Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)

Appendix 2 - PPA Form

Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)

OMB: 1212-0049

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1212-0049 can be found here:

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Appendix 2

Instructions

The following table represents the text that appears when the filer the clicks "Help" on each screen of the
web-based application.
Screen
#

Schedule
Reference

Account
Sign up

Help Text

Getting started

If you have not applied for an e-4010 account yet, click the "Apply for an Account" button
to be directed to the Account Sign Up screen. Enter information for each item on this
screen. The person whose information is entered on this screen is the sole contact
person for the filing. For example:

•

After signing up for an account, a temporary User ID and password will be sent to
the e-mail address entered here.

•

After submitting a filing, a confirmation receipt will be sent to this e-mail address.

•

This person may be contacted by phone or e-mail if PBGC has questions regarding
the filing.

If the contact person does not have an assigned title, enter N/A or no title, as the
application does not allow for items on this screen to be left blank.
The secret question and answer will be used if your User ID/password is lost or
forgotten, so make sure it reflects information that you can remember easily but is
difficult for an unauthorized person to obtain. To retrieve a forgotten or lost ID or
password, you will need to remember both the question you select and the answer to
that question.

The "manage account" feature can be used to change contact information (phone
number, e-mail address, etc.) after an account is established. This feature is accessible
from the e-4010 home screen or any of the Schedule Summary screens.
Who must file

A contributing sponsor of a defined benefit pension plan and each member of the
contributing sponsor's controlled group must file if any one of three specified criteria in
ERISA § 4010.4 is met. In addition, § 4010.6(a)(2) requires that certain information be
reported if a filing was required for the prior information year but is not required for the
current information year. Any filer or other person may submit the information on behalf
of one or more members of a filer's controlled group.

Special reduced reporting rules apply to contributing sponsors to multiple employer
plans, see § 4010.11(d)
Filing due date

With the exception of certain actuarial information, 4010 information must be submitted
electronically on or before the 105th day after the close of the filer's information year.
See § 4010.8(b) and § 4010.10(b) for information on the alternate due date for certain
actuarial information.

In some cases, instead of submitting certain financial information, a reference to a
publicly available source is sufficient. See § 4010.9(d) for information on when publicly
available financial information is sufficient.

January 2009 - updated for PPA

Appendix 2

Instructions

User ID/password

Enter your User ID and password
Forgotten User ID/password

If you lose or forget your User ID, click "Forgot your user ID?" and you will be prompted
to enter your e-mail address. This must be the e-mail address currently associated with
your e-4010 account. You will also be prompted to identify the "secret question" you
chose when you first established an e-4010 account, and to answer that "secret
question". If you answer correctly, an e-mail containing your User ID will be sent to the
e-mail address associated with your account.

If you lose or forget your password, click "Forgot your password?" and you will be
prompted to enter your e-mail address, to identify the "secret question" you chose when
you first established an e-4010 account, and to answer that "secret question". If you
answer correctly, your password will be reset and an e-mail containing a new temporary
password will be sent to the e-mail address associated with your account. The next
time you log in, you will automatically be directed to the "change password" screen.
3

First Time
Login

The first time you log in using your temporary User ID and password, you will be
prompted to select a new User ID and password subject to the following rules:

•

Your User ID must be 8-25 characters in length and may be comprised of letters,
numbers, or a mixture. User IDs are not case-sensitive

•

Your password must be 8-12 characters in length and must contain at least one
number and one letter. Passwords are case-sensitive.

If you are responsible for more than one 4010 filing, the same User ID/password may be
used for all filings.
The secret question and answer will be used to re-set your password if it is lost or
forgotten or if you ever want to change your password, so make sure it reflects
information that you can remember easily but is difficult for any unauthorized person to
obtain.

Note to MyPAA users - If you use MyPAA for premium filings, you will also need a
user ID and password for that system. Your password can be the same for both
systems, but your e-4010 user ID cannot be the same as your MyPAA user ID.
4

Forgot/reset
password

Email address

This must be the e-mail address that is currently associated with your e-4010 account.
Secret question/answer
You must select the "secret question" you chose when you first established an e-4010
account and answer that "secret question".

If you answer correctly, your password will be reset and an e-mail containing a new
temporary password will be sent to the e-mail address currently associated with your e4010 account. The next time you log in, you will automatically be directed to the
"change password" screen.

January 2009 - updated for PPA

Appendix 2

Instructions

Forgot User
ID

Email address
This must be the e-mail address that is currently associated with your e-4010 account.
Secret question/answer

You must select the "secret question" you chose when you first established an e-4010
account and answer that "secret question".

If you answer correctly, an e-mail containing your User ID will be sent to the e-mail
address associated with your account.
6/7

Change
Password

If you want to change your password, select "Change Password" at the top of the
screen. You must be logged into your account in order to do this.
Enter the new password you want to use. It must be between 8-12 characters long.
Your password is case sensitive. You will be prompted to answer your secret question
in order to change your password.

Manage
Account

If you need to update your personal information, click on the "Manage Accounf option at
the top of any screen where the words "Manage Accounf appear (in general, summary
screens). Previously reported contact information for the filing coordinator will appear.
To update the information, just enter new data in the applicable field.

e-4010

This screen shows whether a 4010 filing is still in draft form or if it has already been
submitted to the PBGC. If you are responsible for more than one 4010 filing, this screen
lists all of the filings you've worked on and indicates the filing status (i.e., draft or already
submitted) of each. The first time you log in, the screen will be empty. To begin the
process, click the "Create New 4010 Filing" button. From this screen you can also:

Home Page

•

Edit a draft filing

•

View an already submitted filing by clicking on the "View Filing" button. A form will
appear on the screen showing the information that was submitted to the PBGC.
Draft filings may also be viewed, but they are viewed from the Filing Summary
screen, not from this screen.

•

Print an already submitted filing by first using the view feature described above.
Once the form is on the screen, hit CTRL-P or click "File, Prinf on the browser menu
bar to print a hard copy of the form. Note - There is no "Prinf button.

•

Reassign the filing to someone else. Once you reassign a particular filing, you will
no longer have access to that filing; the next time you login, the reassigned filing will
not appear on your e-4010 home page. You may assign a filing only to someone
who has set up an e-4010 account Additional information on this feature can be
found on screen 42.

•

Amend a previously submitted filing. This "amend" feature should also be used to
attach additional materials to a filing that has already been submitted. For example,
click the "Amend Filing" button to attach a valuation report or a financial statement
that was not available at the time the original filing was submitted.

•

Delete a draft filing

Timing out

After accessing a filing, the application allows twenty minutes between entering
information or clicking a button. After twenty minutes of idle time, the application will
automatically shutdown and information entered, but not saved, will be lost.

January 2009 - updated for PPA

Appendix 2

Instructions

Create new
filing

When creating a new filing you have the choice of entering all information from scratch
or setting up a new filing using information reported in a prior filing. If you select the
"pre-populate" option, you will be able to select which prior filing to use as the starting
point from a complete list of prior filings (for which you are the listed filing coordinator).
You must also report whether the filing is for an information year that begins on or after
January 1,2008, so that the application will know whether the PPA and other regulatory
changes apply.

Create new
filing

This screen appears only if you indicated that you wanted to use a prior filing as a
starting point for a new filing. Select the filing that should be used as a starting point.
In general, Schedule I data will be pre-populated. However, because the data reported
on the other schedules is unlikely to be consistent from year to year, data from other
schedules will not carry over to the newly created draft filing.

