Instructions For Schedule H (Form 5500) - Financial Information - 2009 Page 8

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Any investment asset held by the plan on the last day of the
of the plan assets at the beginning of the plan year. If this is the
plan year; and
initial plan year, you may use the current value of plan assets at
Any investment asset purchased during the plan year and
the end of the plan year to determine the 5% figure.
sold before the end of the plan year except:
If the assets of two or more plans are maintained in one
1. Debt obligations of the U.S. or any U.S. agency.
trust, except as provided below, the plan’s allocable portion of
2. Interests issued by a company registered under the
the transactions of the trust shall be combined with the other
Investment Company Act of 1940 (e.g., a mutual fund).
transactions of the plan, if any, to determine which transactions
3. Bank certificates of deposit with a maturity of one year or
(or series of transactions) are reportable (5%) transactions.
less.
For investments in common/collective trusts (CCTs), pooled
4. Commercial paper with a maturity of 9 months or less if it
separate accounts (PSAs), 103-12 IEs, and registered
is valued in the highest rating category by at least two nationally
investment companies, determine the 5% figure by comparing
recognized statistical rating services and is issued by a
the transaction date value of the acquisition and/or disposition
company required to file reports with the Securities and
of units of participation or shares in the entity with the current
Exchange Commission under section 13 of the Securities
value of the plan assets at the beginning of the plan year. If the
Exchange Act of 1934.
Schedule H is attached to a Form 5500 filed for a plan with all
5. Participations in a bank common or collective trust.
plan funds held in a master trust, check ‘‘No’’ on line 4j. Plans
6. Participations in an insurance company pooled separate
with assets in a master trust that have other transactions should
account.
determine the 5% figure by subtracting the current value of plan
7. Securities purchased from a broker-dealer registered
assets held in the master trust from the current value of all plan
under the Securities Exchange Act of 1934 and either: (1) listed
assets at the beginning of the plan year and check ‘‘Yes’’ or
on a national securities exchange and registered under section
‘‘No,’’ as appropriate. Do not include individual transactions of
6 of the Securities Exchange Act of 1934 or (2) quoted on
(CCTs), (PSAs), master trust investment accounts (MTIAs),
NASDAQ.
103-12 IEs, and registered investment companies in which this
Assets held for investment purposes shall not include any
plan or DFE invests.
investment that was not held by the plan on the last day of the
In the case of a purchase or sale of a security on the market,
plan year if that investment is reported in the annual report for
do not identify the person from whom purchased or to whom
that plan year in any of the following:
sold.
1. The schedule of loans or fixed income obligations in
Special rule for certain participant-directed transactions.
default required by Schedule G, Part I;
Transactions under an individual account plan that a participant
2. The schedule of leases in default or classified as
or beneficiary directed with respect to assets allocated to his or
uncollectible required by Schedule G, Part II;
her account (including a negative election authorized under the
3. The schedule of nonexempt transactions required by
terms of the plan) should not be treated for purposes of line 4j
Schedule G, Part III; or
as reportable transactions. The current value of all assets of the
4. The schedule of reportable transactions required by
plan, including these participant-directed transactions, should
Schedule H, line 4j.
be included in determining the 5% figure for all other
transactions.
Line 4j. Check ‘‘Yes’’ and attach to the Form 5500 the
Line 4k. Check ‘‘Yes’’ if all the plan assets (including
following schedule if the plan had any reportable transactions
insurance/annuity contracts) were distributed to the participants
(see 29 CFR 2520.103-6 and the examples provided in the
and beneficiaries, legally transferred to the control of another
regulation). The schedule must use the format set forth below
plan, or brought under the control of the PBGC.
or a similar format. See 29 CFR 2520.103-11.
Check ‘‘No’’ for a welfare benefit plan that is still liable to pay
A reportable transaction includes:
benefits for claims incurred before the termination date, but not
1. A single transaction within the plan year in excess of 5%
yet paid. See 29 CFR 2520.104b-2(g)(2)(ii).
of the current value of the plan assets;
Line 4l. You must check “Yes” if any benefits due under the
2. Any series of transactions with or in conjunction with the
plan were not timely paid or not paid in full. Include in this
same person, involving property other than securities, which
amount the total of any outstanding amounts that were not paid
amount in the aggregate within the plan year (regardless of the
when due in previous years that have continued to remain
category of asset and the gain or loss on any transaction) to
unpaid.
more than 5% of the current value of plan assets;
Line 4m. Check “Yes” if there was a “blackout period.” A
3. Any transaction within the plan year involving securities
blackout period is a temporary suspension of more than three
of the same issue if within the plan year any series of
(3) consecutive business days during which participants or
transactions with respect to such securities amount in the
beneficiaries of a 401(k) or other individual account pension
aggregate to more than 5% of the current value of the plan
plan were unable to, or were limited or restricted in their ability
assets; and
to, direct or diversify assets credited to their accounts, obtain
4. Any transaction within the plan year with respect to
loans from the plan, or obtain distributions from the plan. A
securities with, or in conjunction with, a person if any prior or
“blackout period” generally does not include a temporary
subsequent single transaction within the plan year with such
suspension of the right of participants and beneficiaries to direct
person, with respect to securities, exceeds 5% of the current
or diversify assets credited to their accounts, obtain loans from
value of plan assets.
the plan, or obtain distributions from the plan if the temporary
The 5% figure is determined by comparing the current value
suspension is: (1) part of the regularly scheduled operations of
of the transaction at the transaction date with the current value
the plan that has been disclosed to participants and
Line 4j schedule. The schedule required to be attached is a schedule of reportable transactions that must be clearly labeled
“Schedule H, line 4j — Schedule of Reportable Transactions.”
(h) Current
(b) Description of asset
(f) Expense
(a) Identity of
(c) Purchase
(d) Selling
(e) Lease
(g) Cost of
(i) Net gain
value of asset
(include interest rate and
incurred
party involved
price
price
rental
asset
or (loss)
on transaction
maturity in case of a loan)
with transaction
date
-36-
Instructions for Schedule H (Form 5500)

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