SCHEDULE MB(Form 5500)Department of the Treasury Internal Revenue Service
Department
of Labor Pension Benefit Guaranty Corporation |
Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information
This schedule is required to be filed under section 104 of the Employee Retirement Income Security Act of 1974 (ERISA) and section 6059 of the Internal Revenue Code (the Code). |
OMB No. 1210-0110
This Form is Open to Public Inspection |
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For calendar plan year 2024 or fiscal plan year beginning and ending |
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Round off amounts to nearest dollar.Caution: A penalty of $1,000 will be assessed for late filing of this report unless reasonable cause is established. |
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A Name of plan ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI |
B Three-digit |
001 |
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C Plan sponsor’s name as shown on line 2a of Form 5500 or 5500-SF ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI |
D
Employer Identification Number (EIN) |
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E Type of plan: (1) X Multiemployer Defined Benefit (2) X Money Purchase (see instructions) |
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1a Enter the valuation date: Month _________ Day _________ Year _________ |
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b Assets |
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(1) Current value of assets |
1b(1) |
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(2) Actuarial value of assets for funding standard account |
1b(2) |
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c (1) Accrued liability for plan using immediate gain methods |
1c(1) |
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(2) Information for plans using spread gain methods: |
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(a) Unfunded liability for methods with bases |
1c(2)(a) |
-123456789012345 |
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(b) Accrued liability under entry age normal method |
1c(2)(b) |
-123456789012345 |
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(c) Normal cost under entry age normal method |
1c(2)(c) |
-123456789012345 |
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(3) Accrued liability under unit credit cost method |
1c(3) |
-123456789012345 |
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d Information on current liabilities of the plan: |
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(1) Amount excluded from current liability attributable to pre-participation service (see instructions) |
1d(1) |
-123456789012345 |
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(2) “RPA ‘94” information: |
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(a) Current liability |
1d(2)(a) |
-123456789012345 |
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(b) Expected increase in current liability due to benefits accruing during the plan year |
1d(2)(b) |
-123456789012345 |
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(c) Expected release from “RPA ‘94” current liability for the plan year |
1d(2)(c) |
-123456789012345 |
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(3) Expected plan disbursements for the plan year |
1d(3) |
-123456789012345 |
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Statement by Enrolled Actuary To the best of my knowledge, the information supplied in this schedule and accompanying schedules, statements and attachments, if any, is complete and accurate. Each prescribed assumption was applied in accordance with applicable law and regulations. In my opinion, each other assumption is reasonable (taking into account the experience of the plan and reasonable expectations) and such other assumptions, in combination, offer my best estimate of anticipated experience under the plan. |
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SIGN |
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Signature of actuary |
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Date |
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Type or print name of actuary |
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Most recent enrollment number |
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Firm name |
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Telephone number (including area code) |
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123456789 ABCDEFGHI ABCDEFGHI ABCDE 123456789
ABCDEFGHI ABCDEFGHI ABCDE |
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Address of the firm |
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If the actuary has not fully reflected any regulation or ruling promulgated under the statute in completing this schedule, check the box and see instructions |
X |
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For Paperwork Reduction Act Notice, see the Instructions for Form 5500 or 5500-SF. |
Schedule MB (Form 5500) 2024 v. 230807 |
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6 Checklist of certain actuarial assumptions: |
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a Interest rate for “RPA ‘94” current liability.