Filing
Summary

A list of the different schedules is displayed. Click the applicable schedule to enter data
or to edit and/or review previously entered data. For Schedule I, you can move directly

to the beginning of Sections I, II, or III. For the other schedules, you must move to the
first screen of the schedule and continue clicking "next" buttons until you reach the
desired screen. From this screen, you can also:
•

Enter freeform text comments for any Schedule (other than Schedule P) by clicking
the "Comments" button0. Because each Schedule P relates to a different plan,
Schedule P comments are entered from the Plan Actuarial Information Summary
instead of from this screen.

•

Attach files to schedules other than Schedule P by clicking the "Attachments" button.
Note • Schedule P attachments are attached via the Schedule P summary page.

•

View files that were previously attached to schedules other than Schedule P by
clicking the "Attachments" button.

•

Delete files that were previously attached to schedules other than Schedule P by
clicking the "Attachments" button.

•

View a draft filing by clicking on the "View Draff button, a form will appear on the
screen showing the information entered as of the last time you clicked "Save". The
"View Draft" feature may be used whether or not the filing is complete.

•

Print a draft filing by first using the view feature described above. Once the form is
on the screen, hit CTRL-P or click "File, Print" on the menu bar to print a hard copy

of the form. There is no "Print" button.
•

Perform validation checks on a draft filing by clicking the "Validate Filing" button. A
list of errors will appear on the screen. To print this list click "File, Prinf on the
browser menu. Note — if you perform a validation check before completing the
entire filing, you will likely get a long list of errors.

•

Logout of the application by clicking the word "Logouf at the top right corner of the
screen. There's no need to worry about losing information because any time you
click a button to be taken back to the Filing Summary, your information will
automatically be saved.

January 2009 - updated for PPA

Appendix 2

Instructions

Filing
Summary
(cont)

•

Submit a filing by clicking the "Submit Filing" button. Before the submission occurs,
the filing will automatically be validated to ensure all necessary information has been
entered and that the filing is internally consistent.

If no errors or inconsistencies are found, the 4010 filing is sent to PBGC and an
e-mail "receipt" will automatically be sent to the e-mail address used when you
first signed up for an account;

If any errors or inconsistencies are found, a list of those errors/inconsistencies
will appear on the screen. The application will not allow a filing to be submitted
until all validation errors have been corrected. To print the error summary, click
"File, Print" on the browser menu.

Once submitted, you will no longer be able to edit the filing. You will, however, be able
to print a hard copy at any time by using the 'View Filing' feature from the home page.
13

Schedule G
- General
Information

Controlled group Information

•

Name: Enter the name of the controlled group. For purposes of 4010 filings, a
"controlled group" is a controlled group of corporations under Code section 414(b)
or a group of trades or businesses under common control under section 414(c) (see
§ 4001.2). It includes all contributing sponsors of the plan and all members of each
contributing sponsor's controlled group.

•

Business code: Enter the 6-digit code that best describes the predominant business
activity of the controlled group. A list of codes can be found in the instructions for
Dremium filinas (available at www.PBGC.qov) or in the instructions for Form 5500. If
entering only one code is inappropriate (i.e., if there is not one clearly applicable
code), use the comments feature to enter additional information.

•

CUSIP number: CUSIP stands for Committee on Uniform Securities Identification
Procedures. A CUSIP number identifies most securities, including stocks of all
registered U.S. and Canadian companies and U.S. government and municipal
bonds. The number consists of nine characters (including letters and numbers) that
uniquely identify a company or issuer and the type of security. If a CUSIP number
has been assigned to publicly traded securities of any member of controlled group,
enter the first 6 characters. If no member of the controlled group has a CUSIP
number, enter N/A. If entering only one CUSIP number is inappropriate, use the
comments feature to enter additional information.

•

Date current Information year ends: In general, the current information year is the
fiscal year of all non-exempt members of the controlled group. If one non-exempt
member has a different fiscal year, the current information year is the calendar year.

•

Filing Contact (If different from filing coordinator): The purpose of this item is to
report who the PBGC should contact if they have a question about the information
reported in the filing. In many cases, this person will be the Filing Coordinator. If
that is the case, leave this item blank. If someone else should be the first point of
contact, enter that person's name and telephone number and other information you
feel is pertinent (e-mail address, title, etc.)

January 2009 - updated for PPA

Instructions

Schedule G
- General
Information
(cont)

Appendix 2

General Filing Information

•

Was a 4010 filing required for the prior Information year? Indicate whether a
full 4010 filing was required for the prior information year. If the only filing
requirement for the prior information year was a requirement to submit a
demonstration of why a full 4010 filing was not required, select "No".

•

Is a 4010 filing required for the current Information year? Select the applicable
box. After entering your selection, click "Next". If you select:
-

"Yes", you will be prompted to begin the 4010 filing,

"No" and a 4010 filing was required for the prior information year, you will be
prompted to complete Schedule FG to demonstrate that a filing is not required
for the current information year,

•

Schedule

FG-80%
FTAP
Gateway
Test

"No" and a 4010 filing was not required for the prior information year, you will be
informed that there is no need to proceed further,

"Help me determine", the application will walk you through the steps needed to
determine if a 4010 filing is required.

§ 4010.6(c) exemption — Check this box if some of the information required to be
reported under 4010 is not being included with this filing because it was already
submitted to the PBGC for another purpose (e.g., as part of the early warning
program). If this box is checked, you must use the comments feature to explain
what materials were previously submitted and when such materials were submitted.

Schedule FG overview

The purpose of Schedule FG is to demonstrate that a filing is not required for the current
information year. Schedule FG must be completed if a 4010 filing was required for the
prior information year and you indicated that a 4010 filing is not required for this year on
Schedule G. Schedule FG may also be completed to help you determine whether or not
a 4010 filing is required. If you're sure a 4010 filing is required for the current year,
there is no need to complete Schedule FG. In this case, click "cancel" to return to the
home page.
80% FTAP gateway test
Reporting is required if any plan sponsored by a member of the controlled group had a
funding target attainment percentage (FTAP) below 80%. The following rules apply for
purposes of making this determination:
•

In general, the FTAP for a plan for a plan year equals the funding target attainment
percentage as provided under ERISA section 303(d)(2) determined as of the
valuation date for the plan year.

•

See § 4010.4(b)(3) for a transition rule applicable to plans with plan years ending in
an information year that ends in 2008 that begins in 2007.

After making your selection, click "Next". If you answer

•

"Yes", a 4010 filing is required for the current information year unless you qualify for
a waiver based on the aggregate 4010 funding shortfall. A question about this waiver
will appear.

•

"No", another question will appear which must be answered before a determination
can be made about whether a filing is required.

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule
FG - Filing
Waiver

This screen will appear only if you answered "yes" to the question on screen 14 (i.e., at
least one plan has an FTAP below 80%). If the aggregate 4010 funding shortfall
exceeds $15 million, select "Yes". Otherwise select "No". For this calculation:
•

The 4010 funding shortfall:

is determined as of the valuation date for the plan year ending within the
information year, and

is equal to the funding shortfall defined in ERISA section 303(c)(4), but
determined without regard to the credit balance reduction under ERISA section
303{f)(4)(B). (See § 4010.11 (c)(2) for a transition rule applicable to plans with
plan years ending in an information year that ends in 2008 that begins in 2007.)

•

Every plan maintained by any member of the controlled group (including exempt
plans) must be included unless that plan has no 4010 funding shortfall (i.e., one
plan's surplus cannot be used to offset another plan's shortfall).

•

The entire 4010 funding shortfall of a multiple employer plan must be included when
determining whether the $15 million controlled-group waiver applies to an employer
that is a contributing sponsor of the multiple employer plan.

After making your selection, click "Next". If you answer:

Schedule
FG - Lien
Filing
Gateway
Test

•

"No", another question will appear which must be answered before a determination
can be made about whether a filing is required.

•

"Yes", a message will appear stating that a 4010 filing is required for the current
information year. To begin entering required information (or to Logout), click "Back to
Filing Summary." Note - Your answers to Schedule FG questions will automatically
be saved.

Reporting is required if there has been a failure of any controlled group member to make
a required installment or other required payment to a plan that results in conditions for
imposition of a lien under ERISA section 303(k) or Code section 430(k) during the
information year and that is not made within 10 days after its due date.
Select "Yes" if any member of the controlled group failed to make a required installment
that met the conditions described above. Otherwise select "No". After making your
selection, click "Next". If you answer:
•

"Yes", a message will appear stating that a 4010 filing is required for the current

information year. To begin entering required information (or to Logout), click "Back to
Filing Summary." Note - Your answers to Schedule FG questions will automatically
be saved.

•

"No", another question will appear which must be answered before a determination
can be made about whether a filing is required.

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule
FG - Large
Funding
Waiver
Filing
Gateway

Reporting is required if any plan maintained by a controlled group member has been
granted one or more minimum funding waivers under ERISA section 303 or Code
section 412(d) totaling in excess of $1 million, any portion of which is still outstanding at
the end of the plan year ending within the information year. For information on when a
waiver is considered outstanding, see § 4010.4(e).

Select "Yes" if an outstanding waiver exists that meets the above criteria. Otherwise,
select "No". After making your selection, click "Next". If you answer
•

"Yes", a message will appear stating that a 4010 filing is required for the current
information year. To begin entering required information (or to Logout), click "Back to
Filing Summary.9 Note - Your answers to Schedule FG questions will automatically
be saved.

•

"No", a message will appear stating that a 4010 filing is not required for the current
information year. In this case:
-

If a filing was required last year, the message will also explain that Schedules G
and FG must be submitted to satisfy § 4010.6(a)(2). Click "Back to Filing
Summary to submit these two schedules or print and review the schedules
before submission. Note - Your answers to Schedule FG questions will
automatically be saved.

If a filing was not required last year, the message will instruct the filer to return to
the Filing Summary and logout

Filing
Required

This screen appears only if, based on the information entered in Schedule FG, a filing is
required. Click "Back to Filing Summary1' to begin entering information or to logout of the
application.

Only
Schedules
G and FG
Required

This screen appears only if, based on the information entered in Schedule FG, no filing
is required for the current year, but based on the information entered in Schedule G, a

No filing
required

This screen appears only if, based on the information entered in Schedule G, no filing
was required for the prior year and based on the information entered in Schedule FG, no
filing is required for the current. Click "Go to e-4010 Home Page" and click logout at the
top of the screen.

filing was required for the prior year. In this case, you must submit Schedules' G and
FG. Click "Back to Filing Summary" and click "Submit Filing"

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule I
- Member
Summary

Identifying information must be reported with respect to each member of the filer's
controlled group as of the last day of the information year unless that member is
"exempt". A member is exempt if each of the following conditions is satisfied:
(i)

The member is not a contributing sponsor of a plan (other than an exempt plan).

(ii)

The member has revenue for its fiscal year ending within the information year that is
5% or less of the controlled group's revenue for the fiscal year(s) ending within the
information year.

(iii) The member has annual operating income for its fiscal year ending within the
information year that is no more than the greater of 5% of the controlled group's
annual operating income for the fiscal year(s) ending within the information year, or
$5 million.
(iv) The member has net assets at the end of the fiscal year ending within the
information year that are no more than the greater of 5% of the controlled group's

net assets at the end of the fiscal year(s) ending within the information year, or $5
million.
This summary is intended to help you track which members have been entered. The first
time you view this screen there is nothing to see. Once you've entered and saved
information about a member, the member's information appears in the summary.
To enter identifying information for a controlled group member, click the "Enter Member

Company" button. This will take you to Schedule I - Section I where you will be
prompted to answer a series of questions.
Note re: contributing sponsors of multiple employer plans — Because only

members of the filer's controlled group need to be reported, a filer who is a contributing
sponsor of a multiple employer plan need not provide identifying information for another
contributing sponsor of the multiple employer plan if that other contributing sponsor is
not a member of the filer's controlled group.

From this screen you can also:

•

Modify previously reported information on a specific member company by clicking
the member company name,

•

Delete a previously entered member company by clicking the "Delete" button next to
that member's name,

•

Save your work and return to the Filing Summary by clicking the "Back to Filing

Summary" button. From there, you will be able to select where, within the
application, you want to go next,

•

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule I
- Section 1

The information required to be entered for each member is as follows:

Company name: Enter the Legal name of the member.
EIN: Enter the Employer identification number of the member. For the first foreign entity
enter 77-7777777. For any additional foreign entities change the last digit or digits of
the reported EIN so that it is unique (77-7777771, 77-7777772, 77-7777773, etc.).

Address: Enter the street address for the headquarters of the member.
City: Enter the city in which the headquarters of the member is located.

State; If the headquarters of the member is located in the United States, click the "state"
box. A list of the 50 states will appear. Click the appropriate state.
Province: If the headquarters of the member is located outside of the United States,
enter the applicable information (province, etc.)
Zip Code: Enter the required information

Telephone: Enter the telephone number corresponding to the address entered above.
If this is outside of the United States, be sure to include a country code.
Relationship: Describe the legal relationship of the member to other members of the
controlled group (e.g., parent subsidiary of Company X).

There is one more question to answer with respect to this member. Click "Next" and the
additional question will appear. If you do not have all of this information readily available,
you may enter what you have, click the "Next" button, and return to this screen at a later
time. You will need to answer at least one more question before you will have an
opportunity to save the information entered on this screen
Note - Company name and EIN entered on this screen are used to create a drop down
menu that appears on other screens. If either name or EIN are temporarily left blank,

the application may direct you back to this screen when such information is needed later
in the application. The other identifying information (address and telephone) has no
impact on the rest of the application and may be entered at anytime before submitting
the filing.
23

Schedule I
- Section 1

If this is a new member, check the box which best describes the new member. If the
member joined the controlled group during the information year, enter the date the
member company became part of the controlled group.
Once completed, you are finished answering questions for this member company and
may either enter another member company by clicking "Enter Next Member" or save
information entered with respect to this member clicking "Save". Clicking "Save" will
take you back to the Member Summary where you will see a list of members for whom
some, or all, identifying information has been entered.

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule I
- Plans Summary

Identifying information must be reported with respect to each plan (including exempt
plans) sponsored by any member of the filer's controlled group as of the last day of the
information year.

This summary is intended to help you track which plans have been entered and whether
actuarial information must be reported for each plan. The first time you view this screen
there is nothing to see. Once you've entered and saved information about a plan, the
plan's information appears in the summary.

To enter identifying information for a plan, click the "Enter Plan" button. This will take
you to Schedule I - Section II where you will be prompted to answer a series of
questions.

When you are finished entering information for one plan, you will be given the option to
enter information about another plan or save and exit this section.
From this screen you can also:

•

Edit an existing plan by clicking the plan name from the table,

•

Modify member information by clicking the "Modify Member Information" button,

•

Save your work and go back to the Filing Summary by clicking the "Back to Filing
Summary" button,

•

Delete a plan by clicking the "Delete" button next to the plan you want to delete.

