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2012

Department of the Treasury Internal Revenue Service

Instructions for Form 5500-EZ Annual Return of One-Participant (Owners and Their Spouses) Retirement Plan Section references are to the Internal Revenue Code unless otherwise noted.

What's New Optional Paid Preparer Information. The instructions have been updated to include optional preparer information. The Internal Revenue Service (IRS) encourages filers to provide the preparer's name and address. See Preparer Information (Optional), later, for more information. Optional Trust Information. The instructions have been updated to include optional trust information. The IRS encourages filers to provide the trust's name and trust EIN. See Specific Instructions, Part II, Line 4a. (Optional) and Line 4b. (Optional), later, for more information. Unpaid Minimum Required Contribution. If a defined benefit plan is subject to the minimum funding requirements of section 412, a filer must enter the amount of the unpaid minimum required contributions for the current year from line 39 of Schedule SB (Form 5500), Single-Employer Defined Benefit Plan Actuarial Information, on line 11a of the Form 5500-EZ. Do not attach Schedule SB (Form 5500) with Form 5500-EZ.

Photographs of Missing Children

The Internal Revenue Service is a proud partner with the National Center for Missing and Exploited Children. Photographs of missing children selected by the Center may appear in instructions on pages that would otherwise be blank. You can help bring these children home by looking at the photographs and calling 1-800-THE-LOST (1-800-843-5678) if you recognize a child.

Filing Tips

To reduce the possibility of correspondence and penalties, we remind filers: Use the online, fillable 2012 Form 5500-EZ on the IRS website. Complete and download the form to your computer to print and sign before mailing. Or, use the official printed paper Form 5500-EZ obtained from the IRS. Complete the form by hand using only black or blue ink. Be sure to enter your information in the specific line fields provided, sign, and date the form before mailing. Or, use approved software, if available. Do not use felt tip pens or other writing instruments that can cause signatures or data to bleed through to the other side of the paper. One-sided documents should have no markings on the blank side. Paper should be clean without glue or other sticky substances. Mar 12, 2013

Do not submit extraneous information such as arrows or notes on the form. Mail Form 5500-EZ for plan year 2012 to the IRS office in Ogden, Utah to be processed. See Where To File in these instructions. A one-participant plan that is eligible to file Form 5500-SF, Short Form Annual Return/Report of Small Employee Benefit Plan, may elect to file Form 5500-SF electronically with the computerized ERISA Filing Acceptance System (EFAST2) rather than filing a Form 5500-EZ on paper with the IRS. See EFAST2 Filing System in these instructions.

Phone Help

If you have questions and need help in completing this form, please call the IRS Help Line at 1-877-829-5500. This toll-free telephone service is available Monday through Friday.

How To Get Forms and Publications

You may order the paper Form 5500-EZ and its instructions by calling 1-800-TAX-FORM (1-800-829-3676). You can also find forms and publications by visiting the IRS Internet website at www.irs.gov/formspubs/.

Personal computer. You can access the IRS website 24 hours a day, 7 days a week at IRS.gov to: View forms, instructions, and publications. See answers to frequently asked tax questions. Search publications online by topic or keyword. Send comments or request help by email. Sign up to receive local and national tax news by email. Telephone. You can order IRS forms and publications by calling 1-800-TAX-FORM (1-800-829-3676).

General Instructions Purpose of Form

Form 5500-EZ is used by one-participant plans that are not subject to the requirements of section 104(a) of the Employee Retirement Income Security Act of 1974 (ERISA) and that are not eligible or choose not to file Form 5500-SF electronically to satisfy certain annual reporting and filing obligations imposed by the Code. For 2012 filings, foreign pension plans that are required to file an annual return must file Form 5500-EZ. Note. A one-participant plan (as defined under Who Must File Form 5500-EZ) cannot file an annual return on Form

Cat. No. 63264C

maintained by the employer at the end of the 2012 plan year does not exceed $250,000, unless 2012 is the final plan year of the plan. For more information on final plan years, see Final Return later.