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6a |
123.12% |
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Pre-retirement |
Post-retirement |
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b Rates specified in insurance or annuity contracts |
X Yes X No X N/A |
X Yes X No X N/A |
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c Mortality table code for valuation purposes: |
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(1) Males |
6c(1) |
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(2) Females |
6c(2) |
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d Valuation liability interest rate |
6d |
123.12% |
123.12% |
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e Salary scale |
6e |
123.12% |
X N/A |
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f Withdrawal liability interest rate: |
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(1) Type of interest rate |
6f(1) |
X Single rate X ERISA 4044 X Other X N/A |
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(2) If “Single rate” is checked in (1), enter applicable single rate |
6f(2) |
% |
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g Estimated investment return on actuarial value of assets for year ending on the valuation date |
6g |
-123.1% |
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h Estimated investment return on current value of assets for year ending on the valuation date |
6h |
-123.1% |
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i Expense load included in normal cost reported in line 9b |
6i |
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X N/A |
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(1) If expense load is described as a percentage of normal cost, enter the assumed percentage |
6i(1) |
% |
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(2) If expense load is a dollar amount that varies from year to year, enter the dollar amount included in line 9b |
6i(2) |
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(3) If neither (1) nor (2) describes the expense load, check the box |
6i(3) |
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X |
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7 New amortization bases established in the current plan year: |
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(1) Type of base |
(2) Initial balance |
(3) Amortization Charge/Credit |
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A |
-123456789012345 |
-123456789012345 |
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A |
-123456789012345 |
-123456789012345 |
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A |
-123456789012345 |
-123456789012345 |
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8 Miscellaneous information: |
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a If a waiver of a funding deficiency has been approved for this plan year, enter the date (MM/DD/YYYY) of the ruling letter granting the approval |
8a |
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b Demographic, benefit, and contribution information |
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instructions for required attachment. |
X Yes X No |
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X Yes X No |
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(3) Is the plan required to provide a projection of employer contributions and withdrawal liability payments? (See instructions) If “Yes,” attach a schedule. |
X Yes X No |
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c Are any of the plan’s amortization bases operating under an extension of time under section 412(e) (as in effect prior to 2008) or section 431(d) of the Code? |
X Yes X No |
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d If line c is “Yes,” provide the following additional information: |
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X Yes X No |
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8d(2) |
12 |
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X Yes X No |
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8d(4) |
12 |
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8d(5) |
YYYY-MM-DD |
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X Yes X No |
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e If box 5h is checked or the plan received an amortization extension for this plan year under Code section 431(d), enter the difference between the amount necessary to satisfy the plan’s minimum funding standard for this plan year and the amount that would have been necessary without using the shortfall method or extending the amortization period(s). |
8e |
-123456789012345 |
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9 Funding standard account statement for this plan year: |
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Charges to funding standard account: |
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a Prior year funding deficiency, if any |
9a |
-123456789012345 |
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b Employer’s normal cost for plan year as of valuation date |
9b |
-123456789012345 |
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c Amortization charges as of valuation date: |
Outstanding balance |
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(1) All bases except funding waivers and certain bases for which the amortization period has been extended |
9c(1) |
-123456789012345 |
-123456789012345 |
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(2) Funding waivers |
9c(2) |
-123456789012345 |
-123456789012345 |
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(3) Certain bases for which the amortization period has been extended |
9c(3) |
-123456789012345 |
-123456789012345 |
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d Interest as applicable on lines 9a, 9b, and 9c |
9d |
-123456789012345 |
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e Total charges. Add lines 9a through 9d |
9e |
-123456789012345 |
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Credits to funding standard account: |
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f Prior year credit balance, if any |
9f |
-123456789012345 |
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g Employer contributions. Total from column (b) of line 3 |
9g |
-123456789012345 |
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Outstanding balance |
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h Amortization credits as of valuation date |
9h |
-123456789012345 |
-123456789012345 |
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i Interest as applicable to end of plan year on lines 9f, 9g, and 9h |
9i |
-123456789012345 |
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j Full funding limitation (FFL) and credits: |
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(1) ERISA FFL (accrued liability FFL) |
9j(1) |
-123456789012345 |
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(2) “RPA ‘94” override (90% current liability FFL) |
9j(2) |
-123456789012345 |
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(3) FFL credit |
9j(3) |
-123456789012345 |
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k (1) Waived funding deficiency |
9k(1) |
-123456789012345 |
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(2) Other credits |
9k(2) |
-123456789012345 |
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l Total credits. Add lines 9f through 9i, 9j(3), 9k(1), and 9k(2) |
9l |
-123456789012345 |
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m Credit balance: If line 9l is greater than line 9e, enter the difference |
9m |
-123456789012345 |
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n Funding deficiency: If line 9e is greater than line 9l, enter the difference |
9n |
-123456789012345 |
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o Current year’s accumulated reconciliation account: |
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(1) Due to waived funding deficiency accumulated prior to the current plan year |
9o(1) |
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(2) Due to amortization bases extended and amortized using the interest rate under section 6621(b) of the Code: |
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(a) Reconciliation outstanding balance as of valuation date |
9o(2)(a) |
-123456789012345 |
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(b) Reconciliation amount (line 9c(3) balance minus line 9o(2)(a)) |
9o(2)(b) |
-123456789012345 |
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(3) Total as of valuation date |
9o(3) |
-123456789012345 |
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10 Contribution necessary to avoid an accumulated funding deficiency. (see instructions.) |
10 |
-123456789012345 |
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11 Has a change been made in the actuarial assumptions for the current plan year? If “Yes,” see instructions . |
X Yes X No |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |