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and ending
Name of plan or DFE
Plan or DFE sponsor's name as shown on line 2a of Form 5500
NO
T
Information on interests in MTIAs, CCTs, PSAs, and 103-12 IEs (to be completed by plans and DFEs)
Name of MTIA, CCT, PSA, or 103-12IE
Name of MTIA, CCT, PSA, or 103-12IE
EIN
PN
(e) Dollar value of interest in MTIA, CCT, PSA, or
103-12IE at end of year (see instructions)
▲
▲
▲
.00
(e) Dollar value of interest in MTIA, CCT, PSA, or
103-12IE at end of year (see instructions)
(d) Entity
code
IN
FO
RM
AT
IO
N
(b) Name of sponsor of entity listed in (a)
(c)
(d) Entity
code
PN
PU
RP
OS
ES
(a)
EIN
ON
LY
,
(b) Name of sponsor of entity listed in (a)
(c)
Employer Identification Number
DO
(a)
D
Three-digit
plan number
US
E
B
Part I
FI
LI
NG
For calendar plan year 2007
or fiscal plan year beginning
C
2007
This Form is Open to
Public Inspection.
File as an attachment to Form 5500.
FO
R
Department of Labor
Employee Benefits Security Administration
A
OMB No. 1210-0110
This schedule is required to be filed under section 104 of the Employee
Retirement Income Security Act of 1974 (ERISA).
▼
Department of the Treasury
Internal Revenue Service
Official Use Only
DFE/Participating Plan Information
▼
SCHEDULE D
(Form 5500)
▲
▲
▲
.00
FO
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For Paperwork Reduction Act Notice and OMB Control Numbers, see the instructions for Form 5500. Cat. No. 22774J Schedule D (Form 5500) 2007
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v10.1
Schedule D (Form 5500) 2007
Page
2
Official Use Only
Name of MTIA, CCT, PSA, or 103-12IE
FI
LI
NG
(a)
(b) Name of sponsor of entity listed in (a)
EIN
(e) Dollar value of interest in MTIA, CCT, PSA, or
103-12IE at end of year (see instructions)
(d) Entity
code
PN
Name of MTIA, CCT, PSA, or 103-12IE
(b) Name of sponsor of entity listed in (a)
Name of MTIA, CCT, PSA, or 103-12IE
(b) Name of sponsor of entity listed in (a)
(a)
EIN
.00
DO
(e) Dollar value of interest in MTIA, CCT, PSA, or
103-12IE at end of year (see instructions)
(d) Entity
code
PN
IN
FO
RM
AT
IO
N
(c)
(d) Entity
code
PN
▲
ON
LY
,
(a)
EIN
PU
RP
OS
ES
(c)
▲
NO
T
(a)
▲
US
E
▲
FO
R
(c)
▲
▲
.00
(e) Dollar value of interest in MTIA, CCT, PSA, or
103-12IE at end of year (see instructions)
▲
▲
▲
.00
Name of MTIA, CCT, PSA, or 103-12IE
(b) Name of sponsor of entity listed in (a)
EIN
(d) Entity
code
PN
(e) Dollar value of interest in MTIA, CCT, PSA, or
103-12IE at end of year (see instructions)
▲
FO
R
(c)
1
1
0
7
0
0
0
2
0
B
▲
▲
.00
Schedule D (Form 5500) 2007
Page
3
Official Use Only
(a)
Information on Participating Plans (to be completed by DFEs)
FI
LI
NG
Part II
Plan name
EIN
(a)
Plan name
PN
US
E
(c)
FO
R
(b) Name of plan sponsor
(a)
Plan name
PN
DO
EIN
ON
LY
,
(c)
NO
T
(b) Name of plan sponsor
(c)
EIN
(a)
Plan name
PN
EIN
(a)
Plan name
PN
IN
FO
RM
AT
IO
N
(b) Name of plan sponsor
(c)
PU
RP
OS
ES
(b) Name of plan sponsor
(b) Name of plan sponsor
EIN
PN
FO
R
(c)
1
1
0
7
0
0
0
3
0
C
Schedule D (Form 5500) 2007
Page
4
Official Use Only
Plan name
FI
LI
NG
(a)
EIN
(a)
Plan name
PN
US
E
(c)
FO
R
(b) Name of plan sponsor
EIN
(a)
Plan name
PN
DO
(c)
NO
T
(b) Name of plan sponsor
EIN
(a)
Plan name
PN
(b) Name of plan sponsor
EIN
(a)
Plan name
PN
IN
FO
RM
AT
IO
N
(c)
PU
RP
OS
ES
(c)
ON
LY
,
(b) Name of plan sponsor
(b) Name of plan sponsor
EIN
PN
FO
R
(c)
1
1
0
7
0
0
0
4
0
D
| File Type | application/pdf |
| File Title | 75500d.pmd |
| Author | rhodhm |
| File Modified | 2007-06-07 |
| File Created | 2007-06-06 |