Annual Return/Report of Employee Benefit Plan

Size: px
Start display at page:

Download "Annual Return/Report of Employee Benefit Plan"

Transcription

1 Form 5500 Department of the Treasury Internal Revenue Servie Department of Labor Employee Benefits Seurity Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit Plan This form is required to be filed for employee benefit plans under setions 104 and 4065 of the Employee Retirement Inome Seurity At of 1974 (ERISA) and setions 6047(e), 6057(b), and 6058(a) of the Internal Revenue Code (the Code). Complete all entries in aordane with the instrutions to the Form Part I Annual Report Identifiation Information For alendar plan year 2013 or fisal plan year beginning 01/01/2013 and ending A This return/report is for: X a multiemployer plan; X a multiple-employer plan; or X a single-employer plan; X a DFE (speify) _C_ B This return/report is: X the first return/report; X the final return/report; X an amended return/report; X a short plan year return/report (less than 12 months). C If the plan is a olletively-bargained plan, hek here X OMB Nos This Form is Open to Publi Inspetion D Chek box if filing under: X Form 5558; X automati extension; X the DFVC program; X speial extension (enter desription) ABCDE Part II Basi Plan Information enter all requested information 1a Name of plan LOCKHEED MARTIN CORPORATION RETIREMENT SAVINGS PLAN FOR SALARIED EMPLOYEES 2a Plan sponsor s name and address; inlude room or suite number (employer, if for a single-employer plan) 07/19/2013 LOCKHEED MARTIN CORPORATION D/B/A 6801 ROCKLEDGE DRIVE, CCT-115 /o BETHESDA, MD ABCDE ABCDE CITYEFGHI AB, ST UK 1b Three-digit plan number (PN) Effetive date of plan YYYY-MM-DD 10/01/1983 2b Employer Identifiation Number (EIN) Sponsor s telephone number d Business ode (see instrutions) Caution: A penalty for the late or inomplete filing of this return/report will be assessed unless reasonable ause is established. Under penalties of perjury and other penalties set forth in the instrutions, I delare that I have examined this return/report, inluding aompanying shedules, statements and attahments, as well as the eletroni version of this return/report, and to the best of my knowledge and belief, it is true, orret, and omplete. SIGN HERE Filed with authorized/valid eletroni signature. YYYY-MM-DD 06/26/2014 DONALD REMSCH ABCDE Signature of plan administrator Date Enter name of individual signing as plan administrator SIGN HERE Filed with authorized/valid eletroni signature. YYYY-MM-DD 06/26/2014 DONALD REMSCH ABCDE Signature of employer/plan sponsor Date Enter name of individual signing as employer or plan sponsor SIGN YYYY-MM-DD ABCDE HERE Signature of DFE Date Enter name of individual signing as DFE Preparer s name (inluding firm name, if appliable) and address; inlude room or suite number. (optional) Preparer s telephone number (optional) For Paperwork Redution At Notie and OMB Control Numbers, see the instrutions for Form Form 5500 (2013) v

2 Form 5500 (2013) Page 2 3a Plan administrator s name and address XSame X as Plan Sponsor Name XSame as Plan Sponsor Address /o ABCDE ABCDE CITYEFGHI AB, ST UK 4 If the name and/or EIN of the plan sponsor has hanged sine the last return/report filed for this plan, enter the name, EIN and the plan number from the last return/report: a Sponsor s name 3b Administrator s EIN Administrator s telephone number b EIN PN Total number of partiipants at the beginning of the plan year Number of partiipants as of the end of the plan year (welfare plans omplete only lines 6a, 6b, 6, and 6d). a Ative partiipants... 6a b Retired or separated partiipants reeiving benefits... 6b Other retired or separated partiipants entitled to future benefits d Subtotal. Add lines 6a, 6b, and d e Deeased partiipants whose benefiiaries are reeiving or are entitled to reeive benefits.... 6e f Total. Add lines 6d and 6e.... 6f g Number of partiipants with aount balanes as of the end of the plan year (only defined ontribution plans omplete this item)... 6g h Number of partiipants that terminated employment during the plan year with arued benefits that were less than 100% vested... 6h Enter the total number of employers obligated to ontribute to the plan (only multiemployer plans omplete this item) a If the plan provides pension benefits, enter the appliable pension feature odes from the List of Plan Charateristis Codes in the instrutions: 2E 2G 2J 2O 2I 2S 2T 3H 3F 2F b If the plan provides welfare benefits, enter the appliable welfare feature odes from the List of Plan Charateristis Codes in the instrutions: 9a Plan funding arrangement (hek all that apply) 9b Plan benefit arrangement (hek all that apply) (1) X Insurane (1) X Insurane (2) X Code setion 412(e)(3) insurane ontrats (2) X Code setion 412(e)(3) insurane ontrats (3) X Trust (3) X Trust (4) X General assets of the sponsor (4) X General assets of the sponsor 10 Chek all appliable boxes in 10a and 10b to indiate whih shedules are attahed, and, where indiated, enter the number attahed. (See instrutions) a Pension Shedules (1) X R (Retirement Plan Information) (2) X MB (Multiemployer Defined Benefit Plan and Certain Money Purhase Plan Atuarial Information) - signed by the plan atuary (3) X SB (Single-Employer Defined Benefit Plan Atuarial Information) - signed by the plan atuary b General Shedules (1) X H (Finanial Information) (2) X I (Finanial Information Small Plan) (3) X A (Insurane Information) (4) X C (Servie Provider Information) (5) X D (DFE/Partiipating Plan Information) (6) X G (Finanial Transation Shedules)

