liquidity Shortfalls 18 Contributions made to the plan for the plan year by employer(s) and employees: (a) Date (MM-DD-YYYY) (b) Amount paid by employer(s) (c) Amount paid by employees (a) Date (MM-DD-YYYY) (b) Amount paid by employer(s) YYYY-MM-DD 6/1/ YYYY-MM-DD YYYY-MM-DD YYYY-MM-DD YYYY-MM-DD YYYY-MM-DD YYYY-MM-DD YYYY-MM-DD YYYY-MM-DD YYYY-MM-DD YYYY-MM-DD Totals 18(b) 2 18(c) 19 Discounted employer contributions see instructions for small plan with a valuation date after the beginning of the year: (c) Amount paid by employees a Contributions allocated toward unpaid minimum required contributions from prior years a b Contributions made to avoid restrictions adjusted to valuation date... 19b c Contributions allocated toward minimum required contribution for current year adjusted to valuation date... 19c Quarterly contributions and liquidity shortfalls: a Did the plan have a funding shortfall for the prior year?... Yes No b If line 2a is Yes, were required quarterly installments for the current year made in a timely manner?... Yes No c If line 2a is Yes, see instructions and complete the following table as applicable: Liquidity shortfall as of end of quarter of this plan year (1) 1st (2) 2nd (3) 3rd (4) 4th

6 Schedule SB (Form 55) 215 Page 3 Part V Assumptions Used to Determine Funding Target and Target Normal Cost 21 Discount rate: a Segment rates: 1st segment: 2nd segment: 3rd segment: _% _% % N/A, full yield curve used b Applicable month (enter code)... 21b 1 22 Weighted average retirement age Mortality table(s) (see instructions) Prescribed - combined Prescribed - separate Substitute Part VI Miscellaneous Items 24 Has a change been made in the non-prescribed actuarial assumptions for the current plan year? If Yes, see instructions regarding required attachment.... Yes No 25 Has a method change been made for the current plan year? If Yes, see instructions regarding required attachment.... Yes No 26 Is the plan required to provide a Schedule of Active Participants? If Yes, see instructions regarding required attachment.... Yes No 27 If the plan is subject to alternative funding rules, enter applicable code and see instructions regarding attachment... Part VII Reconciliation of Unpaid Minimum Required Contributions For Prior Years 28 Unpaid minimum required contributions for all prior years Discounted employer contributions allocated toward unpaid minimum required contributions from prior years (line 19a) Remaining amount of unpaid minimum required contributions (line 28 minus line 29) Part VIII Minimum Required Contribution For Current Year 31 Target normal cost and excess assets (see instructions): a Target normal cost (line 6)... 31a b Excess assets, if applicable, but not greater than line 31a... 31b 32 Amortization installments: Outstanding Balance Installment a Net shortfall amortization installment b Waiver amortization installment If a waiver has been approved for this plan year, enter the date of the ruling letter granting the approval (Month Day Year )_and the waived amount Total funding requirement before reflecting carryover/prefunding balances (lines 31a - 31b + 32a + 32b - 33) Balances elected for use to offset funding Carryover balance Prefunding balance Total balance requirement Additional cash requirement (line 34 minus line 35) Contributions allocated toward minimum required contribution for current year adjusted to valuation date (line 19c) Present value of excess contributions for current year (see instructions) a Total (excess, if any, of line 37 over line 36)... 38a b Portion included in line 38a attributable to use of prefunding and funding standard carryover balances... 38b 39 Unpaid minimum required contribution for current year (excess, if any, of line 36 over line 37) Unpaid minimum required contributions for all years Part I Pension Funding Relief Under Pension Relief Act of 21 (See Instructions) 41 If an election was made to use PRA 21 funding relief for this plan: a Schedule elected... 2 plus 7 years 15 years b Eligible plan year(s) for which the election in line 41a was made Amount of acceleration adjustment Excess installment acceleration amount to be carried over to future plan years

7 PLAN SPONSOR: PLAN NAME: EIN: PIN: 2 PLAN YEAR: 1/1/215-12/31/215 SCHEDULE SB, LINE 26: SCHEDULE OF ACTIVE PARTICIPANT DATA Years of credited service: Under 1 1 to 4 5 to 9 1 to to 19 2 to to 29 3 to to 39 4 & up Total Attained Age No. No. No. No. No. No. No. No. No. No. No. Under to to to to to to to 59 6 to to 69 7 & up Total 2 2 4

