Pbgc Form 600 - Distress Termination Notice Of Intent To Terminate printable pdf download

Pbgc Form 600 - Distress Termination Notice Of Intent To Terminate

Distress Termination

PBGC Form 600

Approved OMB 1212-0036

Notice of Intent to Terminate

Expires 09/30/2010

PART I.

IDENTIFYING INFORMATION

Plan Name

Plan effective date (MM/DD/YYYY)

Last day of plan year

Sponsor’s telephone number

Contributing Sponsor’s name and address

(address should include room or suite no.)

9-digit employer identification number (EIN)

3-digit plan number (PN)

Contributing sponsor’s tax year

If you used a different EIN or PN than that in 2c or 2d for this contributing sponsor/plan in

end (MM/DD/YYYY)

previous filings with the PBGC, also show the number(s) previously reported.

6-digit business code

Plan Administrator’s name and address (if same as 2a, enter “same”)

Plan Administrator’s telephone number

(address should include room or suite no.)

E-mail address (optional)

Name and address of person to be contacted for more information (if same as 3a, enter

Telephone number

“same”) (address should include room or suite no.)

E-mail address (optional)

PART II.

GENERAL PLAN INFORMATION

(MM/DD/YYYY)

Proposed termination date

Estimated number of plan participants as of the proposed termination date

Active participants:

(i)

Fully vested

(i)

(ii)

Partially vested

(ii)

(iii) Nonvested

(iii)

(iv) Total active participants [add a(i) through a(iii)]

(iv)

Retirees or beneficiaries receiving benefits

Separated vested participants entitled to benefits

Total [add 5a(iv) through 5c]

Changes in contributing sponsor associated with plan termination. Check all that apply.

No Change

Sale of company/subsidiary/division (not involving bankruptcy or similar proceeding)

Company/subsidiary/division closed (not involving bankruptcy or similar proceeding)

Merger of company

Contributing sponsor acquired by another business

Another business acquired by contributing sponsor

Contributing sponsor reorganized (in bankruptcy or similar proceeding)

Contributing sponsor liquidated (bankruptcy or similar proceeding)

Pbgc Form 600 - Distress Termination Notice Of Intent To Terminate

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