Reportable Events

Form 10-Advance Instructions
ADVANCE NOTICE
OF REPORTABLE EVENTS
The Form 10-Advance is used by a contributing sponsor of a single-employer plan to notify the Pension Benefit
Guaranty Corporation in advance that a reportable event will occur. For questions regarding this form, contact
(202) 326-4070 or [email protected].

Table of Contents

Page

Part I - General Instructions

2

Part II - Definitions

5

Part III - Specific Instructions

6

A. Change in Contributing Sponsor or
Controlled Group

7

B. Liquidation

8

C. Extraordinary Dividend or
Stock Redemption

9

D. Transfer of Benefit Liabilities

9

E. Application for Minimum
Funding Waiver

10

F. Loan Default

10

G. Insolvency or Similar Settlement

10

Form 10-Advance Instructions
– Modify information any time prior to
submission;
– Pre-populate a filing with data from a
previously submitted filing;
– Route the filing as needed to facilitate ecertifications; and
– Review prior filings submitted via the efiling portal.
The portal can be accessed using the following
address: efilingportal.pbgc.gov.
• Instructions were revised to provide the types
of additional information PBGC may request of
filers liquidating or in an insolvency or similar
settlement.
Notification of future changes to any forms and instructions may be found under “What’s New” on the
Practitioners Page at www.pbgc.gov.

PART I – GENERAL INSTRUCTIONS
Section 4043(b) of the Employee Retirement Income Security Act (ERISA) requires that certain contributing sponsors notify PBGC at least 30 days in
advance of the effective date of certain “reportable
events.” PBGC's regulation on Reportable Events
(29 CFR Part 4043, Subparts A and C) describes in
detail each reportable event and any applicable extension or waiver provisions. The reportable events
for which advance reporting may be required are:
A. Change in contributing sponsor or controlled
group
B. Liquidation of contributing sponsor or
controlled group member
C. Extraordinary dividend or stock redemption
D. Transfer of benefit liabilities
E. Application for minimum funding waiver
F. Loan default
G. Insolvency or similar settlement

Post-Event Reporting Rule
ERISA §4043(a) requires that the plan administrator
and each contributing sponsor notify PBGC within
30 days after the occurrence of certain reportable
events. If an advance notice is filed (using Form 10Advance), no post-event notice (using Form 10) is
required.

Part III of these instructions summarizes the rules for
each event.
The rules in the Reportable Events regulation apply
only to reportable events involving single-employer
plans covered by title IV of ERISA. In these instructions, "plan" always means such a single-employer
plan.

Form 10-Advance and the rules described in these
instructions do not apply to post-event reporting.
See the Form 10 package and 29 CFR Part 4043,
Subparts A and B, for further information about
post-event reporting.

What’s New

Contributing Sponsors Subject To Advance
Reporting

The Form 10-Advance instructions and Form 10Advance have been changed; the key changes
include:
•

Certain contributing sponsors are required to notify
PBGC at least 30 days before the effective date of
certain reportable events unless a waiver or
extension applies (29 CFR §4043.61(a)).

PBGC's new e-filing portal offers a secure
application for submitting Form 10-Advance
information. The application will review filings
and generate a list of omissions and
inconsistencies prior to submission to ensure
that filings are complete.
The web-based
application walks the filer through various
screens, prompting the filer to answer questions
and enter required information. The application
allows filers to, among other things:
– Save a partially completed filing;

A contributing sponsor of a plan is subject to the advance reporting requirement for a reportable event if:
1. on the due date for the reportable event notice,
neither the contributing sponsor nor any member
of the plan’s controlled group to which the event
relates is a public company; and
2. the plans maintained (on the due date for the
2

reportable event notice) by the contributing
sponsor and members of the contributing
sponsor’s controlled group, disregarding
plans with no unfunded vested benefits,
have:

Reporting Waivers
Advance notice is automatically waived for certain reportable events in certain circumstances (see
Part III of these instructions). Advance reporting is
waived for any occurrence that is reportable as more
than one reportable event only if the requirements for
a waiver for each reportable event are met.