3 SCHEDULE D (Form 5500) Department of the Treasury Internal Revenue Servie Department of Labor Employee Benefits Seurity Administration DFE/Partiipating Plan Information This shedule is required to be filed under setion 104 of the Employee Retirement Inome Seurity At of 1974 (ERISA). File as an attahment to Form OMB No This Form is Open to Publi Inspetion. For alendar plan year 2013 or fisal plan year beginning 01/01/2013 and ending 07/19/2013 A Name of plan B Three-digit LOCKHEED MARTIN CORPORATION RETIREMENT SAVINGS PLAN FOR SALARIED EMPLOYEES plan number (PN) C Plan or DFE sponsor s name as shown on line 2a of Form 5500 D Employer Identifiation Number (EIN) LOCKHEED MARTIN CORPORATION Part I Information on interests in MTIAs, CCTs, PSAs, and IEs (to be ompleted by plans and DFEs) (Complete as many entries as needed to report all interests in DFEs) a Name of MTIA, CCT, PSA, or IE: LMC DEFINED CONTRIB MASTER TRUST ABCD STATE STREET BANK & TRUST COMPANY M ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) For Paperwork Redution At Notie and OMB Control Numbers, see the instrutions for Form Shedule D (Form 5500) 2013 v

4 Shedule D (Form 5500) 2013 Page 2-11 x a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions) a Name of MTIA, CCT, PSA, or IE: ABCD ode IE at end of year (see instrutions)

5 6 Shedule D (Form 5500) 2013 Page 3-11 x Part II Information on Partiipating Plans (to be ompleted by DFEs) (Complete as many entries as needed to report all partiipating plans) a Plan name b Name of plan sponsor a Plan name b Name of plan sponsor a Plan name b Name of plan sponsor a Plan name b Name of plan sponsor a Plan name b Name of plan sponsor a Plan name b Name of plan sponsor a Plan name b Name of plan sponsor a Plan name b Name of plan sponsor a Plan name b Name of plan sponsor a Plan name b Name of plan sponsor a Plan name b Name of plan sponsor a Plan name b Name of plan sponsor

6 SCHEDULE H (Form 5500) Department of the Treasury Internal Revenue Servie Department of Labor Employee Benefits Seurity Administration Pension Benefit Guaranty Corporation Finanial Information This shedule is required to be filed under setion 104 of the Employee Retirement Inome Seurity At of 1974 (ERISA), and setion 6058(a) of the Internal Revenue Code (the Code). File as an attahment to Form OMB No This Form is Open to Publi Inspetion For alendar plan year 2013 or fisal plan year beginning 01/01/2013 and ending 07/19/2013 A Name of plan B Three-digit LOCKHEED MARTIN CORPORATION RETIREMENT SAVINGS PLAN FOR SALARIED EMPLOYEES plan number (PN) C Plan sponsor s name as shown on line 2a of Form 5500 D Employer Identifiation Number (EIN) LOCKHEED MARTIN CORPORATION Part I Asset and Liability Statement 1 Current value of plan assets and liabilities at the beginning and end of the plan year. Combine the value of plan assets held in more than one trust. Report the value of the plan s interest in a ommingled fund ontaining the assets of more than one plan on a line-by-line basis unless the value is reportable on lines 1(9) through 1(14). Do not enter the value of that portion of an insurane ontrat whih guarantees, during this plan year, to pay a speifi dollar benefit at a future date. Round off amounts to the nearest dollar. MTIAs, CCTs, PSAs, and IEs do not omplete lines 1b(1), 1b(2), 1(8), 1g, 1h, and 1i. CCTs, PSAs, and IEs also do not omplete lines 1d and 1e. See instrutions. Assets (a) Beginning of Year (b) End of Year a Total noninterest-bearing ash... 1a b Reeivables (less allowane for doubtful aounts): (1) Employer ontributions... 1b(1) (2) Partiipant ontributions... 1b(2) (3) Other... 1b(3) General investments: (1) Interest-bearing ash (inlude money market aounts & ertifiates of deposit)... 1(1) (2) U.S. Government seurities... 1(2) (3) Corporate debt instruments (other than employer seurities): (A) Preferred... 1(3)(A) (B) All other... 1(3)(B) (4) Corporate stoks (other than employer seurities): (A) Preferred... 1(4)(A) (B) Common... 1(4)(B) (5) Partnership/joint venture interests... 1(5) (6) Real estate (other than employer real property)... 1(6) (7) Loans (other than to partiipants)... 1(7) (8) Partiipant loans... 1(8) (9) Value of interest in ommon/olletive trusts... 1(9) (10) Value of interest in pooled separate aounts... 1(10) (11) Value of interest in master trust investment aounts... 1(11) (12) Value of interest in investment entities... 1(12) (13) Value of interest in registered investment ompanies (e.g., mutual funds)... 1(13) (14) Value of funds held in insurane ompany general aount (unalloated ontrats)... 1(14) (15) Other... 1(15) For Paperwork Redution At Notie and OMB Control Numbers, see the instrutions for Form 5500 Shedule H (Form 5500) 2013 v