5500, Annual Return/Report of Employee Benefit Plan, regardless of whether the plan was previously required to file an annual return on Form 5500. Therefore, every one-participant plan required to file an annual return must file paper Form 5500-EZ with the IRS or choose, if eligible, to electronically file Form 5500-SF using the EFAST2 Filing System.

Example. If a plan meets all the requirements for filing Form 5500-EZ and its total assets (either alone or in combination with one or more one-participant plans maintained by the employer) exceed $250,000 at the end of the 2012 plan year, Form 5500-EZ must be filed for each of the employer's one-participant plans including those with less than $250,000 in assets for the 2012 plan year.

Who Must File Form 5500-EZ

You must file Form 5500-EZ for a retirement plan if: 1. The plan is a one-participant plan that is required to file an annual return and you are not eligible or choose not to file the annual return electronically on Form 5500-SF; or 2. The plan is a foreign plan that is required to file an annual return. A one-participant plan means a retirement plan (that is, a defined benefit pension plan or a defined contribution profit-sharing or money purchase pension plan), other than an Employee Stock Ownership Plan (ESOP), which: a. covers only you (or you and your spouse) and you (or you and your spouse) own the entire business (which may be incorporated or unincorporated); or b. covers only one or more partners (or partners and their spouses) in a business partnership; and c. does not provide benefits for anyone except you (or you and your spouse) or one or more partners (or partners and their spouses).

How To File Form 5500-EZ Paper forms for filing. The 2012 Form 5500-EZ may be filed on paper. File the official IRS printed Form 5500-EZ or the downloadable form found on the IRS website; or use approved software, if available. You can complete the online, fillable 2012 Form 5500-EZ found on the IRS website and download it to your computer to print and sign before mailing to the address specified in these instructions. See Where To File. You can obtain the official IRS printed 2012 Form 5500-EZ from the IRS to complete by hand with pen or typewriter using blue or black ink. Entries should not exceed the lines provided on the form. Abbreviate if necessary. Paper forms are available from the IRS as discussed earlier in How To Get Forms and Publications.

A one-participant plan must file an annual return unless the plan meets the conditions for not filing under Who May Not Have To File Form 5500-EZ below.

EFAST2 Filing System

One-participant plans may satisfy their filing obligation under the Code by filing Form 5500-SF electronically under EFAST2 in place of Form 5500-EZ (on paper), provided that the plan covered fewer than 100 participants at the beginning of the plan year. One-participant plans that covered 100 or more participants at the beginning of the plan year are not eligible to file Form 5500-SF, and must file Form 5500-EZ.

A foreign plan means a pension plan that is maintained outside the United States primarily for nonresident aliens. A foreign plan is required to file an annual return if the employer who maintains the plan is: a domestic employer, or a foreign employer with income derived from sources within the United States (including foreign subsidiaries of domestic employers) if contributions to the plan are deducted on its U.S. income tax return.

Eligible one-participant plans need complete only the following questions on the Form 5500-SF: Part I, lines A, B, and C; Part II, lines 1a–5b; Part III, lines 7a–c, and 8a; Part IV, line 9a; Part V, line 10g; and Part VI, lines 11–12e.

Do not file an annual return for a plan that is a qualified foreign plan within the meaning of CAUTION section 404A(e) that does not qualify for the treatment provided in section 402(d).

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Foreign plans (as defined above) are not eligible to file Form 5500 for 2012, regardless of whether the plan was previously required to file an annual return on Form 5500. Every foreign plan that is required to file an annual return must instead file paper Form 5500-EZ.

Under the computerized ERISA Filing Acceptance System (EFAST2), you must electronically file the 2012 Forms 5500 and 5500-SF using EFAST2's web-based filing system or you may file through an EFAST2-approved vendor. The 2012 Form 5500-EZ will be filed on paper and cannot be filed with this electronic system. For more information, see the EFAST2 website at www.efast.dol.gov. For telephone assistance, call the EFAST2 Help Line at 1-866-GO-EFAST (1-866-463-3278). The EFAST2 Help Line is available Monday through Friday.

Note. If you are not filing for a one-participant plan or a foreign plan, electronically file Form 5500 or, if eligible, Form 5500-SF.

Who Does Not Have To File Form 5500-EZ

You do not have to file Form 5500-EZ for the 2012 plan year for a one-participant plan if the total of the plan's assets and the assets of all other one-participant plans

Note. Information filed on Form 5500-EZ and Form 5500-SF is required to be made available to the public. -2-

Where To File

However, the information for a one-participant plan electronically filed using a Form 5500-SF with EFAST2 will not be subject to publication on the Internet.

File the Form 5500-EZ at the following address:

What To File

Department of the Treasury Internal Revenue Service Ogden, UT 84201-0020

Plans required to file an annual return for one-participant (owners and their spouses) retirement plans may file Form 5500-EZ in accordance with its instructions. Filers of Form 5500-EZ are not required to file schedules or attachments related to Form 5500 with the 2012 Form 5500-EZ. However, you must collect and retain for your records completed Schedule MB (Form 5500), Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information, if applicable, and completed and signed Schedule SB (Form 5500), Single-Employer Defined Benefit Plan Actuarial Information, if applicable. Even though you do not have to file the Schedule MB (Form 5500) or Schedule SB (Form 5500) with the 2012 Form 5500-EZ, you are still required to both perform an annual valuation and maintain the funding records associated with plan funding in the same manner as a plan for which the applicable schedule must be filed.

Private delivery services (PDSs). You can use certain private delivery services designated by the IRS to meet the “timely mailing as timely filing/paying” rule for tax returns and payments. The private delivery services include only the following: DHL Express (DHL): DHL Same Day Service. Federal Express (FedEx): FedEx Priority Overnight, FedEx Standard Overnight, FedEx 2Day, FedEx International Priority, and FedEx International First. United Parcel Service (UPS): UPS Next Day Air, UPS Next Day Air Saver, UPS 2nd Day Air, UPS 2nd Day Air A.M., UPS Worldwide Express Plus, and UPS Worldwide Express. The private delivery service can tell you how to get written proof of the mailing date. Private delivery services should use the following address:

Eligible combined plans. The Pension Protection Act of 2006 established rules for a new type of pension plan, an “eligible combined plan,” effective for plan years beginning after December 31, 2009. An eligible combined plan consists of a defined benefit plan and a defined contribution plan that includes a qualified cash or deferred arrangement under section 401(k). The assets of the two plans are held in a single trust, but clearly identified and allocated between plans. The eligible combined plan design is available only to employers that employed an average of at least 2 but not more than 500 employees on each business day during the calendar year preceding the plan year as of which the eligible combined plan is established and that employs at least 2 employees on the first day of the plan year. Because an eligible combined plan includes both a defined benefit plan and a defined contribution plan, the Form 5500-EZ filed for the plan must include all the information that would be required for either a defined benefit plan or a defined contribution plan.

Internal Revenue Service 1973 Rulon White Blvd. Ogden, UT 84404

Who Must Sign

The plan administrator or employer (owner) must sign and date paper Form 5500-EZ for the 2012 filing.

Preparer Information (Optional)

You may optionally enter the preparer's name (including firm's name, if applicable), address, and telephone number in the space provided at the bottom of the second page of Form 5500-EZ. A preparer is any person who prepares an annual return/report for compensation, or who employs one or more persons to prepare for compensation. If the person who prepared the annual return/report is not the employer named in line 2a or the plan administrator named in line 3a, you may name the person on this line. If there are several people who prepare Form 5500-EZ, name the person who is primarily responsible for the preparation of the annual return.

Note. The 2012 Schedule MB (Form 5500) and the 2012 Schedule SB (Form 5500) are available only electronically from the Department of Labor website at www.efast.dol.gov. You can complete the schedules online and print them out for your records. If you are a Form 5500-EZ filer, do not attempt to electronically file the Schedule MB or Schedule SB related to your 2012 Form 5500-EZ filing.