8 PLAN SPONSOR: PLAN NAME: EIN: PIN: 2 PLAN YEAR: 1/1/215-12/31/215 SCHEDULE SB, PART V: STATEMENT OF ACTUARIAL ASSUMPTIONS/METHODS Actuarial Cost Method PPA Contributions are based on plan s Funding Target. The minimum required contribution is the sum of target normal cost plus a 7-year amortization of unfunded funding target liability of the plan. Actuarial Assumptions INTEREST RATES: MORTALITY: ASSET METHOD: TURNOVER: FOR MINIMUM REQUIRED CONTRIBUTIONS: Effective % Tier 1 Segment Rate % Tier 2 Segment Rate % Tier 3 Segment Rate % FOR MAIMUM TA DEDUCTIBLE CONTRIBUTIONS: Tier 1 Segment Rate % Tier 2 Segment Rate % Tier 3 Segment Rate % ASC % Valuation IRS Funding Table ASC IRS Funding Table Actuarial Value of Assets under IRC Section 43(g)(3)(B) None EPENSE LOAD: $2,15 RETIREMENT: The following table of retirement factors was used: SALARY SCALE: 2.% Age Percent Retiring Under 65 % 65 and over 1% OTHER PARAMETERS: Male Female Fraction of married participants 8% 8% Age difference between plan +3-3 participant and beneficiary

9

10 ABCDEFGHI NCPERS EMPLOYEE ABCDEFGHI DEFINED ABCDEFGHI BENEFIT ABCDEFGHI PLAN ABCDEFGHI 2 ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI NATIONAL ABCDEFGHI CONFERENCE ON PUBLIC EMPLOYEE RETIREMENT SYSTEMS , ,351 ( 4 172,12 172, ,12 172, ,611 Panrong ABCDEFGHI iao ABCDEFGHI ABCDEFGHI ABCDE YYYY-MM-DD ACO/DCS ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDE ABCDEFGHI ABCDEFGHI ABCDE PO BO ABCDEFGHI ABCDEFGHI ABCDE Woodstock UK GA /1/215 12/31/215 7/5/

11 PLAN SPONSOR: PLAN NAME: EIN: PIN: 2 PLAN YEAR: 1/1/215-12/31/215 SCHEDULE SB, LINE 22: DESCRIPTION OF WEIGHTED AVERAGE RETIREMENT AGE Age Retirement Rate Retired Lx=1, Not Retired Weight <65 % 1, 65 1% 1, 6,5, Total 1, 6,5, Weighted Average Retirement Age: 65

12 PLAN SPONSOR: PLAN NAME: EIN: PIN: 2 PLAN YEAR: 1/1/215-12/31/215 SCHEDULE SB, PART V: SUMMARY OF PLAN PROVISIONS Plan: NCPERS Employee Defined Benefit Plan Effective Date: January 1, 27 Employer: Employee: Participation: Years of Service: Average Monthly Compensation: Normal Retirement Date: National Conference on Public Employee Retirement Systems Any person who is employed by the Employer or Affiliated Employer, and excludes any person who is employed as an independent contractor. Any Eligible Employee who has completed one Year of Service and has attained age 21 shall be eligible to participate. An Eligible Employee shall become a Participant effective as of the earlier of the first day of the Plan Year or the first day of the seventh month of such Plan Year coinciding with or next following the date such Employee met the eligibility requirement. Computation period of twelve consecutive months, during which a Employee has at least 1, hours of service. Years of Service shall be limited to 5 years prior to the Effective Date of this Plan. Monthly Compensation of a Participant averaged over the 3 consecutive Calendar Years, including periods prior to the Effective Date of the Plan, which produce the highest monthly average within the last ten completed years of e employment. If a Participant has less than 3 consecutive Calendar Years of service from date of employment to date of termination, the Participant s Average Monthly Compensation will be based on the Participant s monthly Compensation during the Participant s months of services form date of employment to date of termination. The first day of the calendar month coinciding with or next following later of age 65 and fifth anniversary of the effective date of participation.

13 PLAN SPONSOR: PLAN NAME: EIN: PIN: 2 PLAN YEAR: 1/1/215-12/31/215 SCHEDULE SB, PART V: SUMMARY OF PLAN PROVISIONS (CONT) Early Retirement Date: Normal Retirement Benefit: Accrued Benefit: Termination Benefit: Normal Form: Optional Forms: Disability Benefits: Death Benefits: This plan does not provide for a retirement date prior to Normal Retirement Date. A participant s retirement benefit is equal to 5% of such Participant s Average Monthly Compensation, computed to the nearest cent. For Participants who are projected to have earned less than twenty-five Years of Service as of the end of the Plan Year in which they attained Normal Retirement Age, the percentage above shall be reduced by one-twenty fifth for each such Year of Service less than Twentyfive. It means Retirement benefit a Participant would receive at Normal Retirement Date, multiplied by a fraction, not greater than one, the numerator of which is the Participant s total number of Years of Service and the denominator of which is the aggregate number of Years of Service the Participant would have accumulated if the Participant continued employment until Normal Retirement Age. A Participant who has at least five Years of Service has a non-forfeitable right to the percentage of his or her Accrued Benefit. Annuity payable for life Joint and Survivor Annuity, Certain and Life Annuity, and Lump Sum. No disability benefits, other than those payable upon termination of employment are provided in this Plan. Pre-retirement: If the Participant dies prior to the Participant s Retirement Date, such Participant s Beneficiary shall receive a death benefit equal to the Actuarial Equivalent of the Accrued Benefit determined as of the Anniversary Date subsequent to or coinciding with the date of death. Post-Retirement: None except as provided by the annuity from elected.

Annual Return/Report of Employee Benefit Plan

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