7 Shedule H (Form 5500) 2013 Page 2 1d Employer-related investments: (a) Beginning of Year (b) End of Year (1) Employer seurities... 1d(1) (2) Employer real property... 1d(2) e Buildings and other property used in plan operation... 1e f Total assets (add all amounts in lines 1a through 1e)... 1f Liabilities 1g Benefit laims payable... 1g h Operating payables... 1h i Aquisition indebtedness... 1i j Other liabilities... 1j k Total liabilities (add all amounts in lines 1g through1j)... 1k Net Assets 1l Net assets (subtrat line 1k from line 1f)... 1l Part II Inome and Expense Statement 2 Plan inome, expenses, and hanges in net assets for the year. Inlude all inome and expenses of the plan, inluding any trust(s) or separately maintained fund(s) and any payments/reeipts to/from insurane arriers. Round off amounts to the nearest dollar. MTIAs, CCTs, PSAs, and IEs do not omplete lines 2a, 2b(1)(E), 2e, 2f, and 2g. Inome (a) Amount (b) Total a Contributions: (1) Reeived or reeivable in ash from: (A) Employers... 2a(1)(A) (B) Partiipants... 2a(1)(B) (C) Others (inluding rollovers)... 2a(1)(C) (2) Nonash ontributions... 2a(2) (3) Total ontributions. Add lines 2a(1)(A), (B), (C), and line 2a(2)... 2a(3) b Earnings on investments: (1) Interest: (A) Interest-bearing ash (inluding money market aounts and ertifiates of deposit)... 2b(1)(A) (B) U.S. Government seurities... 2b(1)(B) (C) Corporate debt instruments... 2b(1)(C) (D) Loans (other than to partiipants)... 2b(1)(D) (E) Partiipant loans... 2b(1)(E) (F) Other... 2b(1)(F) (G) Total interest. Add lines 2b(1)(A) through (F)... 2b(1)(G) (2) Dividends: (A) Preferred stok... 2b(2)(A) (B) Common stok... 2b(2)(B) (C) Registered investment ompany shares (e.g. mutual funds)... 2b(2)(C) (D) Total dividends. Add lines 2b(2)(A), (B), and (C) 2b(2)(D) (3) Rents... 2b(3) (4) Net gain (loss) on sale of assets: (A) Aggregate proeeds... 2b(4)(A) (B) Aggregate arrying amount (see instrutions)... 2b(4)(B) (C) Subtrat line 2b(4)(B) from line 2b(4)(A) and enter result... 2b(4)(C) (5) Unrealized appreiation (depreiation) of assets: (A) Real estate... 2b(5)(A) (B) Other... 2b(5)(B) (C) Total unrealized appreiation of assets. Add lines 2b(5)(A) and (B)... 2b(5)(C)

8 Shedule H (Form 5500) 2013 Page 3 (a) Amount (b) Total (6) Net investment gain (loss) from ommon/olletive trusts... 2b(6) (7) Net investment gain (loss) from pooled separate aounts... 2b(7) (8) Net investment gain (loss) from master trust investment aounts... 2b(8) (9) Net investment gain (loss) from investment entities... 2b(9) (10) Net investment gain (loss) from registered investment ompanies (e.g., mutual funds)... 2b(10) Other inome d Total inome. Add all inome amounts in olumn (b) and enter total... 2d Expenses e Benefit payment and payments to provide benefits: (1) Diretly to partiipants or benefiiaries, inluding diret rollovers... 2e(1) (2) To insurane arriers for the provision of benefits... 2e(2) (3) Other... 2e(3) (4) Total benefit payments. Add lines 2e(1) through (3)... 2e(4) f Corretive distributions (see instrutions)... 2f g Certain deemed distributions of partiipant loans (see instrutions)... 2g h Interest expense... 2h i Administrative expenses: (1) Professional fees... 2i(1) (2) Contrat administrator fees... 2i(2) (3) Investment advisory and management fees... 2i(3) (4) Other... 2i(4) (5) Total administrative expenses. Add lines 2i(1) through (4)... 2i(5) j Total expenses. Add all expense amounts in olumn (b) and enter total... 2j Net Inome and Reoniliation k Net inome (loss). Subtrat line 2j from line 2d... 2k l Transfers of assets: (1) To this plan... 2l(1) (2) From this plan... 2l(2) Part III Aountant s Opinion 3 Complete lines 3a through 3 if the opinion of an independent qualified publi aountant is attahed to this Form Complete line 3d if an opinion is not attahed. a The attahed opinion of an independent qualified publi aountant for this plan is (see instrutions): (1) X Unqualified (2) X Qualified (3) X Dislaimer (4) X Adverse b Did the aountant perform a limited sope audit pursuant to 29 CFR and/or (d)? X Yes X No Enter the name and EIN of the aountant (or aounting firm) below: (1) Name: MITCHELL & TITUS LLP ABCD (2) EIN: d The opinion of an independent qualified publi aountant is not attahed beause: (1) X This form is filed for a CCT, PSA, or MTIA. (2) X It will be attahed to the next Form 5500 pursuant to 29 CFR Part IV Compliane Questions 4 CCTs and PSAs do not omplete Part IV. MTIAs, IEs, and GIAs do not omplete lines 4a, 4e, 4f, 4g, 4h, 4k, 4m, 4n, or IEs also do not omplete lines 4j and 4l. MTIAs also do not omplete line 4l. a b During the plan year: Yes No Amount Was there a failure to transmit to the plan any partiipant ontributions within the time period desribed in 29 CFR ? Continue to answer Yes for any prior year failures until fully orreted. (See instrutions and DOL s Voluntary Fiduiary Corretion Program.)... 4a X Were any loans by the plan or fixed inome obligations due the plan in default as of the lose of the plan year or lassified during the year as unolletible? Disregard partiipant loans seured by partiipant s aount balane. (Attah Shedule G (Form 5500) Part I if Yes is heked.)... 4b X