(i) aggregate unfunded vested benefits of more
than $50 million; and
(ii) an aggregate value of plan assets that is less
than 90 percent of the aggregate premium funding target.

How To File
Forms must be filed electronically. That can be
accomplished by:
1.
Emailing a completed form and any required
attachments to [email protected]; or
2. Using the 4043 module of PBGC's new e-filing
portal. The portal can be accessed using the
following address: efilingportal.pbgc.gov.

The unfunded vested benefits, value of plan assets,
and premium funding targets are those determined
for variable-rate premium purposes for the plan year
preceding the effective date of the event.
Who Must Notify PBGC
Each contributing sponsor subject to advance reporting must notify PBGC that a reportable event will
occur using the PBGC Form 10-Advance. If there is
a change in contributing sponsor, the reporting obligation applies to the contributing sponsor(s) on the
date the advance notice is due.

To request an exemption from e-filing, send a
request via email to [email protected].
If you are filing materials electronically that are larger than 10 megabytes, please use LeapFILE. Enter
“pbgc.leapfile.com” in your Internet browser, click
on “secure upload,” enter “advancereport@pbgc.
gov” in the “Recipient Email” field, and attach the
files.

Note: An authorized representative may file a
report- able event notice on behalf of a contributing
sponsor.

When to File
A single occurrence (such as a controlled group
break-up) may be a reportable event for more than
one plan in the controlled group. In that case, the advance reporting requirement applies to each contributing sponsor of each plan. Any filing will be deemed
to be a filing by all persons required to notify PBGC.

An advance notice of a reportable event must be
filed no later than 30 days before the effective date
of the reportable event. PBGC has extended the 30day deadline for some events in certain specified
circumstances (see Part III of these instructions).

Special Rule for Terminating Plans: The fact that a
plan is terminating does not excuse a failure to
timely file a required reportable event notice.
However, notice is waived if the deadline for filing
the notice is on or after the date on which (1) all of
the plan’s

The filing deadline for any event that is reportable under more than one reportable event will be
the earliest deadline for reporting any one of the
events.
In computing any period of time, the day of the
event from which the period of time begins to run
is not included. The last day of the period is included, unless it is a weekend or Federal holiday,
in which case the period runs until the end of the
next regular business day.

assets (other than any excess assets) are
distributed pursuant to a termination, or (2) a
trustee is appointed for the plan under ERISA
§4042(c).
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for disclosure to either body of Congress or any duly
authorized committee or subcommittee of the
Congress.

Note: There is no longer a special “partial electronic filing” provision whereby a filer could submit certain required information within 1 business
day after the filing deadline. Now, all required information must be submitted by the filing deadline.

Information on Controlled Group Structure
To comply with a requirement that the reportable
event notice include a description of the plan's
controlled group structure (see page 2 of the Form
10-Advance), the filer may submit a copy of an
organization chart or other diagram. The description
or chart may exclude de minimis 5-percent segments
and foreign entities other than foreign parents.

Notice Filing Date
The date an advance notice of a reportable event is
considered to have been filed is the date the notice
and all additional information is received by PBGC
at [email protected] or the date received
through PBGC’s e-filing portal. See 29 CFR §
4000.29.

Effect of Failure to Timely File

What to File

If a notice (or any other required information) is not
provided within the specified time limit, PBGC may
assess a penalty under ERISA §4071 against each
contributing sponsor required to provide the notice
(see 29 CFR Part 4071 and PBGC's Statement of
Policy on Assessment of Penalties for Failure to
Provide Required Information (60 FR 36837, July
18, 1995)). PBGC may pursue any other equitable or
legal remedies available to it under the law.

A contributing sponsor must use the PBGC Form
10-Advance to file an advance reportable event notice with PBGC, and include with the Form 10-Advance both general information and event-specific
information. General information required is listed
at the start of Part III of the instructions and specific
information for each reportable event is described in
Part III and on the Form 10-Advance.