Note. Although the preparer's name, address, and phone number are optional, the IRS encourages filers to provide preparer information on these lines. Treasury regulations require all paid tax return preparers to obtain the Paid Preparer Tax Identification Numbers (PTINs) and put the PTIN on all tax forms. However, the Form 5500 series, at this time, is not subject to the PTIN requirements of section 1.6109-2 of the Treasury regulations.

When To File

File the 2012 return for plan years that started in 2012. Form 5500-EZ must be filed by the last day of the 7th calendar month after the end of the plan year that began in 2012 (not to exceed 12 months in length).

Penalties

Note. If the filing due date falls on a Saturday, Sunday, or legal holiday, the return may be filed on the next day that is not a Saturday, Sunday, or legal holiday.

The Internal Revenue Code imposes a penalty of $25 a day (up to $15,000) for not filing returns in connection with pension, profit-sharing, etc., plans by the required due date. -3-

Approved copies of the Form 5558 will not be returned to the filer. A copy of the completed extension request must be retained with the plan's records.

Specific Instructions Part I – Annual Return Identification Information

See the instructions for Form 5558 and file it with the Department of the Treasury, Internal Revenue Service Center, Ogden, UT 84201-0045.

First Return

Note. Line A of the Form 5558 asks for “Name of filer, plan administrator, or plan sponsor”. The name of the plan sponsor is generally the same as the employer name for a one-participant plan.

Check box A(1) if this is the first filing for this plan. Do not check this box if you have ever filed for this plan, even if it was a different form (for example, Form 5500).

Amended Return

If you are filing an amendment for a “one-participant plan” that filed a Form 5500-SF electronically, you may submit the amendment either electronically using the Form 5500-SF with EFAST2 or on paper using the Form 5500-EZ with the IRS. If you are filing an amended return for a one-participant plan that previously filed on a paper Form 5500-EZ, you must submit the amended return using the paper Form 5500-EZ with the IRS.

Note. Filers are automatically granted an extension of time to file Form 5500-EZ until the extended due date of the federal income tax return of the employer (and are not required to file Form 5558) if all the following conditions are met: (1) the plan year and the employer's tax year are the same, (2) the employer has been granted an extension of time to file its federal income tax return to a date later than the normal due date for filing the Form 5500-EZ, and (3) a copy of the application for extension of time to file the federal income tax return is retained with the plan's records. Be sure to check box B at the top of the form. An extension granted by using this exception cannot be extended further by filing a Form 5558 after the normal due date (without extension) of Form 5500-EZ.

Short Plan Year

Foreign Plan

Check box A(2) if you are filing an amended Form 5500-EZ to correct errors and/or omissions in a previously filed annual return for the 2012 plan year. The amended Form 5500-EZ must conform to the requirements under the How To File section earlier.

Check box C if the return is filed by a foreign plan. See Who Must File Form 5500-EZ earlier.

Check box A(4) if this form is filed for a period of less than 12 months. Show the dates at the top of the form.

Part II – Basic Plan Information

For a short plan year, file a return by the last day of the 7th month following the end of the short plan year. Modify the heading of the form to show the beginning and ending dates of your short plan year and check box A(4) for a short plan year. If this is also the first or final return filed for the plan, check the appropriate box (box A(1) or A(3)).

Line 1a. Enter the formal name of the plan. Line 1b. Enter the three-digit plan number (PN) that the employer assigned to the plan. Plans should be numbered consecutively starting with 001. Once a plan number is used for a plan, it must be used as the plan number for all future filings of returns for the plan, and this number may not be used for any other plan even after the plan is terminated.

Final Return

All one-participant plans should file a return for their final plan year indicating that all assets have been distributed.

Line 1c. Enter the date the plan first became effective.

Check box A(3) if all assets under the plan(s) (including insurance/annuity contracts) have been distributed to the participants and beneficiaries or distributed or transferred to another plan. The final plan year is the year in which distribution of all plan assets is completed.