•

Assign an actuary to complete a particular Schedule P. For additional information
on the "assign an actuary" feature, see screen 50.

Saving Schedule I, Section II prior to completion
The "Save" feature is not available on every screen of this section. If you want to save
your work before you get to a screen with a "Save" button, keep clicking "Next" until you
get one.

Items that require you select one of two or more options (i.e., "radio buttons") must be
completed before you can click "Next". This is because the screen that will appear next
may depend on how you answered a particular question. Items that require entering
data (rather than selecting an option) may be left blank at first, but will need to be
completed prior to submission.

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule I
- Section II

Note re: exempt plan sponsors — If the plan sponsor is an exempt member, instead
of entering plan information on this screen, enter the identifying information as a

Schedule I comment by clicking the "Comments" button on the Filing Summary.
The information required to be entered for each member is as follows:
Plan name: Enter the legal name of the defined benefit pension plan.

Plan sponsor: Select a plan sponsor from the list of non-exempt member companies.
If the plan sponsor is not on the list of non-exempt member companies, it most likely
means that you have not yet entered member information with respect to that plan
sponsor. Click the "Enter Member" button to enter the plan sponsor information. You

will be diverted back to Schedule I - Section I so that you may enter information
regarding the plan sponsor. The next time you go to Schedule I - Section II, this plan
sponsor will appear on the drop down menu. Note, in this case, the plan name will not
have been saved. You will need to re-enter the plan name when you return to Schedule
I - Section II.
If the sponsor does not appear on the list, it could mean that the sponsor is an exempt

member for whom identifying member information is not required. In that case, follow
the instructions in the above note re: exempt plan sponsors.

Plan number: Enter the three-digit plan number.
Whether plan Is a multiple employer plan: If the plan is a multiple employer plan,
check "yes" and attach a document listing all contributing sponsors of the plan. This list
must include the information required under § 4010.7(b)(1)(vi).

Whether the requirement to submit actuarial Information under § 4010.8(c) Is
waived. In general, a Schedule P (Plan Actuarial Information) must be completed for
each plan reported in Schedule I. However, there are two situations where a Schedule
P is not required. Specifically, a Schedule P is not required if the plan is:
•

An "exempt plan" under in 4010.8(c» as described below, or

•

A multiple employer plan and the actuarial information for the plan is being
submitted (or has been submitted) by another contributing sponsor of the plan. If

this is the reason a Schedule P is not required, enter the name of the filer who is
submitting the actuarial information for the multiple employer plan in the Schedule I
comment box.

Exempt Plans — Provided there are no outstanding minimum funding waivers or missed
installments, a plan is an exempt plan if, as of the end of the plan year ending within the
information year, it has:

•

Fewer than 500 participants (see note below) and a 4010 funding shortfall (as
defined below) of less than $15 million, or

•

Benefit liabilities less than or equal to the fair market value of the plan's assets.

The 4010 funding shortfall:

•

Is determined as of the valuation date for the plan year ending within the information
year, and

•

is equal to the funding shortfall defined in ERISA section 303(c)(4), but determined
without regard to the credit balance reduction under ERISA section 303(f)(4){B).
(See § 4010.11(c)(2) for a transition rule applicable to plans with to plan years
ending in an information year that ends in 2008 that begin in 2007.)

Note re counting participants for purposes of determining whether plan is

exempt: For this purpose, participant count may be determined on either the valuation
date or the last day of the plan year.
January 2009 - updated for PPA

Instructions

Schedule I
- Section II
(continued)

Appendix 2

Plan freeze Information: Check "Yes" if the plan is frozen in any capacity. For
example, check "Yes" if the plan was amended at any time during or before the current
information year to:
•

Cease benefit accruals for some or all active participants (i.e., pay and service are
frozen) after a specified date,

•

Change the benefit formula so that service after a specified date is not recognized
for benefit accrual purposes (i.e., service is frozen, pay is not),

•

Change the plan eligibility requirements so that employees hired after a specified
date are not covered by the plan, or

•

Modify the plan in some similar fashion.

If a freeze applies only to one location, type of employee, part of the benefit formula,
etc., answer "Yes", and explain on the next screen.
If you answer

•

"Yes", you must provide additional information about the freeze. Click "Next" and the
next question will appear.

•

"No" the next screen will be skipped and the final Schedule I question will appear.

Saving information

The "Save" feature is not available from this screen. If you want to save your work at
this time, you will need to answer the question and hit "Next". You may need to do this
a few times before you get to a screen where you can click "Save". Note that The
yes/no questions on this screen must be completed before you can proceed. The other
items may be left blank for now, but will need to be completed prior to submission.
26

Schedule I
- Section II
Plan Freeze
information

If this screen appears, you must have indicated that the plan was frozen in some

capacity. If that is not the case, use the "back" button to return to screen 25 and change
your answer.

Report the following information:

Date of freeze: Enter the date the plan was frozen. If there have been multiple freezes,
enter the date of the most recent freeze and use the comments feature to provide
additional information.

Nature of freeze: Check the box indicating the nature of the freeze. If the options
provided do not adequately describe the nature of the freeze, check the
"Other/Combination" option and enter an explanation.
Note re: multiple freezes — If there was more than one freeze, enter additional
information related to the other freeze(s) as a comment by clicking the "Comments"
button in the Filing Summary.
Once completed:

•

If you were not required to submit 4010 information last year, you are finished
answering questions about this plan. Click "Next" and you will be prompted to
choose what you want to do next (for example, enter information about another
plan, return to the Filing Summary, etc.)

•

If you were required to submit 4010 information last year, there is one more
question to answer with respect to this plan. Click "Next" and the additional
question will appear.

January 2009 - updated for PPA

Instructions

Schedule 1
-Section II

Appendix 2

Has the EIN or PN changed...? If, as of the last day of the prior information year,
the plan did not exist, was not covered by Title IV of ERISA, or was sponsored by an
entity outside of the controlled group, check the "N/A (new plan)" box. Otherwise select
"Yes" or "No" as applicable. If you answer:
•

"No", you are finished answering questions about this plan. Click "Next" and you will
be prompted to choose what you want to do next (for example, enter information
about another plan, save and return to the Filing Summary, etc.),

•

"Yes", you must provide additional information about the change in EIN/PN. Click
"Next" and a related question will appear,

•

"N/A (new plan)", you must provide additional information about the new plan. Click
"Next" and a related question will appear.

Saving information

The "Save" feature is not available from this screen. If you want to save your work at
this time, you will need to answer the question and hit "Next".
28

Schedule I
- Section II

There is nothing to enter on this screen. It will appear once you have answered all
questions related to a particular plan. The purpose is to indicate what you'd like to do
next. If you click the:

•

"Enter Next Plan" button - The information you've entered with respect to this plan
will be saved and you will be taken back to the first screen in this section. At that
point you may begin entering identifying information for another plan.

•

"Save" button - The information you've entered with respect to this plan will be
saved and you will be taken back to the Plan Summary. From there you can get to
the Filing Summary.

Schedule I
-Section II

Change in
EIN/PN

•

"Cancel" button - The information you've entered with respect to this plan will not be
saved. You will be taken back to the Plan Summary.

•

"Back" button - You will be taken back to the most recent screen. The information
you've entered with respect to this plan will not be saved.

If this screen appears, you must have indicated that the EIN or PN has changed. If that
is not the case, use the "back" button to return to screen 27 and change your answer.

