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pdfCUMULATIVE CHANGES
SCHEDULE G
(Form 5500)
Department of the Treasury
Internal Revenue Service
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).
2008
▼
Department of Labor
Employee Benefits Security
Administration
For calendar plan year 2008
or fiscal plan year beginning
C
MM / D D / Y Y Y Y
Name of plan sponsor as shown on line 2a of Form 5500
MM / D D / Y Y Y Y
Three-digit
plan number
D
Employer Identification Number
▼
B
Schedule of Loans or Fixed Income Obligations in Default or Classified as Uncollectible
Party-in-interest
(b) Identity and address of obligor
Street
City
▲
▲
.00
▲
▲
.00
▲
▲
.00
▲
(d) Principal
▲
3R
Amount
received during
reporting year
State
D
Original amount of loan
PR
Name
(c)
and ending
Name of plan
Part I
(a)
This Form is Open to
Public Inspection.
File as an attachment to Form 5500.
O
O
F
A
Official Use Only
Financial Transaction Schedules
(e) Interest
▲
Zip Code
(f) Unpaid balance at end of year
▲
▲
▲
.00
(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
Amt. overdue
(h) Principal
▲
▲
.00
▲
Amt. overdue
(i) Interest
▲
▲
▲
.00
For Paperwork Reduction Act Notice and OMB Control Numbers, see the instructions for Form 5500. Cat. No. 14739A Schedule G (Form 5500) 2008
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Schedule G (Form 5500) 2008
Page
2
Official Use Only
(a)
Party-in-interest
(b) Identity and address of obligor
Name
Street
City
▲
▲
▲
.00
(d) Principal
▲
▲
▲
.00
(e) Interest
▲
▲
▲
.00
Original amount of loan
Amount
received during
reporting year
Zip Code
(f) Unpaid balance at end of year
▲
O
O
F
(c)
State
▲
▲
.00
(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
(a)
▲
▲
Party-in-interest
(c)
3R
Name
City
Original amount of loan
Amount
received during
reporting year
Amt. overdue
(i) Interest
▲
▲
▲
.00
▲
.00
D
(b) Identity and address of obligor
Street
.00
▲
PR
Amt. overdue
(h) Principal
State
▲
▲
▲
.00
(d) Principal
▲
▲
▲
.00
(e) Interest
▲
▲
▲
.00
Zip Code
(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
Amt. overdue
(h) Principal
▲
▲
.00
▲
2
3
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8
0
Amt. overdue
(i) Interest
0
0
2
▲
0
▲
▲
F
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.00
Schedule G (Form 5500) 2008
Page
3
Official Use Only
Part II
Schedule of Leases in Default or Classified as Uncollectible
(a) Party-in-interest
(b) Identity of lessor/lessee
(c)
Relationship to plan, employer, employee organization or other party-in-interest
(e)
Original cost
(h) Expenses paid during the plan year
▲
(f)
O
O
F
(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)
▲
.00
▲
Current value at time of lease
▲
▲
(i)
.00
▲
(g) Gross rental receipts during the plan year
▲
.00
▲
.00
▲
▲
▲
.00
▲
▲
.00
Amount in arrears
▲
Relationship to plan, employer, employee organization or other party-in-interest
3R
(c)
▲
D
(a) Party-in-interest
(b) Identity of lessor/lessee
▲
Net receipts
PR
▲
(j)
▲
(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
(h) Expenses paid during the plan year
▲
(f)
▲
.00
▲
Current value at time of lease
▲
▲
(i)
(g) Gross rental receipts during the plan year
▲
▲
(j)
2
3
0
▲
.00
▲
▲
▲
.00
▲
▲
.00
Amount in arrears
.00
▲
▲
Net receipts
.00
▲
▲
▲
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Schedule G (Form 5500) 2008
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4
Official Use Only
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
(h) Cost of asset
(d) Purchase price
(e)
▲
▲
(i)
Selling price
▲
(f)
.00
▲
▲
.00
▲
(j)
▲
.00
▲
▲
▲
.00
▲
▲
.00
▲
▲
.00
▲
▲
.00
▲
.00
PR
.00
▲
Identity of party involved
D
(a)
▲
.00
Net gain or (loss) on each transaction
▲
(g) Expenses incurred in connection with transaction
▲
▲
Current value of asset
▲
Lease rental
▲
▲
O
O
F
▲
(c)
3R
(b) Relationship to plan, employer, or other party-in-interest
Description of transactions including maturity date, rate of interest, collateral, par or maturity value
(h) Cost of asset
(d) Purchase price
▲
(e)
.00
▲
▲
(i)
Selling price
▲
(f)
▲
▲
.00
▲
▲
(j)
Lease rental
▲
▲
Current value of asset
Net gain or (loss) on each transaction
.00
▲
▲
▲
(g) Expenses incurred in connection with transaction
▲
▲
.00
▲
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| File Type | application/pdf |
| File Title | 85500g.pmd |
| Author | rhodhm |
| File Modified | 2008-06-27 |
| File Created | 2008-05-01 |