For Questions, Problems, Copies of Forms
If any required information has previously been submitted to PBGC, the filer may refer to the previous
submission instead of resubmitting the information.

If you have questions or problems regarding reportable events, contact:

If the same event is reportable as more than one reportable event, separate notices may be filed, or a
single notice may be filed covering all of the events.
If filing a single notice, the notice must include all
the required information for each event. (See also
“When to File.”)

Pension Benefit Guaranty Corporation
Corporate Finance and Restructuring Department
1200 K Street, NW
Washington, DC 20005-4026
Telephone: 202-326-4070
Email: [email protected]

PBGC may require that a contributing sponsor submit additional information within 7 days after the
date of PBGC’s written request. PBGC may shorten
this 7-day period where it determines that the interests of PBGC or participants may be prejudiced by a
delay in receipt of the information.

If you are having problems using the e-filing portal,
contact PBGC at [email protected].

Note: Any non-public information submitted to
PBGC as part of a reportable event notice shall not
be made public, except as may be relevant to any
administrative or judicial action or proceeding or

Copies of Form 10-Advance and instructions may be
obtained
from
PBGC’s
website
at
http://www.pbgc.gov/prac/forms.html.

TTY/ASCII users may call the Federal Relay
Service toll-free at 1-800-877-8339 and ask to be
connected to 202-326-4070.

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PART II - DEFINITIONS
Benefit liabilities means the benefits of participants
and their beneficiaries under the plan (within the
meaning of section 401(a)(2) of the Code).

premium filing (if applicable). ). If the plan has
never made a PBGC premium filing, enter the EIN
assigned to the contributing sponsor by the IRS for
income tax purposes and the PN assigned by the
contributing sponsor.

Code means the Internal Revenue Code of 1986, as
amended.

Event year means the plan year in which a reportable event occurs.

Contributing sponsor means a person that is a contributing sponsor as defined in ERISA §4001(a)(13).

Filing extension claimed means the specific filing
extension claimed under the relevant regulation and
reflected in the Notice Due Date.

Controlled group means, in connection with any
person, a group consisting of that person and all
other persons under common control with that person (generally 80 percent ownership; see 29 CFR
§4001.3). Any reference to a plan's controlled group
means all contributing sponsors of the plan and all
members of each contributing sponsor's controlled
group.

Foreign entity means a member of a controlled
group that:
1. Is not a contributing sponsor of a plan;
2. Is not organized under the laws of (or, if an
individual, is not a domiciliary of) any State of
the United States, the District of Columbia,
Puerto Rico, the Virgin Islands, American
Samoa, Guam, and the Wake Island; and

Date of event means the date described in PBGC
regulations for the specific reportable event.

3. For the fiscal year that includes the effective date
of the reportable event, meets one of the
following tests:
a. Is not required to file any United States
federal income tax form;

De minimis 5-percent segment means, in connection with a plan's controlled group, one or more
entities that in the aggregate have for a fiscal year:
1. Revenue not exceeding 5 percent of the controlled group's revenue;

b. Has no income reportable on any United
States federal income tax form other than
passive income not exceeding $1,000; or

2. Annual operating income not exceeding the
greater of:
a. 5 percent of the controlled group's annual operating income, or
b. $5 million; and

c. Does not own substantial assets in the United
States (disregarding stock of a member of the
plan's controlled group) and is not required to
file any quarterly United States tax return for
employee withholding.

3. Net tangible assets at the end of the fiscal year(s)
not exceeding the greater of:
a. 5% of the controlled group's net tangible
assets at the end of the fiscal year(s), or
b. $5 million.

Foreign parent means a foreign entity that is a direct
or indirect parent of a person that is a contributing
sponsor of a plan.