You must enter both the prior Employer Identification Number and the prior Plan
Number, even if only one of these items has changed.
Once you enter this information, you are finished answering questions about this plan.
You may begin entering information about another plan by clicking the "Enter Next Plan"
button or save this information and return to the Plan Summary by clicking "Save".

January 2009 - updated for PPA

Instructions

Appendix 2

Schedule I
- Section II

If this screen appears, you must have reported that this plan is new. If that is not the
case, use the "back" button to return to screen 27 and change your answer.

New plan
explanation

first maintained by the controlled group.

Date plan was first maintained by controlled group: Enter the date that the plan was

Explanation: Select the reason why the plan was not reported last year
•

•

Newly-established plan,

Spun-off or transferred from a plan sponsored by a member outside controlled
group, or

•

Spun-off from plan sponsored by member within the controlled group.

If none of these explanation apply, click "Other" and enter an explanation for why the
plan was not reported last year in the space provide on this screen.

Once you enter this information, you are finished answering questions about this plan.
You may begin entering information about another plan by clicking the "Enter Next Plan"
button or save this information and return to the Plan Summary by clicking "Save".
31

Schedule I
- Section III

Former controlled group members: For any entity, other than an exempt entity, that
ceased to be a member of the controlled group during the information year and is thus,
not reported in Schedule I, section I of this year's filing, enter the following information in
the space provided:
•

Member name,

•

Employer Identification Number,

•

Date the entity ceased to be a member,

•

Legal relationship of the member to the other members (e.g., parent, subsidiary,
brother-sister, etc.), and

•

Explanation (e.g., no longer a member of the controlled group, now meets the
definition of an exempt entity).

Former plans: For any plan, other than an exempt plan, that ceased to be maintained
by a member of the controlled group during the information year, and is thus not
reported in Schedule I, section II of this year's filing, enter the following information in

the space provided:
•

Plan name,

•

Plan sponsor's Employer Identification Number,

•

Plan number,

•

Explanation (e.g., terminated, transferred to a member outside of the controlled
group),

•

Date the plan ceased to be maintained by the controlled group, and if applicable,

•

Name of the controlled group and sponsor currently maintaining the plan.

Once completed, click "Save" and you be taken to the Filing Summary

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule F
-Type of
Submission

In general, financial statements for the fiscal year ending within the information year
(including balance sheets, income statements, cash flow statements, and notes to the
financial statements) must be provided for each non-exempt member.

If the financial information of a non-exempt member is combined with the information of
other members in consolidated financial statements, in lieu of the information noted
above, a filer may provide consolidated financial statements. In this case:
•

additional information (revenues, operating income, and net assets) must be
reported for each non-exempt member (see § 4010.9 (b)),

•

Financial information about entities that are not members of the controlled group
(e.g., joint ventures) or that are exempt entities may be included in the consolidated
financial statements.

After selecting which of the permitted filing alternatives is being used (separate financial
statements, consolidated financial statements, or a combination), click "Next".
Special rule for multiple employer plans
A filer who is a contributing sponsor of a multiple employer plan need not provide

financial information for another contributing sponsor of the multiple employer plan if that
other contributing sponsor is not a member of the filer's controlled group.

For multiple employer plans only information on employers that are among the 10
largest employers in terms of participants (for hourly plans) or contributions (for salaried)
plans would need to be provided, see §4010.11(d)(3).
Saving an incomplete Schedule F

In most cases, Schedule F information can not be saved until you've gone through all
the applicable Schedule F screens. If you want to save a partially completed Schedule
F, keep clicking the "Next" button until you get to the last Schedule F screen.
Items that require you select one of two or more options (i.e., "radio buttons") must be
answered before you can click "Next" and save a partially completed schedule. Items
that require entering data (rather than selecting an option) may be left blank for now, but
will need to be completed prior to submission.
33

Schedule F
-Type of
Submission

A list of non-exempt members is displayed. For each listed non-exempt member
indicate whether its financial information is included in consolidated financial statements
or individual financial information will be provided (as an attachment or by reference).
Once completed, click "Save".

Note - this screen appears only if you indicated that the financial information includes a
combination of consolidated information and individual member information. If this is not
correct, click the "Cancel" button to change your response to the previous question.

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule F
- Summary

A list of all non-exempt members is displayed. However, how the list is displayed varies
based on how you answered previous questions.
Case 1 - combined financial information for all non-exempt members

All non-exempt members are listed in one table labeled "Consolidated Members". You
must answer a series of questions on the next few screens about the consolidated
financial statements and enter additional information (revenues, operating income, and
net assets) separately with respect to each non-exempt member. To answer these
questions for the first time or to change a previously entered response, click the "Edit"
button. After completing Schedule F, you will be directed back to this screen.
"Yes" in the column labeled "Complete" next to a member's name indicates that all
required information has been entered. "No" indicates that one or more of the required
data items has yet to be entered for that member.

Case 2 - Separate financial information for each non-exempt member

All non-exempt members are listed in one table labeled "Individually Listed Members".
You must answer a series of questions on the next few screens about each of these
members. Click the "Edit" button next to a listed member to begin answering questions
about that member's financial information. The "Edit" button can also be used to modify
previously entered information. After answering all of the financial questions with respect
to that member, you will be directed back to this screen. From there, you may click "Edit"
next to another member's name to begin answering the same questions with respect to
that member or go back to the Filing Summary and choose.

"Yes" in the column labeled "Complete" next to a member's name indicates that all
required information has been reported. "No" indicates that information on this member
is incomplete.
Case 3 - Reported information contains some consolidated and some separate
financial information.

Two tables appear, one listing the non-exempt members you indicated were included in
the consolidated financial statements and another listing the rest of the non-exempt
members. Follow the instructions noted above under both Case 1 and Case 2.
From this screen you can also:
•

Change your answer to whether a particular member's financial information is
included in the consolidated financial statements by clicking the "Change
Consolidated or Individual Submission Status" button at the top of the screen;

•

Edit previously entered financial information by clicking the applicable "Edit* button.
Note - the application will walk you through all of the remaining Schedule F screens.
You can not jump directly to a particular Schedule F question; just keep clicking
"Next" until you get to the screen you want

•

Modify member information by clicking the "Modify Member Information" button;

•

Save your work and return to the Filing Summary by clicking the "Back to Filing
Summary" button.

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule F
- Financial
Information
Reporting
Method
(type of
information)

In general, audited financial statements for the fiscal year ending within the information
year must be made available as part of the filing. If audited statements are unavailable,
unaudited financial statements are acceptable as long as the audited financial statement
is submitted to PBGC within 15 days after it is prepared.

If no financial statements are available, a federal tax return for the tax year ending within
the information year is acceptable provided an audited and an unaudited financial
statement are submitted to PBGC within 15 days after they are prepared.
Note - the application does not currently provide a mechanism for submitting audited
financial statements after the 4010 filing is submitted. Until this feature is added, the

requirement may be satisfied bv sendina an e-mail to ERISA.4010(S).Dbac.aov with the

audited statement attached or, if it is publicly available, information as to where it can be
obtained.

