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Schedule MB (Form 5500) 2012

Page

New amortization bases established in the current plan year:

(1) Type of base

(2) Initial balance

(3) Amortization Charge/Credit

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Miscellaneous information:

If a waiver of a funding deficiency has been approved for this plan year, enter the date (MM-DD-YYYY) of the

YYYY-MM-DD

ruling letter granting the approval ...............................................................................................................................

Yes

Is the plan required to provide a Schedule of Active Participant Data? (See the instructions.) If “Yes,” attach schedule.

Are any of the plan’s amortization bases operating under an extension of time under section 412(e) (as in effect prior to

Yes

2008) or section 431(d) of the Code? ................................................................................................................................... .

If line c is “Yes,” provide the following additional information:

Yes

(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)

(3) Was an extension approved by the Internal Revenue Service under section 412(e) (as in effect prior to

Yes

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)

the number of years in line (2)) .............................................................................................................................

YYYY-MM-DD

(5) If line 8d(3) is “Yes,” enter the date of the ruling letter approving the extension .................................................. 8d(5)

(6) If line 8d(3) is “Yes,” is the amortization base eligible for amortization using interest rates applicable under section

Yes

6621(b) of the Code for years beginning after 2007? ......................................................................................................

If box 5h is checked or line 8c is “Yes,” enter the difference between the minimum required contribution for the

year and the minimum that would have been required without using the shortfall method or extending the

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amortization base(s) ...................................................................................................................................................

Funding standard account statement for this plan year:

Charges to funding standard account:

Prior year funding deficiency, if any ............................................................................................................................

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Employer’s normal cost for plan year as of valuation date .........................................................................................

Outstanding balance

Amortization charges as of valuation date:

(1) All bases except funding waivers and certain bases for which the

9c(1)

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amortization period has been extended .......................................................

(2) Funding waivers ........................................................................................... 9c(2)

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(3) Certain bases for which the amortization period has been extended ..........

9c(3)

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Interest as applicable on lines 9a, 9b, and 9c ............................................................................................................

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Total charges. Add lines 9a through 9d ......................................................................................................................

Credits to funding standard account:

Prior year credit balance, if any ..................................................................................................................................

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Employer contributions. Total from column (b) of line 3 .............................................................................................

Outstanding balance

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Amortization credits as of valuation date ...........................................................

Interest as applicable to end of plan year on lines 9f, 9g, and 9h...............................................................................

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Full funding limitation (FFL) and credits:

(1) ERISA FFL (accrued liability FFL) .............................................................

9j(1)

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(2) “RPA ‘94” override (90% current liability FFL) ..........................................

9j(2)

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(3) FFL credit ............................................................................................................................................................

9j(3)

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(1) Waived funding deficiency .................................................................................................................................. 9k(1)

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(2) Other credits ....................................................................................................................................................... 9k(2)

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Total credits. Add lines 9f through 9i, 9j(3), 9k(1), and 9k(2) ......................................................................................

Credit balance: If line 9l is greater than line 9e, enter the difference..........................................................................

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Funding deficiency: If line 9e is greater than line 9l, enter the difference ...................................................................

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