EIN/PN means the nine-digit employer identification
number assigned by the Internal Revenue Service to
a person and the three-digit plan number assigned to

Notice due date means the deadline (including
extensions) for filing notice of a reportable event
with PBGC. If no extension is claimed, the notice
due date is 30 days before the date of event.

a plan. The EIN/PN reported should be the
EIN/PN most recently reported for a PBGC
11

event, notice due date, notice filing date, and filing extension claimed, if any

Notice filing date means the date the notice of a
reportable event is received by PBGC.

•

Person means an individual, partnership, joint
venture, corporation, mutual company, joint-stock
company, trust, estate, unincorporated organization, association, or employee organization.

•

Specific Information for Particular Events
Financial Information - Where a reportable event
requires reporting financial information, please include the following for all controlled group members
(unless publicly available):

Public company means a person subject to the reporting requirements of §13 or §15(d) of the Securities Exchange Act of 1934 or a subsidiary (as
defined for purposes of the Securities Exchange Act
of 1934) of a person subject to such reporting
requirements.

•

Single-employer plan means any defined benefit
plan (as defined in ERISA §3(35)) that is not a multiemployer plan (as defined in ERISA §4001(a)(3))
and that is covered by title IV of ERISA.

•

•
PART III - SPECIFIC INSTRUCTIONS
General Information Required for All Reportable
Events; see also each reportable event listed below
for event-specific information required:
•
•
•

•

•
•
•

•

A brief statement describing the extension
claimed or reason for late filing
Certification by individual submitting the form

Audited financial statements for the most recent fiscal year (including balance sheet, income
statement, cash flow statement, and notes to the
financial statements)
If audited financial statements are not available,
unaudited financial statements for the most recent fiscal year
If neither audited nor unaudited financial statements are available, copies of federal tax returns
for the most recent tax year

Note: If the above required financial information is
publicly available, please indicate where the financial statements can be obtained (SEC, company website, etc.).

The name of the plan
The name and address of the filer
The name, title, e-mail address, and phone number of an individual whom PBGC should
contact if it has questions about the filing
The EIN/PN reported should be the EIN/PN
most recently reported for a PBGC premium
filing (if applicable). If the plan has never made
a PBGC premium filing, enter the EIN assigned
to the contributing sponsor by the IRS for income
tax purposes and the PN assigned by the
contributing sponsor
The type of event that occurred (indicated by
marking the appropriate box)
A brief statement of the pertinent facts relating to
the reportable event
Additional information to be filed for each type
of event (check all boxes for information
attached to form)
An explanation of any information required to
be filed but missing from the filing. The date of

Actuarial Information - Where a reportable event
requires reporting actuarial information, please include the following for each plan maintained by any
member of the plan’s controlled group:
•

Copy of the most recent Actuarial Valuation
Report that includes or is supplemented with all
of the items described below:
– 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);
– A summary of the actuarial assumptions and
methods used for purposes of ERISA section

10

303 and any changes in those assumptions
and methods since the previous valuation
and justifications for any change; in the case of

the beginning of the plan year;
– 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 Schedule SB of the Form
5500;

a plan that provides lump sums, other than de
mini- mis lump sums, the summary must include
the assumptions on which participants are
assumed to elect a lump sum and how lump
sums are valued;

– The effective interest rate (as defined in
ERISA section 303(h)(2)(A) and Code
section 430(h)(2)(A));

– Expected disbursements (benefit payments
and expenses) during the plan year; and

– The target normal cost calculated pursuant to
ERISA section 303 without regard to subsection 303(i)(2) (and Code section 430 without
regard to subsection 430(i)(2));

– 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 the
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).

– 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 year;
– 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 atrisk status for 5 consecutive years;
– 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;
•
– The funding standard carryover balance and
the prefunding balance (maintained pursuant
to ERISA section 303(f)(1) and Code section
430(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);

•
•

Statement of any material change in liabilities
of the plan occurring after the date of the
most recent Actuarial Valuation Report
Most recent month-end market value of plan
assets
Contact name, telephone number, and
employer of the plan actuary if different
from that listed on the most recently
filed Schedule SB to Form 5500

A. Change in Contributing Sponsor or
Controlled Group
(see 29 CFR §4043.62)

– A list of amortization bases (shortfall and
waiver) under ERISA section 303 and Code
section 430, including the year the base was
established, the original amount, the installment amount, and the remaining balance at

Definition of Event - A reportable event occurs
for a plan when there is a transaction that results,
or will result, in one or more persons ceasing to be
members of the plan's controlled group.