Select which type of information is being reported and click "Next".
Saving an incomplete Schedule F

Schedule F information can not be saved until you've gone through all the applicable
Schedule F screens. If you want to save a partially completed Schedule F, keep clicking
the "Next" button until you get to the last Schedule F screen.
Items that require you select one of two or more options (i.e., "radio buttons") must be
answered before you can click "Next" and save a partially completed schedule. Items
that require entering data (rather than selecting an option) may be left blank for now, but
will need to be completed prior to submission.
36

Schedule F
- Financial
Information

Financial information is required to be attached to the filing unless such information is
otherwise publicly available. Select "Yes" if financial information will be attached
electronically to this filing. Otherwise, "select "No, because it is publicly available"

Reporting
method

Once selected, click "Next".
Saving an incomplete Schedule F

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule F
- Financial
Information

If this screen appears, you must have indicated that financial information is not attached
because it is publicly available. If that is not the case, use the "back" button to return to

Publicly
available
information

Indicate where the publicly available information can be obtained (i.e., SEC or
Elsewhere). If "Elsewhere" is selected, enter information regarding where the financial
information can be obtained (for example, a company's website address). In either
case, enter the date the information was made available to the public.

screen 36 and change your answer.

If you are entering information with respect to an individual, there are no more questions
with respect to that member. Click "Next" to return to the Financial Information
Summary where you begin answering Schedule F questions for another member or
save your work and logout.

If you are entering information with respect to consolidated financial statements,
additional data is required. Click "Next" to provide the additional information. If you are
not ready to do so, you will still need to click "Next" to be able to save your work.
38

Schedule F
- Financial
Information

A list of each non-exempt member company included in the consolidated financial
statements will be displayed. Enter the revenue, operating income, and net assets for
each listed member. These amounts may be rounded (but not truncated) to the nearest
thousand. For example, if revenues are $98,765,432.10, you may report $98,765,000.
This information is required for all non exempt entities including foreign subsidiaries.
Once complete, click "Save".

If you do not have all the information needed to complete this screen at this time, click
"Save". The next time you return to the Schedule F Summary, "Yes" will appear in the
"Completed" column next to members for whom full information has been entered. "No"
in this column indicates that additional information still needs to be entered with respect
to that member.
39

Schedule P
- Summary

The purpose of Schedule P is to report Plan Actuarial Information for each non-exempt
plan sponsored by a member of the controlled group as of the last day of the information
year. If the filing coordinator has assigned an actuary to a particular plan, both the Filing
Coordinator and that actuary will have access to that Schedule P. Access is limited to
one actuary at a time.
This summary is automatically populated with the names of all plans reported in
Schedule I - Section II unless the requirement to report actuarial information for such
plan is waived (e.g., exempt plans and certain multiple employer plans). Click on any
plan name to begin reporting Plan Actuarial Information for a particular plan. When you
finish entering information for one plan, you will be given the option of entering actuarial
information for another plan or saving the information you've entered so far and exiting
this section. To help you keep track of which plan's Schedule P is on the screen at any
time, the plan name appears at the top of the screen.
If a plan does not appear, it most likely means you omitted the plan when you completed
Schedule I - Section II or inadvertently reported that a Schedule P was not required.
You can return to that screen and modify plan information as needed by clicking the
"Modify Plan Information" button. However, if you omitted the plan sponsor as well, you

should click the "Modify Member Information" button first, as Schedule I does not let you
enter plan information until the plan sponsor's name and EIN have been entered.

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule P

From this screen you can also:

- Summary
(continued)

•

Enter comments related to a particular plan by clicking the "Comments" button next
to the applicable plan.

•

Attach files (for example, a valuation report) by clicking the "Attachments" button.

•

Modify or delete previously entered comments by clicking the "Comments" button
next to the applicable plan.

•

Modify previously entered Schedule P information for a particular plan by clicking on
the plan name,

•

Return to the Filing Summary by clicking the "Back to Filing Summary" button.

•

Modify Schedule I information by clicking the "Modify Member Information" or
"Modify Plan Information" button. Note - because assigned actuaries do not have
access to Schedule I, this feature is available only to Filing Coordinators.

Print Schedule P so that the enrolled actuary can review/certify the information. This
certification is not done electronically. Instead, click the "Print Schedule P Certification''
button to print a form version of Schedule P. Obtain the signature of the enrolled
actuary and keep it for your records. PBGC may request to see a copy of the
certification for each plan at any time.
Enrolled Actuary's certification
§ 4010.8(a)(6) requires that an enrolled actuary certify that the to the best of his/her
knowledge and belief, the actuarial information submitted above is true, correct,
complete, and conforms to all applicable laws and regulations. To the extent the
certification is qualified, as permitted under 26 CFR § 301.6059-1 (d), an explanation
must also be submitted.
Special note applicable only to assigned actuaries
Once you are done entering information, you may click the "Notify FC" button to
automatically generate and send an e-mail to the Filing Coordinator to let them know
your part of the filing process is complete. This feature is optional. If you prefer to
contact the Filing Coordinator directly, you do not need to click this button. Note clicking this button does not constitute "certifying0 the results. The procedure for
certifying results is the same regardless of who enters the information into the
application.

January 2009 - updated for PPA

Instructions

Schedule P
- Basic
Plan
Information

Appendix 2

Complete each of the data fields for the selected plan.

Enrolled actuary Information: Enter the name, EA number, and telephone number of
the enrolled actuary responsible for certifying reported actuarial information. Reporting
the actuary's e-mail address is optional. Note - the enrolled actuary does not need to be
the enrolled actuary who certifies Schedule B of Form 5500 or the actuary who certifies
a premium filing.
Plan year Information: For the plan year ending within the information year, enter the
date the plan year begins and ends and indicate whether that plan year is a short plan
year (i.e. less than 12 full months).
Once completed, click "Next" to continue entering Plan Actuarial Information for this
plan, "Back" or "Cancel" to return to the Plan Actuarial Information Summary without
saving.

Note that the "Save" feature is not available from this screen. You will need to answer a
few more questions before you can save your work. Just keep clicking the "Next" button
until you get to the last Schedule P screen (where you'll see a "Save" button).
Saving an incomplete Schedule P
Schedule P information cannot be saved until you've gone through all the Schedule P
screens. If you need to save a partially completed Schedule P, keep clicking the "Next"

button until you get to the last Schedule P screen (where you'll see a "Save" button).

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule P
- Funded
Status
Information
(§4044
basis)

Number of participants: If census data was projected from a date before the end of
the plan year ending within the information year, enter the counts as of that date.
Otherwise, enter the breakdown of the actual census used to determine benefit
liabilities. The methodology used to allocate participants to a particular category (active,
terminated vested, retired), should be consistent with the methodology used to report
current liability on Schedule B of Form 5500.
Benefit liabilities before reflecting expense load: Enter the value of benefit liabilities
determined using assumptions and methods for valuing benefits to be paid as annuities
in trusteed plans terminating at the end of the plan year with one exception: the value
entered must be the value before reflecting the expense load required under
§ 4044.52(e). See § 4010.8(d) for information on how to calculate benefit liabilities in an
on-going plan.
The values may be rounded to the nearest thousand. For example, if the benefit liability
for active participants is $123,456,789, you may enter $123,457,000 or $123,456,789. If
the liability is $123,456,389, you may enter $123,456,000 or $123,456,389.
If projected census data is used to determine benefit liabilities, any reasonable
methodology may be used to allocate liabilities into the various categories (e.g. based
on the participant's status as of the date the underlying data was collected, in a manner
that results in a breakdown proportional to the prior year, etc.). The comment feature
(available via the Plan Actuarial Information Summary) may be used to document the
allocation methodology, but doing so is entirely optional.

Totals: To view the total participant count and pre-expense load liability amount, click
the "Calculate Total" button. If you do not click this button, totals will automatically be
calculated when you hit the "Next" button. In this case, if you return to this screen at a
later time, or print the filing, the totals will appear. Note - if you change a previously
entered number, the totals will not change until you click "Calculate Total" or "Next."

