Pbgc Form 10 PDF Details

At the intersection of employer obligations and pension safety nets stands the Pension Benefit Guaranty Corporation (PBGC) Form 10. This critical document serves as a linchpin for the notification of reportable events regarding single-employer pension plans, a mechanism designed to safeguard the financial integrity of the pension insurance system in the United States. Employers or plan administrators reach for this form when certain events, potentially threatening the solvency or operational structure of a pension plan, occur. These events range from significant changes in the employer’s financial health, like bankruptcy or a failure to make required contributions, to shifts in plan demographics, including active participant reductions. The form demands detailed information, including but not limited to, the narrative of the event, involved parties' contact details, and quantitative data such as participant numbers or missed payments. Additionally, further documentation may be required, encompassing loan defaults, liquidation details, or changes in the contributing sponsor or controlled group, underscoring the form's role in providing a comprehensive view of the event's implications for the pension plan. By compiling and submitting this form, plan administrators or contributing sponsors engage in a crucial dialogue with the PBGC, ensuring transparency and initiating possible interventions to protect pension beneficiaries.

QuestionAnswer
Form NamePbgc Form 10
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesform notice events, form event reportable, event reportable events, form event notice

Form Preview Example

POST-EVENT NOTICE

OF REPORTABLE EVENTS

PBGC Form 10

Approved OMB #1212-0013 Expires 03/31/2012

This form may be used by a plan administrator or contributing sponsor of a single-employer plan when notifying the

Pension Beneit Guaranty Corporation that a reportable event has occurred.

IDENTIFYING INFORMATION

 

 

 

 

 

 

 

 

 

Name of iler

 

 

Plan name

 

 

 

 

 

 

 

 

 

 

Street address of iler

 

 

 

Name / title of individual to contact

 

 

 

 

 

 

 

 

 

 

City, State, Zip

 

 

Street address of contact

 

 

 

 

 

 

 

 

 

 

EIN of contributing sponsor

Plan number

 

City, State, Zip

 

 

Plan administrator

 

 

 

 

 

 

Filer is:

 

 

 

 

 

 

 

 

Telephone number of contact

Ext.

 

Contributing sponsor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REPORTABLE EVENTS

 

See instructions for descriptions of these events. Check all boxes that apply.

 

Active participant reduction

 

 

 

Change in contributing sponsor or controlled group

Failure to make required contributions

Inability to pay beneits when due

Distribution to a substantial owner

Transfer of beneit liabilities

Liquidation

Extraordinary dividend or stock redemption Application for minimum funding waiver

Loan default

Bankruptcy or similar settlement

 

 

BRIEF DESCRIPTION

Briely describe the pertinent facts relating to the event.

The next page lists additional information that must be submitted with this form, if not included above.

PBGC Form 10

ADDITIONAL INFORMATION TO BE FILED

Active Participant Reduction

Statement explaining the cause of the reduction (e.g., facility shutdown or sale)

Number of active participants at the date the event occurs, at the beginning of the current plan year, and at the

beginning of the prior plan year

Failure to Make Required Contributions

Due date and amount of both the missed contribution and the next payment due

Most recent actuarial valuation report

Description of the plan’s controlled group structure, including the name of each controlled group member

Name of each plan maintained by any member of the plan’s controlled group, its contributing sponsor(s) and EIN/PN

Inability to Pay Beneits When Due

Date of any missed beneit payment and amount of beneits due

Next date on which the plan is expected to be unable to pay beneits, the amount of the projected shortfall, and the number of plan participants expected to be affected

Amount of the plan’s liquid assets at the end of the quarter,

and the amount of its disbursements for the quarter

Most recent actuarial valuation report

Name, address and phone number of plan trustee (and of any custodian)

Distribution to a Substantial Owner

Name, address and phone number of person receiving the distribution(s)

Change in Contributing Sponsor or Controlled Group

Description of the plan’s old and new controlled group structures, including the name of each controlled group member

Name of each plan maintained by any member of the plan’s old and new controlled groups, its contributing sponsor(s)

and EIN/PN

Liquidation

Description of the plan’s controlled group structure before and after the liquidation, including the name of each controlled group member

Name of each plan maintained by any member of the plan’s controlled group, its contributing sponsor(s) and EIN/PN

Extraordinary Dividend or Stock Redemption

Name and EIN of person making the distribution

Date and amount of cash distribution(s) during iscal year

Description, fair market value, and date or dates of any non-cash distributions

Statement whether the recipient was a member of the plan’s controlled group

Application for Minimum Funding Waiver

Copy of waiver application, with all attachments

Loan Default

Copy of the relevant loan documents (e.g., promissory note, security agreement)

Due date and amount of any missed payment

Copy of any written notice of default or any notice of acceleration from lender

Amount, form and date of each distribution

Most recent actuarial valuation report

Transfer of Beneit Liabilities

Name, contributing sponsor and EIN/PN of transferee plan(s)

Explanation of the actuarial assumptions used in determining the value of beneit liabilities (and, if appropriate, plan assets) transferred

Estimate of the assets, liabilities, and number of participants whose beneits are transferred

Note: To the extent this information is iled with the IRS Form 5310A, PBGC will accept a copy of that iling.

Bankruptcy or Similar Settlement

Copy of bankruptcy petition or similar document

Docket sheet or other list of documents iled

Last date for iling claims, if known

Name, address and phone number of any trustee, receiver or similar person

Most recent actuarial valuation report for each plan in the controlled group

Description of the plan’s controlled group structure, including the name of each controlled group member

Name of each plan maintained by any member of the plan’s controlled group, its contributing sponsor(s) and EIN/PN

How to Edit Pbgc Form 10 Online for Free

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It really is easy to complete the document using this detailed tutorial! Here's what you want to do:

1. It is recommended to fill out the pbgc form event online properly, thus be attentive when working with the areas that contain these specific fields:

How to prepare form event reportable part 1

2. Once your current task is complete, take the next step – fill out all of these fields - Distribution to a substantial owner, Transfer of beneit liabilities, Application for minimum funding, Loan default, Bankruptcy or similar settlement, BRIEF DESCRIPTION, and Briely describe the pertinent with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Briely describe the pertinent, Loan default, and Distribution to a substantial owner inside form event reportable

3. The third part is usually straightforward - fill out all of the fields in Active Participant Reduction, Statement explaining the cause of, Failure to Make Required, Due date and amount of both the, Name of each plan maintained by, Inability to Pay Beneits When Due, Date of any missed beneit payment, Next date on which the plan is, Description of the plans old and, Name of each plan maintained by, Liquidation, Description of the plans, Name of each plan maintained by, Extraordinary Dividend or Stock, and Name and EIN of person making the in order to complete this segment.

Completing segment 3 of form event reportable

4. It is time to complete this next segment! Here you'll have all these Next date on which the plan is, Distribution to a Substantial Owner, Name address and phone number of, Transfer of Beneit Liabilities, Name contributing sponsor and, Explanation of the actuarial, Copy of waiver application with, Loan Default, Copy of the relevant loan, Due date and amount of any missed, Bankruptcy or Similar Settlement, Copy of bankruptcy petition or, Note To the extent this, and Name of each plan maintained by blank fields to do.

Explanation of the actuarial, Copy of bankruptcy petition or, and Bankruptcy or Similar Settlement in form event reportable

Always be extremely attentive while completing Explanation of the actuarial and Copy of bankruptcy petition or, as this is the section in which many people make some mistakes.

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