11

For this purpose, a transaction includes, but is
not limited to, a legally binding agreement,
whether or not written, to transfer ownership, an
actual transfer of ownership, and an actual
change in ownership that

Facts: Plan Q is maintained by Company Q. Company Q enters into a binding contract to sell a portion
of its assets and to transfer employees participating
in Plan Q, along with Plan Q, to Company R, which
is not a member of Company Q's controlled group.
There will be no change in the structure of Company Q's controlled group. On the effective date of the
sale, Company R will become the contributing sponsor of Plan Q.

occurs as a matter of law or through the exercise or
lapse of pre-existing rights. Whether an agreement is
legally binding is to be determined without regard to
any conditions in the agreement.
Note: This event does not include a transaction that
will result solely in a reorganization involving a
mere change in identity, form, or place of organization, however effected.

Reporting: There is a reportable event because, as
a result of the transaction (i.e., the date the binding contract was executed), Company Q (and any
other member of its controlled group) will cease
to be a member of Plan Q’s controlled group. Because Company Q is the contributing sponsor on
the 30th day prior to the effective date of the sale,
Company Q has the reporting obligation

A legally binding agreement means an agreement
that provides for obligations that are material to
and enforceable by and against the parties to the
agreement, regardless of whether any conditions of
the agreement have been met or satisfied (in other words, an agreement does not fail to be legally
binding solely because it is subject to conditions that
have not been performed).

Reporting Waivers - Reporting of this event is
waived if:
Small plan and mid-size plans: The event involves a change in the contributing sponsor and
the transferred plan has 500 or fewer participants;
or

Examples - The following examples assume that the
contributing sponsors are subject to advance reporting and that no waivers apply.

De minimis 5-percent segment: The person or
persons that will cease to be members of the plan's
controlled group represent a de minimis 5-percent
segment of the plan's old controlled group for the
most recent fiscal year(s) ending on or before the
effective date of the reportable event.

Controlled Group Breakup
Facts: Plan A's controlled group consists of Company A (its contributing sponsor), Company B (which
maintains Plan B), and Company C. As a result of a
transaction, the controlled group will break into two
separate controlled groups -- one segment consisting
of Company A and the other segment consisting of
Companies B and C.

If a filer is unable with reasonable diligence to obtain any information about a controlled group other
than the filer’s controlled group, the filer may instead
file a statement to that effect.

Reporting: No later than 30 days before the effective
date of the transaction, Company A (Plan A's contributing sponsor) is required to report that Companies B
and C will leave Plan A's controlled group. Company
B (Plan B's contributing sponsor) is required to report that Company A will leave Plan B's controlled
group. Company C is not required to report because
it is not a contributing sponsor.

B. Liquidation
(see 29 CFR §4043.63)
Definition of Event - A reportable event occurs for a
plan when a member of the plan's controlled group:
1. Is involved in any transaction to implement its
complete liquidation (including liquidation into

Change in Contributing Sponsor
10

another controlled group member);

unless the event would be reportable under this or
another reportable event.

2. Institutes or has instituted against it a proceeding
to be dissolved or is dissolved, whichever
occurs

Definition of Event - A reportable event occurs for a
plan when any member of the plan’s controlled group
declares a dividend or redeems its own stock, and the
amount or net value of the distribution, when
combined with other such distributions during the
same fiscal year of the person, exceeds the person’s
net income before after-tax gain or loss on any sale of
assets, as determined in accordance with general- ly
accepted accounting principles and practices, for the
prior fiscal year. A distribution by a person to a
member of its controlled group is disregarded.

first; or
3. Liquidates in a case under the federal Bankruptcy Code, or under any similar law.
Note: An event described above may also be reportable under Insolvency or Similar Settlement (see
Part III.G).
Reporting Waiver; de minimis 5-percent segment
- Reporting of this event is waived if the person that
liquidates is a de minimis 5-percent segment of the
plan's controlled group for the most recent fiscal
year(s) ending on or before the effective date of the
reportable event, and each plan that was maintained
by the liquidating member is maintained by another member of the plan's controlled group after the
liquidation.