9 Shedule H (Form 5500) 2013 Page 4-1X d Yes No Amount Were any leases to whih the plan was a party in default or lassified during the year as unolletible? (Attah Shedule G (Form 5500) Part II if Yes is heked.)... 4 X Were there any nonexempt transations with any party-in-interest? (Do not inlude transations reported on line 4a. Attah Shedule G (Form 5500) Part III if Yes is heked.)... 4d X e Was this plan overed by a fidelity bond?... 4e X f Did the plan have a loss, whether or not reimbursed by the plan s fidelity bond, that was aused by fraud or dishonesty?... 4f X g Did the plan hold any assets whose urrent value was neither readily determinable on an established market nor set by an independent third party appraiser?... 4g X h Did the plan reeive any nonash ontributions whose value was neither readily determinable on an established market nor set by an independent third party appraiser?... 4h X i Did the plan have assets held for investment? (Attah shedule(s) of assets if Yes is heked, and see instrutions for format requirements.)... 4i X j Were any plan transations or series of transations in exess of 5% of the urrent value of plan assets? (Attah shedule of transations if Yes is heked, and see instrutions for format requirements.)... 4j X k Were all the plan assets either distributed to partiipants or benefiiaries, transferred to another plan, or brought under the ontrol of the PBGC?... 4k X l Has the plan failed to provide any benefit when due under the plan?... 4l X m If this is an individual aount plan, was there a blakout period? (See instrutions and 29 CFR )... 4m X n If 4m was answered Yes, hek the Yes box if you either provided the required notie or one of the exeptions to providing the notie applied under 29 CFR n X 5a Has a resolution to terminate the plan been adopted during the plan year or any prior plan year? If Yes, enter the amount of any plan assets that reverted to the employer this year... X Yes X No Amount: b If, during this plan year, any assets or liabilities were transferred from this plan to another plan(s), identify the plan(s) to whih assets or liabilities were transferred. (See instrutions.) 5b(1) Name of plan(s) 5b(2) EIN(s) 5b(3) PN(s) LOCKHEED MARTIN CORPORATION SALARIED SAVINGS PLAN If the plan is a defined benefit plan, is it overed under the PBGC insurane program (see ERISA setion 4021)?... X Yes X No X Not determined Part V Trust Information (optional) 6a Name of trust 6b Trust s EIN

10 SCHEDULE R (Form 5500) Department of the Treasury Internal Revenue Servie Department of Labor Employee Benefits Seurity Administration Pension Benefit Guaranty Corporation Retirement Plan Information This shedule is required to be filed under setion 104 and 4065 of the Employee Retirement Inome Seurity At of 1974 (ERISA) and setion 6058(a) of the Internal Revenue Code (the Code). File as an attahment to Form OMB No This Form is Open to Publi Inspetion. For alendar plan year 2013 or fisal plan year beginning 01/01/2013 and ending 07/19/2013 A Name of plan B Three-digit LOCKHEED MARTIN CORPORATION RETIREMENT SAVINGS PLAN FOR SALARIED EMPLOYEES plan number 040 (PN) 001 C Plan sponsor s name as shown on line 2a of Form 5500 D Employer Identifiation Number (EIN) LOCKHEED MARTIN CORPORATION Part I Distributions All referenes to distributions relate only to payments of benefits during the plan year. 1 Total value of distributions paid in property other than in ash or the forms of property speified in the instrutions Enter the EIN(s) of payor(s) who paid benefits on behalf of the plan to partiipants or benefiiaries during the year (if more than two, enter EINs of the two payors who paid the greatest dollar amounts of benefits): EIN(s): Profit-sharing plans, ESOPs, and stok bonus plans, skip line 3. 3 Number of partiipants (living or deeased) whose benefits were distributed in a single sum, during the plan year Part II Funding Information (If the plan is not subjet to the minimum funding requirements of setion of 412 of the Internal Revenue Code or ERISA setion 302, skip this Part) 4 Is the plan administrator making an eletion under Code setion 412(d)(2) or ERISA setion 302(d)(2)?... X Yes X No X N/A If the plan is a defined benefit plan, go to line 8. 5 If a waiver of the minimum funding standard for a prior year is being amortized in this plan year, see instrutions and enter the date of the ruling letter granting the waiver. Date: Month Day Year If you ompleted line 5, omplete lines 3, 9, and 10 of Shedule MB and do not omplete the remainder of this shedule. 6 a Enter the minimum required ontribution for this plan year (inlude any prior year aumulated funding 6a defiieny not waived)... b Enter the amount ontributed by the employer to the plan for this plan year.... 6b Subtrat the amount in line 6b from the amount in line 6a. Enter the result (enter a minus sign to the left of a negative amount) If you ompleted line 6, skip lines 8 and 9. 7 Will the minimum funding amount reported on line 6 be met by the funding deadline?... X Yes X No X N/A 8 If a hange in atuarial ost method was made for this plan year pursuant to a revenue proedure or other authority providing automati approval for the hange or a lass ruling letter, does the plan sponsor or plan administrator agree with the hange?... X Yes X No X N/A Part III Amendments 9 If this is a defined benefit pension plan, were any amendments adopted during this plan year that inreased or dereased the value of benefits? If yes, hek the appropriate box. If no, hek the No box.... X Inrease X Derease X Both X No Part IV ESOPs (see instrutions). If this is not a plan desribed under Setion 409(a) or 4975(e)(7) of the Internal Revenue Code, skip this Part. 10 Were unalloated employer seurities or proeeds from the sale of unalloated seurities used to repay any exempt loan?... X Yes X No 11 a Does the ESOP hold any preferred stok?... X Yes X No b If the ESOP has an outstanding exempt loan with the employer as lender, is suh loan part of a bak-to-bak loan? (See instrutions for definition of bak-to-bak loan.)... X Yes X No 12 Does the ESOP hold any stok that is not readily tradable on an established seurities market?... X Yes X No For Paperwork Redution At Notie and OMB Control Numbers, see the instrutions for Form Shedule R (Form 5500) 2013 v

