Form 1 Questionnaire

Draft Questions for 2017 ASPP

(12/20/16)

1.Are actuarial data available for this plan?

Yes – continue

No – go to Part 8, Remarks.

2.What is the employers’ total pension liability (TPL) for this plan?

$

3.What is the fiduciary net position (FNP) for this plan?

$

4.What is the employer’s net pension liability (NPL) for this plan?

$

5. Below is the calculated ratio of fiduciary net position (FNP) to employer’s total pension liability (TPL) for this plan. Is the ratio correct?

%

Yes – continue

No – If No, please correct #2 or #3.

6.What is the actuarially determined contribution amount for this plan?

$

7.What were the contributions actually received in relation to the actuarial determined contribution for this plan?

$

8.What is the amount of covered-employee payroll for this plan?

$

9.What is the current discount rate for this plan?

%

10.The table below asks about the sensitivity of net pension liability/(asset) to changes in the discount rate for this plan. What is the amount of the net pension liability with a 1% decrease in the discount rate? What is the amount of the net pension liability with a 1% increase in the discount rate?

                               

	1% Decrease	Current Discount Rate	1% Increase
Discount Rate	((Fill from #9) minus 1)%	(Fill from #9)%	((Fill from #9) plus 1)%
Net Pension Liability Amount	$_____________	$(Fill from #4)	$_____________