Determination Rules - For purposes of this event,
the net value of a non-cash distribution is the fair
market value of assets transferred by the person making the distribution, reduced by the fair market value of any liabilities assumed or consideration given
by the recipient in connection with the distribution.
Net value determinations should be based on readily
available fair market value(s) or independent
appraisal(s) performed within one year before the
distribution is made. To the extent that fair market
values are not readily available and no such
appraisals exist, the fair market value of an asset
transferred in connection with a distribution or a
liability assumed by a recipient of a distribution is
deemed to be equal to 200 percent of the book value
of the asset or liability on the books of the person
making the distribution. Stock redeemed is deemed
to have no value.

Note: Additional Information — Under 29 CFR §
4043.3(d), and as noted above under “What to File,”
PBGC may request additional information. Items that
may be requested for this event include:
1. The estimated liquidation proceeds and the controlled
group’s anticipated allocation of those proceeds to its
creditors;
2. An itemized list of liquidation expenses the controlled
group expects to incur;
3. Timing of the expected liquidation of assets,
distribution of proceeds, and payment of expenses as
detailed in #1 and 2; and
4. Details of any prior liquidation proceeds already
distributed since the controlled group made the decision
to liquidate, including the name of the creditor, amount,
and type of debt (secured or unsecured).

Reporting Waiver; de minimis 5-percent segment
- Reporting is waived if the person making the distribution is a de minimis 5-percent segment of the
plan’s controlled group for the most recent fiscal
year(s) ending on or before the effective date of the
reportable event.

C. Extraordinary Dividend or Stock
Redemption
(see 29 CFR §4043.64)

D. Transfer of Benefit Liabilities
(see 29 CFR §4043.65)

ERISA Definition - The reportable event described
below replaces the reportable event on extraordinary dividends and stock redemptions described in
ERISA §4043(c)(11). Thus, reporting of any event
described under ERISA §4043(c)(11) is waived,

Definition of Event - A reportable event occurs for
a plan when:
1. The plan makes a transfer of benefit liabilities to
a person, or to a plan or plans maintained by a
11

person or persons, that are not members of the
transferor plan’s controlled group; and

ing the actuarial assumptions prescribed for valuing
benefits in trusteed plans under 29 CFR §§4044.5157.

2. The amount of benefit liabilities transferred, in
conjunction with other benefit liabilities transferred during the 12-month period ending on
the date of the transfer, is 3 percent or more of
the plan’s total benefit liabilities. For this
purpose, value both the benefit liabilities
transferred and the plan’s total benefit
liabilities as of any one date in the plan year in
which the transfer occurs, using actuarial
assumptions that comply with Code §414(l).

Fully funded plans: The transfer complies with
section 414(l) of the Code using reasonable actuarial assumptions and, after the transfer, the transferor
and transferee plans are fully funded as determined in
accordance with 29 CFR Parts 4044.51 through
4044.57 (dealing with valuation of benefits and assets in trusteed terminating plans) and 29 CFR Part
4010.8(d)(1)(ii).
If a filer is unable with reasonable diligence to obtain any of the above information about a controlled
group other than the filer’s controlled group, the filer
may instead file a statement to that effect.

The date of a transfer of benefit liabilities shall
be determined on the basis of the facts and
circumstanc- es of the particular situation. For
transfers subject
to Code §414(l), the date
determined in accordance with that section and 26
CFR §1.414(l)-1(b)(11) will be considered the date
of transfer.