11 Shedule R (Form 5500) 2013 Page 2-1 x Part V Additional Information for Multiemployer Defined Benefit Pension Plans 13 Enter the following information for eah employer that ontributed more than 5% of total ontributions to the plan during the plan year (measured in dollars). See instrutions. Complete as many entries as needed to report all appliable employers. a Name of ontributing employer b EIN Dollar amount ontributed by employer d Date olletive bargaining agreement expires (If employer ontributes under more than one olletive bargaining agreement, hek box X and see instrutions regarding required attahment. Otherwise, enter the appliable date.) Month Day Year e Contribution rate information (If more than one rate applies, hek this box X and see instrutions regarding required attahment. Otherwise, omplete lines 13e(1) and 13e(2).) (1) Contribution rate (in dollars and ents) (2) Base unit measure: X Hourly X Weekly X Unit of prodution X Other (speify): a Name of ontributing employer b EIN Dollar amount ontributed by employer d Date olletive bargaining agreement expires (If employer ontributes under more than one olletive bargaining agreement, hek box X and see instrutions regarding required attahment. Otherwise, enter the appliable date.) Month Day Year e Contribution rate information (If more than one rate applies, hek this box X and see instrutions regarding required attahment. Otherwise, omplete lines 13e(1) and 13e(2).) (1) Contribution rate (in dollars and ents) (2) Base unit measure: X Hourly X Weekly X Unit of prodution X Other (speify): a Name of ontributing employer b EIN Dollar amount ontributed by employer d Date olletive bargaining agreement expires (If employer ontributes under more than one olletive bargaining agreement, hek box X and see instrutions regarding required attahment. Otherwise, enter the appliable date.) Month Day Year e Contribution rate information (If more than one rate applies, hek this box X and see instrutions regarding required attahment. Otherwise, omplete lines 13e(1) and 13e(2).) (1) Contribution rate (in dollars and ents) (2) Base unit measure: X Hourly X Weekly X Unit of prodution X Other (speify): a Name of ontributing employer b EIN Dollar amount ontributed by employer d Date olletive bargaining agreement expires (If employer ontributes under more than one olletive bargaining agreement, hek box X and see instrutions regarding required attahment. Otherwise, enter the appliable date.) Month Day Year e Contribution rate information (If more than one rate applies, hek this box X and see instrutions regarding required attahment. Otherwise, omplete lines 13e(1) and 13e(2).) (1) Contribution rate (in dollars and ents) (2) Base unit measure: X Hourly X Weekly X Unit of prodution X Other (speify): a Name of ontributing employer b EIN Dollar amount ontributed by employer d Date olletive bargaining agreement expires (If employer ontributes under more than one olletive bargaining agreement, hek box X and see instrutions regarding required attahment. Otherwise, enter the appliable date.) Month Day Year e Contribution rate information (If more than one rate applies, hek this box X and see instrutions regarding required attahment. Otherwise, omplete lines 13e(1) and 13e(2).) (1) Contribution rate (in dollars and ents) (2) Base unit measure: X Hourly X Weekly X Unit of prodution X Other (speify): a Name of ontributing employer b EIN Dollar amount ontributed by employer d Date olletive bargaining agreement expires (If employer ontributes under more than one olletive bargaining agreement, hek box X and see instrutions regarding required attahment. Otherwise, enter the appliable date.) Month Day Year e Contribution rate information (If more than one rate applies, hek this box X and see instrutions regarding required attahment. Otherwise, omplete lines 13e(1) and 13e(2).) (1) Contribution rate (in dollars and ents) (2) Base unit measure: X Hourly X Weekly X Unit of prodution X Other (speify):

12 Shedule R (Form 5500) 2013 Page 3 14 Enter the number of partiipants on whose behalf no ontributions were made by an employer as an employer of the partiipant for: a The urrent year... 14a b The plan year immediately preeding the urrent plan year... 14b The seond preeding plan year Enter the ratio of the number of partiipants under the plan on whose behalf no employer had an obligation to make an employer ontribution during the urrent plan year to: a The orresponding number for the plan year immediately preeding the urrent plan year... 15a b The orresponding number for the seond preeding plan year... 15b Information with respet to any employers who withdrew from the plan during the preeding plan year: a Enter the number of employers who withdrew during the preeding plan year... 16a b If line 16a is greater than 0, enter the aggregate amount of withdrawal liability assessed or estimated to be assessed against suh withdrawn employers... 16b If assets and liabilities from another plan have been transferred to or merged with this plan during the plan year, hek box and see instrutions regarding supplemental information to be inluded as an attahment.... X Part VI Additional Information for Single-Employer and Multiemployer Defined Benefit Pension Plans 18 If any liabilities to partiipants or their benefiiaries under the plan as of the end of the plan year onsist (in whole or in part) of liabilities to suh partiipants and benefiiaries under two or more pension plans as of immediately before suh plan year, hek box and see instrutions regarding supplemental information to be inluded as an attahment... X 19 If the total number of partiipants is 1,000 or more, omplete lines (a) through () a Enter the perentage of plan assets held as: Stok: % Investment-Grade Debt: % High-Yield Debt: % Real Estate: % Other: % b Provide the average duration of the ombined investment-grade and high-yield debt: X 0-3 years X 3-6 years X 6-9 years X 9-12 years X years X years X years X 21 years or more What duration measure was used to alulate line 19(b)? X Effetive duration X Maaulay duration X Modified duration X Other (speify):

13

14

15

16

17

18

19

20

21

22

23

24

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Servie Department of Labor Employee Benefits Seurity Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit Plan

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Servie Department of Labor Employee Benefits Seurity Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit Plan

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Report Identification Information

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Report Identification Information

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

a Sponsor s name. ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI 3c Administrator s telephone

a Sponsor s name. ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI 3c Administrator s telephone Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 55 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee Benefit

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

(and proxy tax under section 6033(e)) 2012

(and proxy tax under section 6033(e)) 2012 Form Department of the Treasury Internal Revenue Servie A For alendar year 01 or other tax year beginning, and ending 4 Unrelated business taxable. Subtrat line from line. If line is greater than line,

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

TAX RETURN FILING INSTRUCTIONS

TAX RETURN FILING INSTRUCTIONS TA RETURN FILING INSTRUCTIONS FORM 0-T FOR THE YEAR ENDING ~~~~~~~~~~~~~~~~~ June 0, 014 Prepared for Prepared by Amount due or refund Make hek payable to Mail tax return and hek (if appliable) to Susquehanna

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Report Identification Information

