Document
2020 Sch D
ICR 202112-1210-003 · OMB 1210-0110 · Object 117105101.
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | 2020 Sch D |
| Author | Bruce Silver |
| Last Modified By | Writer |
| File Modified | 2021-03-18 |
| File Created | 2026-09-01 |
| Conversion State | complete |
Extracted Text
SCHEDULE D (Form 5500) Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration DFE/Participating Plan Information This schedule is required to be filed under section 104 of the Employee Retirement Income Security Act of 1974 (ERISA). File as an attachment to Form 5500. OMB No. 1210-0110 2021 This Form is Open to Public Inspection. For calendar plan year 2021 or fiscal plan year beginning and ending A Name of plan ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI B Three-digit plan number (PN) 001 C Plan or DFE sponsor’s name as shown on line 2a of Form 5500 ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI D Employer Identification Number (EIN) 012345678 Part I Information on interests in MTIAs, CCTs, PSAs, and 103-12 IEs (to be completed by plans and DFEs) (Complete as many entries as needed to report all interests in DFEs) a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 For Paperwork Reduction Act Notice, see the Instructions for Form 5500. Schedule D (Form 5500) 2021 v. 201209 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 a Name of MTIA, CCT, PSA, or 103-12 IE: ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCD b Name of sponsor of entity listed in (a): ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 d Entity code 1 e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions) -123456789012345 6 Part II Information on Participating Plans (to be completed by DFEs) (Complete as many entries as needed to report all participating plans) a Plan name ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI b Name of plan sponsor ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 a Plan name ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI b Name of plan sponsor ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 a Plan name ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI b Name of plan sponsor ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 a Plan name ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI b Name of plan sponsor ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 a Plan name ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI b Name of plan sponsor ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 a Plan name ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI b Name of plan sponsor ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 a Plan name ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI b Name of plan sponsor ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 a Plan name ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI b Name of plan sponsor ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 a Plan name ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI b Name of plan sponsor ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 a Plan name ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI b Name of plan sponsor ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 a Plan name ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI b Name of plan sponsor ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123 a Plan name ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI b Name of plan sponsor ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI c EIN-PN 123456789-123