E. Application for Minimum Funding Waiver
(see 29 CFR §4043.66)
Definition of Event - A reportable event occurs
when an application for a minimum funding waiver
is submitted for a plan.

Note: For purposes of this reportable event, the payment of a lump sum, or purchase of an irrevocable
commitment to provide an annuity, in satisfaction of
benefit liabilities is not considered a transfer of benefit liabilities.

Extension of Reporting Deadline - The notice date
is extended until 10 days after the report- able event
has occurred.

Reporting Waivers - Reporting is waived if:

F. Loan Default
(see 29 CFR §4043.67)

Complete plan transfer: The transfer is a transfer
of all of the transferor plan’s benefit liabilities and
assets to one other plan.

Definition of Event - A reportable event occurs for a
plan when, with respect to a loan with an outstanding
balance of $10 million or more to a member of the
plan’s controlled group:

Transfer of less than 3 percent of assets: The value
of the assets being transferred —
1. Equals the present value of the accrued benefits
(whether or not vested) being transferred, using
actuarial assumptions that comply with section
414(l) of the Code; and
2. In conjunction with other assets transferred
during the same plan year, is less than 3 percent
of the assets of the transferor plan as of at least
one day in that year.

1. There is an acceleration of payment or a default
under the loan agreement; or
2. The lender waives or agrees to an amendment of
any covenant in the loan agreement for the purpose of avoiding a default.
G. Insolvency or Similar Settlement
(see 29 CFR §4043.68)

Section 414(l) safe harbor: The benefit liabilities
of 500 or fewer participants are transferred and the
transfer complies with section 414(l) of the Code us-

Definition of Event - A reportable event occurs with
10

respect to a plan when any member of the plan's
controlled group:
1. Commences, or has commenced against it,
any insolvency proceeding (including, but not
lim- ited to, the appointment of a receiver)
other than a bankruptcy case under the
Bankruptcy Code;
2. Commences, or has commenced against it, a
pro- ceeding to effect a composition,
extension, or settlement with creditors;
3. Executes a general assignment for the benefit
of creditors; or
4. Undertakes to effect any other nonjudicial
com- position, extension, or settlement with
substan- tially all its creditors.
Note: An event described above may also be
reportable under Liquidation (see Part III. B).

Extension of Reporting Deadline - For a case or
proceeding under 1 or 2 described in the definition of
an insolvency or similar event above that is not
commenced by a member of the plan’s controlled
group, the notice date is extended until 10 days after
the commencement of the case or proceeding.

Note: Additional Information — Under 29 CFR §
4043.3(d), and as noted above under “What to File,”
PBGC may request additional information. Items that
may be requested for this event include:
1. The estimated proceeds from the sale of assets and the
controlled group’s anticipated allocation of those
proceeds to its creditors;
2. An itemized list of asset sale expenses the controlled
group expects to incur;
3. Timing of the expected sale of assets, distribution of
proceeds, and payment of expenses as detailed in #1 and
2; and
4. Details of any prior asset sale proceeds already
distributed since the reportable event date, including the
name of the creditor, amount, and of debt (secured or
unsecured).

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PAPERWORK REDUCTION ACT NOTICE
PBGC needs this information, which is required to be filed under ERISA §4043 and 29 CFR Part 4043,
Subparts A and C, so that it can take action to protect participants and the termination insurance program
in appropriate cases. Information provided to PBGC pursuant to ERISA 4043 is confidential to the extent
provided by the Freedom of Information Act, the Privacy Act, and ERISA §4043(f). PBGC estimates that it
will take an average of 3 hours and $745 to comply with these requirements. If you have any comments
concerning the accuracy of this estimate or suggestions for improving this form, please send your comments
to the Pension Benefit Guaranty Corporation, Regulatory Affairs Group, Office of the General Counsel, 1200
K Street, NW, Washington, DC 20005-4026. This collection of information has been approved by the Office
of Management and Budget (OMB) under control number [pending] and expires on XX,XXXX. An agency
may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it
displays a currently valid OMB control number.

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