Form 5500-Sf Draft - Short Form Annual Return/report Of Small Employee Benefit Plan - 2017 Page 3

Download a blank fillable Form 5500-Sf Draft - Short Form Annual Return/report Of Small Employee Benefit Plan - 2017 in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 5500-Sf Draft - Short Form Annual Return/report Of Small Employee Benefit Plan - 2017 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Form 5500-SF 2017

Page

Part VI

Pension Funding Compliance

Is this a defined benefit plan subject to minimum funding requirements? (If "Yes," see instructions and complete Schedule SB

Yes

(Form 5500) and line 11a below) ...............................................................................................................................................................

11a

Enter the unpaid minimum required contributions for all years from Schedule SB (Form 5500) line 40 ........................ 11a

Is this a defined contribution plan subject to the minimum funding requirements of section 412 of the Code or section 302 of

Yes

ERISA? ......................................................................................................................................................................................................

(If "Yes," complete line 12a or lines 12b, 12c, 12d, and 12e below, as applicable.)

If a waiver of the minimum funding standard for a prior year is being amortized in this plan year, see instructions, and enter the date of the letter ruling

granting the waiver. ................................................................................................................................. Month _______

Day _______

Year ________

If you completed line 12a, complete lines 3, 9, and 10 of Schedule MB (Form 5500), and skip to line 13.

Enter the minimum required contribution for this plan year ............................................................................................. 12b

123456789012345

Enter the amount contributed by the employer to the plan for this plan year .................................................................. 12c

-123456789012345

Subtract the amount in line 12c from the amount in line 12b. Enter the result (enter a minus sign to the left of a

12d

YYYY-MM-DD

negative amount) ...........................................................................................................................................................

Yes

N/A

Will the minimum funding amount reported on line 12d be met by the funding deadline? ..............................................

Part VII

Plan Terminations and Transfers of Assets

13a

Yes

Has a resolution to terminate the plan been adopted in any plan year? ...............................................................................

If “Yes,” enter the amount of any plan assets that reverted to the employer this year ................................................... 13a

Were all the plan assets distributed to participants or beneficiaries, transferred to another plan, or brought under the

Yes

control of the PBGC? ...................................................................................................................................................................

If, during this plan year, any assets or liabilities were transferred from this plan to another plan(s), identify the plan(s) to

which assets or liabilities were transferred. (See instructions.)

13c(1) Name of plan(s):

13c(2) EIN(s)

13c(3) PN(s)

ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI

123456789

012

ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI