Form 5500-C/r - Return/report Of Employee Benefit Plan - 1998 Page 6

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6
Complete page 1, and pages 3 through 6 only, if you are filing Form 5500-C.
Form 5500-C/R (1998)
Page
27
Current value of plan assets and liabilities at the beginning and end of the plan year. Combine the value of plan assets held in more than
one trust. Allocate the value of the plan’s interest in a commingled trust containing the assets of more than one plan on a line-by-line basis
unless the trust meets one of the specific exceptions described in the instructions. Do not enter the value of the portion of an insurance
contract that guarantees during this plan year to pay a specific dollar benefit at a future date. Round off amounts to the nearest dollar.
Any other amounts are subject to rejection. Plans with no assets at the beginning and end of the plan year enter -0- on line 27f.
(a) Beginning
(b) End of
of year
year
Assets
27a
a Cash
27b
b Receivables
c Investments:
27c(1)
(1)
U.S. Government securities
27c(2)
(2)
Corporate debt and equity instruments
27c(3)
(3)
Real estate and mortgages (other than to participants)
(4)
Loans to participants:
(4)A
A
Mortgages
(4)B
B Other
27c(5)
(5)
Other
27c(6)
(6)
Total investments. Add lines 27c(1) through 27c(5)
27d
d Buildings and other property used in plan operations
27e
e Other assets
27f
f Total assets. Add lines 27a, 27b, 27c(6), 27d, and 27e
Liabilities
27g
g
Payables
27h
h
Acquisition indebtedness
27i
i
Other liabilities
27j
j
Total liabilities. Add lines 27g through 27i
k
Net assets. Subtract line 27j from line 27f
27k
28
Plan income, expenses, and changes in net assets for the plan year. Include all income and expenses of the plan including any trust(s) or
separately maintained fund(s) and any payments/receipts to/from insurance carriers. Round off amounts to the nearest dollar. Any other
amounts are subject to rejection.
(a) Amount
(b) Total
Income
a Contributions received or receivable in cash from:
28a(1)
(1)
Employer(s) (including contributions on behalf of self-employed individuals)
28a(2)
(2)
Employees
28a(3)
(3)
Others
28a(4)
(4)
Add lines 28a(1) through 28a(3)
28b
b Noncash contributions. Enter the total of lines 28a(4) and lines 28b in column (b)
28c
c Earnings from investments (interest, dividends, rents, royalties)
28d
d Net realized gain (loss) on sale or exchange of assets
28e
e Other income (specify)
28f
f Total income. Add lines 28b through 28e
Expenses
g Distribution of benefits and payments to provide benefits:
28g(1)
(1)
Directly to participants or their beneficiaries
28g(2)
(2)
Other
28g(3)
(3)
Total distribution of benefits and payments to provide benefits
28h
h
Administrative expenses (salaries, fees, commissions, insurance premiums)
28i
i Other expenses (specify)
28j
j
Total expenses. Add lines 28g through 28i
k Net income (loss). Subtract line 28j from line 28f
28k

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