More information

DARCANGELO & CO., LLP LOMOND COURT UTICA NY

DARCANGELO & CO., LLP LOMOND COURT UTICA NY Form 5500 (2006) Page 2 Official Use Only 3a Plan administrator s name and address (If same as plan sponsor, enter "Same") 3b Administrator s EIN SAME 3c Administrator s telephone number 4 If the name

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Number, street, and room or suite no. (If a P.O. box, see page 5 of instructions.) C Date incorporated

Number, street, and room or suite no. (If a P.O. box, see page 5 of instructions.) C Date incorporated Form 0-L Department of the Treasury Internal Revenue Servie A Inome Dedutions (See instrutions for limitations on dedutions.) Tax and Payments (See page of instrutions) Chek if: () Consolidated return

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 55 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee Benefit

More information

2009 Plan Information Worksheet

2009 Plan Information Worksheet Plan Sponsor Information 2009 Plan Information Worksheet Status: Plan Sponsor's Name Plan Sponsor's Mailling Address Foreign American University of Beirut 3 DAG Hammarskjold Plaza, 8th Floor Abbreviated

More information

State of New Mexico Distribution Request for Deferred Compensation Plan

State of New Mexico Distribution Request for Deferred Compensation Plan State of New Mexio Distribution Request for Deferred Compensation Plan DC-4075 (12/2015) For help, please all 1-866-827-6639 www.newmexio457d.om 1 Things to Remember Complete all of the setions on the

More information

Exempt Organization Business Income Tax Return

Exempt Organization Business Income Tax Return Form For alendar year 014 or other tax year eginning, and ending. 4 Unrelated usiness taxale inome. Sutrat line from line. If line is greater than line, enter the smaller of zero or line 401 01-1-15 LHA

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Exempt Organization Business Income Tax Return

Exempt Organization Business Income Tax Return Form OMB No. 1545-0687 For alendar year 2016 or other tax year eginning, and ending. Information aout Form 0-T and its instrutions is availale at www.irs.gov/form0t. Department of the Treasury Open to

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit

More information

County of San Diego Retirement Benefit Options

County of San Diego Retirement Benefit Options County of San Diego Retirement Benefit Options NDC-0619 (09/2016) For help, please all 888-DC4-LIFE mydcplan.om 1 Things to Remember Complete all of the setions on the Retirement Benefit Options form that

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 55 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee Benefit

More information

ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI

ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI Form 5500 (2014) Page 2 3a Plan administrator s name and address XSame as Plan Sponsor X EFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c/o EFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI 123456789 ABCDEFGHI ABCDEFGHI ABCDE

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit

More information

Exempt Organization Business Income Tax Return

Exempt Organization Business Income Tax Return Form Department of the Treasury Internal Revenue Servie A For alendar year 015 or other tax year eginning, and ending. Information aout Form 0-T and its instrutions is availale at www.irs.gov/form0t. Do

More information

2013 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)

2013 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Form Part I Short Form 99-EZ Return of Organization Exempt From Inome Tax 213 Under setion 51(), 527, or 4947(a)(1) of the Internal Revenue Code (exept private foundations) Do not enter Soial Seurity numers

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Short Form Return of Organization Exempt From Inome Tax Under setion 501, 527, or 4947(1) of the Internal Revenue Code (exept private foundations) OMB 1545-1150 2015 Department of the Treasury

More information

Short Form 990-EZ Return of Organization Exempt From Income Tax

Short Form 990-EZ Return of Organization Exempt From Income Tax Form B G I J K Short Form 990-EZ Return of Organization Exempt From Inome Tax 2014 Under setion 501(), 527, or 4947(a)(1) of the Internal Revenue Code (exept private foundations) Do not enter soial seurity

More information

State of New Mexico Participation Agreement for Deferred Compensation Plan

State of New Mexico Participation Agreement for Deferred Compensation Plan State of New Mexio Partiipation Agreement for Deferred Compensation Plan DC-4068 (06/2016) For help, please all 1-866-827-6639 www.newmexio457d.om 1 Things to Remember Please print Payroll Center/Plan

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit

More information

Important information about our Unforeseeable Emergency Application

Important information about our Unforeseeable Emergency Application Page 1 of 4 Questions? Call 877-NRS-FORU (877-677-3678) Visit us online Go to nrsforu.om to learn about our produts, servies and more. Important information about our Unforeseeable Emergeny Appliation

More information

Health Savings Account Application

Health Savings Account Application Health Savings Aount Appliation FOR BANK USE ONLY: ACCOUNT # CUSTOMER # Health Savings Aount (HSA) Appliation ALL FIELDS MUST BE COMPLETED. Missing fields may delay the aount opening proess and possibly

More information

Short Form 990-EZ Return of Organization Exempt From Income Tax

Short Form 990-EZ Return of Organization Exempt From Income Tax Form Short Form 990-EZ Return of Organization Exempt From Inome Tax 05 B Chek if appliale: G I J K Under setion 50(), 57, or 4947(a)() of the Internal Revenue Code (exept private foundations) Do not enter

More information

PUBLIC FILE COPY DO NOT FILE THIS COPY WITH THE IRS.

