SCHEDULE SB(Form 5500)Department of the Treasury Internal Revenue Service
Department
of Labor Pension Benefit Guaranty Corporation |
Single-Employer Defined Benefit 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). File as an attachment to Form 5500 or 5500-SF. |
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: X Single X Multiple-A X Multiple-B |
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F Prior year plan size: X 100 or fewer X 101-500 X More than 500 |
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Part I |
Basic Information |
1 Enter the valuation date: Month _________ Day _________ Year _________ |
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2 Assets: |
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a Market value |
2a |
-123456789012345 |
b Actuarial value |
2b |
-123456789012345 |
19 Discounted employer contributions – see instructions for small plan with a valuation date after the beginning of the year: |
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a Contributions allocated toward unpaid minimum required contributions from prior years. |
19a |
-123456789012345 |
b Contributions made to avoid restrictions adjusted to valuation date. |
19b |
-123456789012345 |
c Contributions allocated toward minimum required contribution for current year adjusted to valuation date. |
19c |
-123456789012345 |
20 Quarterly contributions and liquidity shortfalls: |
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a Did the plan have a “funding shortfall” for the prior year? X Yes X No |
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b If line 20a is “Yes,” were required quarterly installments for the current year made in a timely manner? X Yes X No |
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c If line 20a is “Yes,” see instructions and complete the following table as applicable: |
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Liquidity shortfall as of end of quarter of this plan year |
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(1) 1st |
(2) 2nd |
(3) 3rd |
(4) 4th |
-123456789012345 |
-123456789012345 |
-123456789012345 |
-123456789012345 |
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Part V |
Assumptions Used to Determine Funding Target and Target Normal Cost |
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21 Discount rate: |
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a Segment rates: |
1st segment: 123.12_% |
2nd segment: 123.12_% |
3rd
segment: |
X N/A, full yield curve used |
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b Applicable month (enter code) |
21b |
1 |
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22 Weighted average retirement age |
22 |
12 |
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23 Mortality table(s) (see instructions) |
_ Prescribed - combined |
_ Prescribed - separate |
_ Substitute |
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Part VI |
Miscellaneous Items |
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24 Has a change been made in the non-prescribed actuarial assumptions for the current plan year? If “Yes,” see instructions regarding required attachment. X Yes X No |
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25 Has a method change been made for the current plan year? If “Yes,” see instructions regarding required attachment. X Yes X No |
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26 Demographic and benefit information |
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a Is the plan required to provide a Schedule of Active Participants? If “Yes,” see instructions regarding required attachment. |
X Yes X No |
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b Is the plan required to provide a projection of expected benefit payments? If “Yes,” see instructions regarding required attachment |
X Yes X No |
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27 If the plan is subject to alternative funding rules, enter applicable code and see instructions regarding attachment |
27 |
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Part VII |
Reconciliation of Unpaid Minimum Required Contributions For Prior Years |
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28 Unpaid minimum required contributions for all prior years |
28 |
-123456789012345 |
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29 Discounted employer contributions allocated toward unpaid minimum required contributions from prior years (line 19a) |
29 |
-123456789012345 |
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30 Remaining amount of unpaid minimum required contributions (line 28 minus line 29) |
30 |
-123456789012345 |
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Part VIII |
Minimum Required Contribution For Current Year |
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31 Target normal cost and excess assets (see instructions): |
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a Target normal cost (line 6c) |
31a |
-123456789012345 |
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b Excess assets, if applicable, but not greater than line 31a |
31b |
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32 Amortization installments: |
Outstanding Balance |
Installment |
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a Net shortfall amortization installment |
-123456789012345 |
-123456789012345 |
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b Waiver amortization installment |
-123456789012345 |
-123456789012345 |
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33 If a waiver has been approved for this plan year, enter the date of the ruling letter granting the approval (Month _________ Day _________ Year _________ )_and the waived amount |
33 |
-123456789012345 |
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34 Total funding requirement before reflecting carryover/prefunding balances (lines 31a - 31b + 32a + 32b - 33)..... |
34 |
-123456789012345 |
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Carryover balance |
Prefunding balance |
Total balance |
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35 Balances elected for use to offset funding requirement |
-123456789012345 |
-123456789012345 |
-123456789012345 |
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36 Additional cash requirement (line 34 minus line 35) |
36 |
-123456789012345 |
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37 Contributions allocated toward minimum required contribution for current year adjusted to valuation date (line 19c) |
37 |
-123456789012345 |
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38 Present value of excess contributions for current year (see instructions) -123456789012345 |
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a Total (excess, if any, of line 37 over line 36) |
38a |
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b Portion included in line 38a attributable to use of prefunding and funding standard carryover balances |
38b |
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39 Unpaid minimum required contribution for current year (excess, if any, of line 36 over line 37) |
39 |
-123456789012345 |
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40 Unpaid minimum required contributions for all years |
40 |
-123456789012345 |
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Part IX |
Pension Funding Relief Under the American Rescue Plan Act of 2021 (See Instructions) |
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41 If an election was made to use the extended amortization rule for a plan year beginning on or before December 31, 2021, check the box to indicate the first plan year for which the rule applies. X 2019 X 2020 X 2021 |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | 2024 Schedule SB |
Author | United States Department of Labor |
File Modified | 0000-00-00 |
File Created | 2024-07-22 |