Expense load: Enter the dollar amount of the applicable expense load calculated in
accordance with § 4044.52(e). The amount may be rounded (but not truncated) to the
nearest thousand. For example, if the amount is $4,444,444.44, you may enter
$4,444,000.
Total benefit liabilities after reflecting load: To view the total benefit liability amount,
click the "Calculate Total" button. If you do not click this button, totals will automatically
be calculated when you hit the "Nexf button. In this case, if you return to this screen at
a later time, or print the filing, the totals will appear. Note - if you change a previously
entered number, the totals will not change until you click the "Calculate Total" or "Nexf
button.

Once completed, click "Next" to continue entering Plan Actuarial Information for this
plan, "Back" to go back one screen and modify your answers, or "Cancel" to return to
the Plan Actuarial Information Summary without saving.
Saving an incomplete Schedule P
Schedule P information cannot be saved until you've gone through all the Schedule P
screens. If you need to save a partially completed Schedule P, keep clicking the "Nexf
button until you get to the last Schedule P screen (where you'll see the "Save" button).
Items that require you select one of two or more options (i.e., "radio buttons") must be
answered before you can save a partially completed section. Items that require entering
data (rather than selecting an option) may be left blank for now, but will need to be
completed prior to submission.

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule P
- Funded
Status
Information
(§4044
basis)

Census data used to determine benefit liabilities: § 4010.8(d)(1) provides that
census data may be determined as of the end of the plan year ending within the
information year (i.e. the date entered on the previous screen) or as of the beginning of
the subsequent plan year. If actual plan census data is not available as of either of
those dates, a projection of plan census data from a date within the plan year ending
within the information year is permitted. Such a projection must use reasonable actuarial
methods including adjusting for significant events, if applicable. See § 4010.8(d)(2).
Interest rates: Enter the interest rate to determine benefit liabilities reported on the
previous screen and number of years in the discount period for which that interest rate is
used. Note - the interest rate and duration must be calculated in accordance with
§ 4044.52(a).

Enter rates as percentages. For example, if the applicable rate for the first 20 years is
4.21 %, enter 4.21, not .0421 for rate and 20 for number of years. Required interest rates
are published monthly on www.pbac.qov.

Fair market value of assets: Enter the value at the end of the plan year that ends
within the information year. Do not include contributions made after the end of the plan
year, even if those contributions are designated as contributions for the prior plan year.
The value may be rounded (but not truncated) to the nearest thousand. For example, if
the fair value of assets is $123,456,789.33, you may enter $123,457,000.

Items that require you select one of two or more options (i.e., "radio buttons") must be
answered before you can save a partially completed section. Items that require entering
data (rather than selecting an option) may be left blank for now, but will need to be
completed prior to submission.

January 2009 - updated for PPA

Instructions

Schedule P
- Other
information

Appendix 2

This screen does not appear if the plan year began before 2008.

Funding target as if plan were in at-risk status: Enter the funding target for the plan
year ending within the information year (calculated in accordance with ERISA section
303(d)(i», but determined as if the plan has been in at-risk status for a consecutive
period of at least 5 plan years (i.e., as if at-risk provisions are fully phased-in and at-risk
load applies).
Funding target attainment percentage: Enter the funding target attainment
percentage for the plan year ending within the information year. This is the same
percentage that was used in the 4010 gateway test Round to one decimal place (for
example 73.6%). The percentage should be the same as what will be reported on
Schedule SB for the plan year ending within the information year.

Adjusted funding target attainment percentage: Enter the adjusted funding target
attainment percentage for the plan year ending within the information year. Round to
one decimal place (for example 73.6%). The percentage should be the same as what
will be reported on Schedule SB for the plan year ending within the information year.

Benefit limitations: Check "Yes" if the plan was subject to any of the benefit limitations
provided in ERISA section 206(g) applied as of end of the plan year ending within the
information year. This includes plans for which the actuarial certification of the adjusted
funding target attainment percentage (AFTAP) was not made by the first day of the tenth
month of the plan year and was thus, conclusively presumed to be less than 60%.
Otherwise, check "No".

Large waiver Information: Check "Yes" if:

•

As of the end of the plan year ending within the information year, the plan has one
more outstanding minimum funding waivers under ERISA section 302(c) or Code
section 412(c), and

•

the total amount waived with respect to such waivers exceeded $1 million.

Lien Information: Check "Yes" if:

•

During the information year, there was a failure to make a required installment or
other required payment to the plan that resulted in conditions for imposition of a lien
under ERISA section 303(k) or Code section 430(k), and

•

Such required payment was not made within 10 days after its due date.

Saving an incomplete Schedule P

Schedule P information cannot be saved until you've gone through all the Schedule P
screens. If you need to save a partially completed Schedule P, keep clicking the "Next"
button until you get to the last Schedule P screen (where you'll see the "Save" button).
Items that require you select one of two or more options (i.e., "radio buttons") must be
answered before you can save a partially completed section. Items that require entering
data (rather than selecting an option) may be left blank for now, but will need to be
completed prior to submission. Note that the "Save" feature is not available from this
screen. You will need to answer a few more questions before you can save your work.
Just keep clicking the "Next" button until you get to the last Schedule P screen (where
you'll see a "Save" button).

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule P
- Benefit
limitations
explanation

If this screen appears, you must have indicated that on the last day of the plan year, a
benefit limitation applied. If that is not the case, use the "back" button to return to
screen 43 and change your answer.

Enter a brief summary explaining which benefit limitation(s) applied and the date on
which the limitation(s) first started applying.

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule P
-Additional
Actuarial
Information

A copy of the plan's actuarial valuation report for the plan year ending within the
information year is required as part of the 4010 filing. The report must be submitted
electronically. With the exception of plan years beginning before 2008 or plans subject
to special funding rules under sections 104,105,106 and 402(b) of the Pension
Protection Act of 2006, the report must contain or be supplemented by the following
items of information. (See § 4010.8(a)(11)).

(i)

The funding target calculated pursuant to ERISA section 303 without regard to
subsection 303(i)(1), setting forth separately the value of the liabilities attributable to
retirees and beneficiaries receiving payment, terminated vested participants, and
active participants (showing vested and nonvested benefits separately);

(ii) A summary of the actuarial assumptions and methods used for purposes of ERISA
section 303 and any change in those assumptions and methods since the previous
valuation and justifications for any change. In the case of a plan that provides lump
sums, other than de minimis lump sums, the summary must include the
assumptions on which participants are assumed to elect a lump sum and how lump

sums are valued;

(iii) The effective interest rate (as defined in ERISA section 303(h)(2)(A));
(iv) The target normal cost calculated pursuant to ERISA section 303 without regard to
subsection 303(i)(2);

(v) For the plan year and the four preceding plan years, a statement as to whether the
plan was in at-risk status for that plan yean

(vi) In the case of a plan that is in at-risk status, the target normal cost calculated
pursuant to ERISA section 303 as if the plan has been in at-risk status for 5
consecutive years;

(vii) The value of the plan's assets (reflecting any averaging method) as of the valuation
date and the fair market value of the plan's assets as of the valuation date;
(viii) Except for plan years beginning before 2008, the funding standard carryover
balance and the prefunding balance (maintained pursuant to ERISA section

303(f)(1)) as of the beginning of the plan year and a summary of any changes in
such balances in the past year (e.g., amounts used to offset minimum funding
requirement, amounts reduced in accordance with any elections under ERISA
section 303(f)(5) or Code section 430(f)(5), interest credited to such balances, and
excess contributions used to increase such balances);

(ix) A list of amortization bases (shortfall and waiver) under ERISA section 303,
including the year the base was established, the original amount the installment
amount, and the remaining balance at the beginning of the plan year;

(x) An age/service scatter for active participants including average compensation
information for pay-related plans and average account balance information for
hybrid plans presented in a format similar to that described in the instructions to the
Form 5500 schedule for single-employer defined benefit plan actuarial information;
(xi) Expected disbursements (benefit payments and expenses) during the plan year;

(xii) A summary of the principal eligibility and benefit provisions on which the valuation of
the plan was based (and any changes to those provisions since the previous
valuation), along with descriptions of any benefits not included in the valuation, any
significant events that occurred during that plan year, and the plan's early retirement
factors; in the case of a plan that provides lump sums, other than de minimis lump
sums, the summary must include information on how annuity benefits are converted
to lump sum amounts (for example, whether early retirement subsidies are
reflected);

January 2009 - updated for PPA

Appendix 2

Instructions

Schedule P
-Additional
Actuarial
Information

(continued)

Note re: Plan years beginning before 2008 or plans subject to special funding rules
under sections 104, 105, 106 of the Pension Protection Act of 2006-The report must
contain or be supplemented by the information required by § 4010.8(a)(5) as in effect as
of December 31,2007, apply to the plan. A list of this required data can be found on
page 21 of the e-4010 instructions for information years beginning before 2008. [insert
link]

Note re: frozen airline plans electing alternate funding schedule under section 402(b) of
the Pension Protection Act of 2006 - The list of this required data is not available on line
at this time. If one or more of the plans included in this filing has elected the alternate
funding schedule under section 402(b) of PPA, contact PBGC at 202-326-4070,
extension 3075 to discuss the requirements related to data that must be attached to the
filing (in connection with the actuarial valuation report).

If the additional information described above is not available by the filing due date, it
may be submitted no later than 15 days after the Form 5500 filing. See § 4010.8(b).
Select the statement that describes when this information on this plan is expected to be
submitted and whether the required information is completely contained:
•

within one actuarial valuation report or

•

in part, in an actuarial valuation report and in part, in another file or file(s).

Note - Although the enrolled actuary must certify to the information on Schedule P, it is
possible that someone else will be entering the information into the application and
attaching the applicable files. As such, the actuary cannot certify as to whether a report
was actually attached prior to submission. Thus, the actuary need only certify whether
the materials he/she prepared are contained in one or more documents and whether
he/she believes they will be submitted along with the filing or at a later date.
Once completed, click "Next" to continue entering Plan Actuarial Information for this
plan, "Back" to go back one screen and modify your answers, or "Cancel" to return to
the Plan Actuarial Information Summary without saving information that has been
entered since the last save.
Attaching files (valuation reports and supplements, if necessary)

To submit a report or other document along with this filing, use the "Attachments"
feature on the Schedule P Summary page. Note - You cannot get directly to the
Schedule P Summary from this screen. You must first click "Next" to get to the Actuarial
Certification page. From there, clicking "Save" will save all of the information entered
with respect to this plan and take you to the Schedule P Summary page.

Delayed due date for submitting additional actuarial information
To submit additional actuarial information at a later date, as permitted under
§ 4010.10(b), log into the system and you will be directed to the e-4010 home page.
Click the "amend filing" button and you will be able to attach an additional file and
resubmit the filing. Once submitted, an e-mail "receipt" will automatically be sent to the
e-mail address used when you first signed up for an account.
Saving an incomplete Schedule P
Schedule P information cannot be saved until you've gone through all the Schedule P
screens. If you need to save a partially completed Schedule P, keep clicking the "Next"
button until you get to the last Schedule P screen (where you'll see the "Save" button).

Appendix 2

Instructions

Schedule P

There is nothing to enter on this screen. It will appear once you have answered all
questions related to a particular plan. If you click the "save" button, you will be re
directed to the Schedule P Filing Summary Page where you can choose what you'd like
to do next.

Attachments

The following types of files may be attached to a 4010 submission:
•

Microsoft Word

•

WordPerfect

•

Microsoft Excel

•

Adobe Portable Document Format (pdf)

•

Microsoft Visio

•

Microsoft Powerpoint

If the file(s) exceed one megabyte in size, PBGC recommends that they be compressed
using a compression or "zip" program (e.g., WinZip or PKZip).

Upon request, other file types may also be acceptable. To make such a request send
an e-mail to [email protected] or call 1-800-736-2444. extension 4070. TTY/TDD
users may call the Federal relay service at 1-800-877-8339 and ask to be connected.
Local callers may directly dial 202-326-4070, extension 3075.

Electronic files attached to the 4010 filing must include a description (for example, org
chart, or actuarial valuation report for Hourly Plan). For Schedule P attachments, the
description must include enough information to easily determine the plan (or plans) to
which the attachment relates, but it is not necessary to include the official plan name.

To attach an electronic file to the filing, click the "Browse" button to locate the file on
your computer, select the applicable file, enter a description and then click the
"Attachments" button. After attaching file(s), click "Back to Filing Summary".
From this screen you can also:

•

Delete a previously attached file by clicking the "Delete" button next to the
attachment you want to delete.

•

View a previously attached file by clicking the "View" button next to the attachment
you want to view.

Schedule
G/FG/I/F/P

Enter any additional information that will assist the PBGC in its review of the controlled
group's 4010 filing requirement.

Comments

For Schedules other than P (Plan Actuarial Information), if a comment relates to a
particular member or plan and not to the filing in general, the comment should identify

the relevant member or plan. For example - if the filer wants to include a Schedule I
comment reporting that the one controlled group member's address will be changing in

a few months, the name of that member should be noted in the comment.
Each Schedule P has its own comments field, so it is not necessary to identify the plan
to which the comment relates. If the print feature is used, comments will appear on the
applicable Schedule P

Once completed, click "Save" to return to the Filing Summary.

January 2009 - updated for PPA

Appendix 2

Instructions

Reassign
filing

This screen appears only if you click the "Reassign Filing Coordinator" button on the
e-4010 home page.

Enter the e-mail address of the person who will be taking over Filing Coordinator
responsibilities for a particular filing. Once you have reassigned a filing, the new filing
Coordinator will receive a notification via e-mail. From that point forward, you will not
have access to the re-assigned filing.

If the newly assigned filing coordinator will also need access to a previously submitted
filing for this controlled group, you must also reassign that filing. To do so, go to the
e-4010 home page and click the "reassign" button next to the applicable submitted filing.
Note. You may only assign a filing to someone who has an e-4010 account.
50

Assign
Actuary

This screen appears only if you click the "Assign Actuary" button on the Schedule I,
Plan Summary page (see screen 24).

Enter the e-mail address of the actuary who will be entering Schedule P information for
this plan directly into the application. This actuary does not have to be the same actuary
who will be certifying the Schedule P information. In many cases, a junior level actuary
will be the one who actually enters the data and a senior level actuary will certify the
result. In this situation, enter the e-mail address of the person who will actually be
entering the data.

Once you have assigned an actuary, the actuary will receive a notification via e-mail
alerting him/her to the assignment. Even if you assign an actuary to a particular
Schedule P, you, as the Filing Coordinator, will retain the ability to enter or modify
information on that Schedule P.
Note: You may only assign an actuary who has an e-4010 account.

January 2009 - updated for PPA

File Type	application/pdf
File Modified	2009-01-14
File Created	2009-01-14