PUBLIC FILE COPY DO NOT FILE THIS COPY WITH THE IRS. THIS FEDERAL FORM 990 SHOULD BE USED FOR COPYING FOR ANYONE REQUESTING A COPY OF THE FORM 99 ALL SCHEDULES OF CONTRIBUTORS HAVE BEEN REMOVED FROM THIS COPY AS ALLOWED BY LAW. DO NOT FILE THIS COPY WITH

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Part I. Revenue. Operating and Administrative Expenses. For calendar year 2011 or tax year beginning, 2011, and ending, 20

Part I. Revenue. Operating and Administrative Expenses. For calendar year 2011 or tax year beginning, 2011, and ending, 20 Form 990-PF Department of the Treasury Internal Revenue Servie Return of Private Foundation or Setion 4947(a)(1) Nonexempt Charitale Trust Treated as a Private Foundation Note. The foundation may e ale

More information

STATE REGISTRATION NO Short Form Return of Organization Exempt From Income Tax

STATE REGISTRATION NO Short Form Return of Organization Exempt From Income Tax Form Department of the Treasury Internal Revenue Servie A B For the 0 alendar year, or tax year eginning Chek if appliale: C Name of organization JUL, 0 and ending JUN 0, 0 OMB No. 55-50 Open to Puli Inspetion

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Short Form Return of Organization Exempt From Inome Tax Under setion 501(), 57, or 4947(a)(1) of the Internal Revenue Code (exept private foundations) OMB No. 1545-1150 013 Department of the

More information

County of San Diego Participation Agreement for 457(b) Deferred Compensation Plan

County of San Diego Participation Agreement for 457(b) Deferred Compensation Plan County of San Diego Partiipation Agreement for 457(b) Deferred Compensation Plan DC-4769 (07/16) For help, please all 1-888-DC4-LIFE www.mydcplan.om 1 Things to Remember Complete all of the setions on

More information

COLLECTIVE INVESTMENT SCHEMES (DEFINITION) ORDER 2017

COLLECTIVE INVESTMENT SCHEMES (DEFINITION) ORDER 2017 Colletive Investment Shemes (Definition) Order 2017 Artile 1 Statutory Doument No. 2017/0260 Colletive Investment Shemes At 2008 COLLECTIVE INVESTMENT SCHEMES (DEFINITION) ORDER 2017 Approved by Tynwald:

More information

See separate instructions. Your first name and initial. Your social security number John Smith Applied For

See separate instructions. Your first name and initial. Your social security number John Smith Applied For Form () 40 U.S. Individual Inome Tax Return 2016 OMB No. 1545-0074 Attah Form(s) W-2 here. Also attah Forms W-2G and -R if tax was withheld. 6001-30-16 1 2 3 IRS Use Only - Do not write or staple in this

More information

** PUBLIC DISCLOSURE COPY ** Short Form Return of Organization Exempt From Income Tax 990-EZ Name change HOSPITAL FOUNDATION

** PUBLIC DISCLOSURE COPY ** Short Form Return of Organization Exempt From Income Tax 990-EZ Name change HOSPITAL FOUNDATION OMB 1545-50 Under setion 501, 57, or 4947(1) of the Internal Revenue Code Form (exept lak lung enefit trust or private foundation) Sponsoring organizations of donor advised funds, organizations that operate

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Short Form Return of Organization Exempt From Inome Tax Under setion 501(), 57, or 4947(a)(1) of the Internal Revenue Code (exept private foundations) OMB No. 1545-1150 013 Department of the

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form Department of the Treasury Internal Revenue Servie A B G I J K Address hange Name hange Initial return Final return/terminated Amended return Appliation pending Aounting Method: Wesite: u Form of

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee Benefit

More information

Application for Determination for Employee Benefit Plan

Application for Determination for Employee Benefit Plan Department of the Treasury Internal Reenue Serie Appliation for Determination for Employee Benefit Plan (Under setions 401(a) and 501(a) of the Internal Reenue Code) OMB. 1545-0197 Expires 11-30-95 For

More information

Retirement Benefits Schemes (Miscellaneous Amendments) RETIREMENT BENEFITS SCHEMES (MISCELLANEOUS AMENDMENTS) REGULATIONS 2014

Retirement Benefits Schemes (Miscellaneous Amendments) RETIREMENT BENEFITS SCHEMES (MISCELLANEOUS AMENDMENTS) REGULATIONS 2014 Retirement Benefits Shemes (Misellaneous Amendments) Index RETIREMENT BENEFITS SCHEMES (MISCELLANEOUS AMENDMENTS) REGULATIONS 2014 Index Regulation Page 1 Title... 3 2 Commenement... 3 3 Amendment of the

More information

Short Form Annual Return/Report of Small Employee Benefit Plan

Short Form Annual Return/Report of Small Employee Benefit Plan 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

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Short Form Return of Organization Exempt From Inome Tax Under setion 0(),, or 9(a)() of the Internal Revenue Code (exept private foundations) OMB No. -0 0 Department of the Treasury Internal

More information

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.

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. This form is referenced in an endnote at the Bradford Tax Institute. CLICK HERE to go to the home page. Attention: Telephone requests for the forms, schedules, and instructions for the 2008 Form 5500-series

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 55 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee Benefit

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Short Form Return of Organization Exempt From Inome Tax Under setion 50(), 57, or 4947(a)() of the Internal Revenue Code (exept private foundations) OMB No. 545-50 0 Department of the Treasury

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Short Form 990-EZ Return of Organization Exempt From Income Tax

Short Form 990-EZ Return of Organization Exempt From Income Tax Form Short Form 990-EZ Return of Organization Exempt From Inome Tax 05 Under setion 50(), 57, or 4947(a)() of the Internal Revenue Code (exept private foundations) Do not enter soial seurity numers on

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Short Form Return of Organization Exempt From Inome Tax Under setion 501(), 527, or 4947(a)(1) of the Internal Revenue Code (exept private foundations) OMB No. 1545-1150 2013 Department of

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation. Initial return of a former public charity ...

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation. Initial return of a former public charity ... 611 Form 99-PF Return of Private Foundation or Setion 4947(a)(1) Trust Treated as Private Foundation Department of the Treasury u Do not enter Soial Seurity numers on this form as it may e made puli. Internal

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

PUBLIC DISCLOSURE COPY - STATE REGISTRATION NO Short Form Return of Organization Exempt From Income Tax

PUBLIC DISCLOSURE COPY - STATE REGISTRATION NO Short Form Return of Organization Exempt From Income Tax Form 990-EZ PUBLIC DISCLOSURE COPY - STATE REGISTRATION NO. 900 Short Form Return of Organization Exempt From Inome Tax Under setion 0(),, or 9() of the Internal Revenue Code (exept private foundations)

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Short Form Return of Organization Exempt From Inome Tax Under setion 0(),, or 9() of the Internal Revenue Code (exept private foundations) OMB -0 0 Department of the Treasury Internal Revenue

More information

PUBLIC DISCLOSURE COPY Short Form Return of Organization Exempt From Income Tax

PUBLIC DISCLOSURE COPY Short Form Return of Organization Exempt From Income Tax Form 990-EZ PUBLIC DISCLOSURE COPY Short Form Return of Organization Exempt From Inome Tax Under setion 501(), 527, or 4947(a)(1) of the Internal Revenue Code (exept private foundations) OMB No. 1545-1150

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee

More information

Short Form 990-EZ Return of Organization Exempt From Income Tax

Short Form 990-EZ Return of Organization Exempt From Income Tax Form Short Form 99-EZ Return of Organization Exempt From Inome Tax 216 Department of the Treasury Internal Revenue Servie Under setion 51(), 527, or 4947(a)(1) of the Internal Revenue Code (exept private

More information

Short Form Return of Organization Exempt From Income Tax 990-EZ 2011

Short Form Return of Organization Exempt From Income Tax 990-EZ 2011 OMB. 155-1150 Under setion 501(), 57, or 97(a)(1) of the Internal Revenue Code Form (exept lak lung enefit trust or private foundation) Sponsoring organizations of donor advised funds, organizations that

More information

(b) Net investment ) <) (c) Adjusted net (d) Disbursements 53, , , , goods sold 420 C Gross profit or (loss) (attach schedule)

(b) Net investment ) <) (c) Adjusted net (d) Disbursements 53, , , , goods sold 420 C Gross profit or (loss) (attach schedule) Form 990-PF Return of Private Foundation or Setion 4947(aXl) Trust Treated as Private Foundation Do not enter soial seurity numbers Department of on this form as it may be made publi. the Treasury Internal

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 55 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Part I Annual Return/Report of Employee Benefit

More information

Public Disclosure Copy

Public Disclosure Copy Form 990-EZ ** PUBLIC DISCLOSURE COPY ** Short Form Return of Organization Exempt From Inome Tax Under setion 0(),, or 9() of the Internal Revenue Code (exept private foundations) OMB -0 0 Department of

More information

EXTENDED TO MAY 16, 2016 Short Form Return of Organization Exempt From Income Tax. terminated 430 FRANKLIN VILLAGE DR, #

EXTENDED TO MAY 16, 2016 Short Form Return of Organization Exempt From Income Tax. terminated 430 FRANKLIN VILLAGE DR, # Form 990-EZ ETENDED TO MAY, 0 Short Form Return of Organization Exempt From Inome Tax Under setion 0(),, or 9(a)() of the Internal Revenue Code (exept private foundations) OMB No. -0 0 Department of the

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form Department of the Treasury Internal Revenue Servie A B G I J K Chek if appliale: Address hange Name hange Initial return Final return/terminated Amended return Appliation pending Aounting Method:

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation. Initial return of a former public charity ...

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation. Initial return of a former public charity ... CO3809 0 Form 990-PF Return of Private Foundation or Setion 4947(a)() Trust Treated as Private Foundation Department of the Treasury u Do not enter soial seurity numers on this form as it may e made puli.

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form Department of the Treasury Internal Revenue Servie A B G I J K Chek if appliale: Address hange Name hange Initial return Final return/terminated Amended return Appliation pending Aounting Method:

More information

Short Form 990-EZ Return of Organization Exempt From Income Tax

Short Form 990-EZ Return of Organization Exempt From Income Tax Form Short Form 990-EZ Return of Organization Exempt From Inome Tax 05 Department of the Treasury Internal Revenue Servie Under setion 50(), 57, or 4947(a)() of the Internal Revenue Code (exept private

More information

PUBLIC DISCLOSURE COPY THE PREEMPTIVE LOVE COALITI

PUBLIC DISCLOSURE COPY THE PREEMPTIVE LOVE COALITI Caution: Forms printed from within Adoe Aroat produts may not meet IRS or state taxing ageny speifiations. When using Aroat.x produts, unhek the "Shrink oversized pages to paper size" and unhek the "Expand

More information

Short Form 990-EZ Return of Organization Exempt From Income Tax

Short Form 990-EZ Return of Organization Exempt From Income Tax Form Short Form 990-EZ Return of Organization Exempt From Inome Tax 06 Department of the Treasury Internal Revenue Servie Under setion 50(), 57, or 4947(a)() of the Internal Revenue Code (exept private

More information

Short Form 990-EZ Return of Organization Exempt From Income Tax

Short Form 990-EZ Return of Organization Exempt From Income Tax Form B G I Short Form 990-EZ Return of Organization Exempt From Inome Tax 2013 Under setion 501(), 527, or 4947(a)(1) of the Internal Revenue Code (exept private foundations) Do not enter Soial Seurity

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form Department of the Treasury Internal Revenue Servie A B I J K Under setion 51(), 527, or 4947(a)(1) of the Internal Revenue Code (exept lak lung enefit trust or private foundation) u Sponsoring organizations

More information

Annual Return/Report of Employee Benefit Plan

Annual Return/Report of Employee Benefit Plan Form 5500 Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration Pension Benefit Guaranty Corporation Annual Return/Report of Employee Benefit

More information

Short Form Return of Organization Exempt From Income Tax 990-EZ 2011

Short Form Return of Organization Exempt From Income Tax 990-EZ 2011 OMB No. 155-1150 Form Under setion 501(), 527, or 97(a)(1) of the Internal Revenue Code (exept lak lung enefit trust or private foundation) Sponsoring organizations of donor advised funds, organizations

More information