Schedule G Financial Transaction Schedules

SCHEDULE G
(Form 5500)
Department of the Treasury
Internal Revenue Service

έ File as an attachment to Form 5500.

For calendar plan year 2007 or fiscal plan year beginning
A Name of Plan

,

Name of plan sponsor as shown on line 2a of Form 5500

Part I

OMB No. 1210-0110

This schedule is required to be filed under section 104 of the Employee
Retirement Income Security Act of 1974 (ERISA) and section 6058(a) of the
Internal Revenue Code (the Code).

Department of Labor
Employee Benefits Security Administration

C

Official Use Only

Financial Transaction Schedules

2007
This Form is Open to
Public Inspection.

and ending
,
B Three-digit
plan number έ
D Employer Identification Number

Schedule of Loans or Fixed Income Obligations in Default or Classified as Uncollectible
(c)
Original amount of loan

(b)
Identity and address of obligor

(a)

Amount received during reporting year
(d) Principal
(e) Interest

(f)
Unpaid balance at end of year

(g)
Detailed description of loan including dates of making and maturity, interest rate, the type and
value of collateral, any renegotiation of the loan and the terms of the renegotiation, and other material items

Amount overdue
(h) Principal

(i) Interest

For Paperwork Reduction Act Notice and OMB Control Numbers, see the instructions for Form 5500.

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Schedule G (Form 5500) 2007

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(b)
Identity and address of obligor

(a)

Amount received during reporting year
(d) Principal
(e) Interest

(c)
Original amount of loan

(f)
Unpaid balance at end of year

(g)
Detailed description of loan including dates of making and maturity, interest rate, the type and
value of collateral, any renegotiation of the loan and the terms of the renegotiation, and other material items

Amount overdue
(h) Principal

(i) Interest

(b)
Identity and address of obligor

(a)

Amount received during reporting year
(d) Principal
(e) Interest

(c)
Original amount of loan

(f)
Unpaid balance at end of year

(g)
Detailed description of loan including dates of making and maturity, interest rate, the type and
value of collateral, any renegotiation of the loan and the terms of the renegotiation, and other material items

Amount overdue
(h) Principal

(i) Interest

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Part II

Schedule of Leases in Default or Classified as Uncollectible
(b) Identity of
lessor/lessee

(a)

(c) Relationship to plan, employer, employee
organization or other party-in-interest

(d) Terms and description (type of property, location and date it was purchased, terms
regarding rent, taxes, insurance, repairs, expenses, renewal options, date property was leased)
(e) Original
cost

(f) Current value at
time of lease

(g) Gross rental receipts
during the plan year

(h) Expenses paid during
the plan year

(i) Net
receipts

(j) Amount in
arrears

(b) Identity of
lessor/lessee

(a)

(c) Relationship to plan, employer, employee
organization or other party-in-interest

(d) Terms and description (type of property, location and date it was purchased, terms
regarding rent, taxes, insurance, repairs, expenses, renewal options, date property was leased)
(e) Original
cost

(f) Current value at
time of lease

(g) Gross rental receipts
during the plan year

(h) Expenses paid during
the plan year

(i) Net
receipts

(j) Amount in
arrears

(b) Identity of
lessor/lessee

(a)

(c) Relationship to plan, employer, employee
organization or other party-in-interest

(d) Terms and description (type of property, location and date it was purchased, terms
regarding rent, taxes, insurance, repairs, expenses, renewal options, date property was leased)
(e) Original
cost

(f) Current value at
time of lease

(g) Gross rental receipts
during the plan year

(h) Expenses paid during
the plan year

(i) Net
receipts

(j) Amount in
arrears
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Part III

Nonexempt Transactions
If a nonexempt prohibited transaction occurred with respect to a disqualified person, file Form 5330 with the IRS to
pay the excise tax on the transaction.
(a) Identity of party involved

(b) Relationship to plan, employer, or other party-in-interest

(c) Description of transactions including maturity date, rate of interest, collateral, par or maturity value

(d) Purchase price

(e) Selling price

(f) Lease rental

(h) Cost of asset

(i) Current value of asset

(j) Net gain or (loss) on
each transaction

(a) Identity of party involved

(g) Expenses incurred in
connection with transaction

(b) Relationship to plan, employer, or other party-in-interest

(c) Description of transactions including maturity date, rate of interest, collateral, par or maturity value

(d) Purchase price

(e) Selling price

(f) Lease rental

(h) Cost of asset

(i) Current value of asset

(j) Net gain or (loss) on
each transaction

(a) Identity of party involved

(g) Expenses incurred in
connection with transaction

(b) Relationship to plan, employer, or other party-in-interest

(c) Description of transactions including maturity date, rate of interest, collateral, par or maturity value

(d) Purchase price

(e) Selling price

(f) Lease rental

(h) Cost of asset

(i) Current value of asset

(j) Net gain or (loss) on
each transaction

(g) Expenses incurred in
connection with transaction

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