Form 5500 - Schedule Mb - Multiemployer Defined Benefit Plan And Certain Money Purchase Plan Actuarial Information - 2015 Page 3

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3 -
1 x
Schedule MB (Form 5500) 2015
Page
(1) Males ......................................................................................... 6c(1)
(2) Females .................................................................................... 6c(2)
d
6d
123.12
123.12
%
%
Valuation liability interest rate ..........................................................
e
6e
X
X
123.12
%
N/A
123.12
%
N/A
Expense loading ..............................................................................
f
6f
X
N/A
Salary scale .....................................................................................
123.12
%
g
Estimated investment return on actuarial value of assets for year ending on the valuation date ......................... 6g
-123.1
%
h
Estimated investment return on current value of assets for year ending on the valuation date ........................... 6h
-123.1
%
7
New amortization bases established in the current plan year:
(1) Type of base
(2) Initial balance
(3) Amortization Charge/Credit
A
-123456789012345
-123456789012345
A
-123456789012345
-123456789012345
A
-123456789012345
-123456789012345
8
Miscellaneous information:
a
If a waiver of a funding deficiency has been approved for this plan year, enter the date (MM-DD-YYYY) of the
8a
YYYY-MM-DD
ruling letter granting the approval ...............................................................................................................................
b(1)
Is the plan required to provide a projection of expected benefit payments? (See the instructions.) If “Yes,” attach a
X
X
Yes
No
schedule ............................................................................................................................................................................
b(2)
Is the plan required to provide a Schedule of Active Participant Data? (See the instructions.) If “Yes,” attach a
X
X
Yes
No
schedule.
c
Are any of the plan’s amortization bases operating under an extension of time under section 412(e) (as in effect prior to
X
X
Yes
No
2008) or section 431(d) of the Code? ................................................................................................................................... .
d
If line c is “Yes,” provide the following additional information:
X
X
Yes
No
(1) Was an extension granted automatic approval under section 431(d)(1) of the Code? ........................................
(2) If line 8d(1) is “Yes,” enter the number of years by which the amortization period was extended ....................... 8d(2)
12
(3) Was an extension approved by the Internal Revenue Service under section 412(e) (as in effect prior to
X
X
Yes
No
2008) or 431(d)(2) of the Code? ...........................................................................................................................
(4) If line 8d(3) is “Yes,” enter number of years by which the amortization period was extended (not including
8d(4)
12
the number of years in line (2)) .............................................................................................................................
(5) If line 8d(3) is “Yes,” enter the date of the ruling letter approving the extension .................................................. 8d(5)
YYYY-MM-DD
(6) If line 8d(3) is “Yes,” is the amortization base eligible for amortization using interest rates applicable under section
X
X
Yes
No
6621(b) of the Code for years beginning after 2007? ......................................................................................................
e
If box 5h is checked or line 8c is “Yes,” enter the difference between the minimum required contribution for the
8e
year and the minimum that would have been required without using the shortfall method or extending the
-123456789012345
amortization base(s) ...................................................................................................................................................
9
Funding standard account statement for this plan year:
Charges to funding standard account:
a
9a
Prior year funding deficiency, if any ............................................................................................................................
-123456789012345
b
9b
-123456789012345
Employer’s normal cost for plan year as of valuation date .........................................................................................
c
Outstanding balance
Amortization charges as of valuation date:
(1) All bases except funding waivers and certain bases for which the
9c(1)
-123456789012345
-123456789012345
amortization period has been extended .......................................................
(2) Funding waivers ...........................................................................................
9c(2)
-123456789012345
-123456789012345
(3) Certain bases for which the amortization period has been extended ..........
9c(3)
-123456789012345
-123456789012345
d
9d
-123456789012345
Interest as applicable on lines 9a, 9b, and 9c ............................................................................................................
e
9e
Total charges. Add lines 9a through 9d ......................................................................................................................
-123456789012345
Credits to funding standard account:
f
9f
-123456789012345
Prior year credit balance, if any ..................................................................................................................................
g
9g
-123456789012345
Employer contributions. Total from column (b) of line 3 .............................................................................................
Outstanding balance
h
9h
-123456789012345
Amortization credits as of valuation date ...........................................................
-123456789012345
i
9i
Interest as applicable to end of plan year on lines 9f, 9g, and 9h ..............................................................................
-123456789012345

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