Line 2a. Each row is designed to contain specific information regarding the employer. Please limit your response to the information required in each row as specified below: 1. Enter in the first row the name of the employer. 2. Enter in the second row the trade name if different from the name entered in the first row. 3. Enter in the third row the in care of (“C/O”) name. 4. Enter in the fourth row the street address. A post office box number may be entered if the Post Office does not deliver mail to the employer's street address. 5. Enter in the fifth row the name of the city, the two character abbreviation of the U.S. state or possession and ZIP code.

Extension of Time To File

Check box B if either of the following applies: 1. You are filing a Form 5558, Application for Extension of Time To File Certain Employee Plan Returns. (Do not attach Form 5558 to your Form 5500-EZ. See below for more information.) 2. You are using an extension based on the extended due date of your federal income tax return. (See the Note below.)

Note. You can use Form 8822-B, Change of Address — Business, to notify the IRS if you changed your business mailing address or your business location.

A one-time extension of time to file Form 5500-EZ (up to 21 2 months) may be obtained by filing Form 5558 on or before the normal due date (not including any extensions) of the return. You must file Form 5558 with the IRS. -4-

have an EIN, apply for one as explained in the instructions for line 2b.

Foreign address. For foreign addresses, enter the information in the order of the city, province or state, and the name of the country. Follow the country's practice in placing the postal code in the address. Do not abbreviate the country name.

Line 3c. Enter the plan administrator's telephone number including the area code. Line 4a. (Optional) You may use this line to enter the “Name of trust.” If a plan uses more than one trust or custodial account for its fund, you should enter the primary trust or custodial account in which the greatest dollar amount or largest percentage of the plan assets as of the end of the plan year is held on this line. For example, if a plan uses three different trusts, X, Y, and Z, with the percentages of plan assets, 35%, 45%, and 20%, respectively, trust Y that held the 45% of plan assets would be entered on line 6a.

Line 2b. Enter the employer's nine-digit employer identification number (EIN). For example, 00-1234567. Do not enter a social security number (SSN). Employers without an EIN must apply for one as soon as possible. EINs are issued by the IRS. To apply for an EIN: Mail or fax Form SS-4, Application for Employer Identification Number, obtained by calling 1-800-TAX-FORM (1-800-829-3676) or at the IRS website at IRS.gov. Call 1-800-829-4933 to receive your EIN by telephone. Select the Online EIN Application link at IRS.gov. The EIN is issued immediately once the application information is validated. The online application process is not yet available for corporations with addresses in foreign countries.

Line 4b. (Optional) You may use this line to enter the “Trust's Employer Identification Number (EIN)” assigned to the employee benefit trust or custodial account, if one has been issued to you. The trust EIN should be used for transactions conducted for the trust. If you do not have a trust EIN, enter the EIN you would use on Form 1099-R, Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc., to report distributions from employee benefit plans and on Form 945, Annual Return of Withheld Federal Income Tax, to report withheld amounts of income tax from those payments. Do not use a social security number in place of an EIN. Form 5500-EZ is open to public inspection. Because of privacy concerns, the inclusion of a social security number may result in the rejection of the filing. Trust EINs can be obtained from the IRS by applying for one on Form SS-4, Application for Employer Identification Number. See instructions to line 2b (Form 5500-EZ) for applying for an EIN. Also see IRS EIN application link page for further information.

Note. Although EINs for a plan's trust or custodial account are generally not required to be furnished on the Form 5500 and its schedules or Form 5500-EZ, the IRS will issue EINs for other reporting purposes. EINs for trusts or custodial accounts associated with plans may be obtained as explained above. Line 2c. Enter the employer's telephone number including the area code. Line 2d. Enter the six-digit applicable code that best describes the nature of the plan sponsor's business from the list of principal business activity codes later in these instructions. Line 3a. Each row is designed to contain specific information regarding the plan administrator. Please limit your response to the information required in each row of boxes as specified below: 1. Enter in the first row the name of the plan administrator unless the administrator is the employer identified in line 2a. If this is the case, enter the word "same" on line 3a and leave the remainder of line 3a, and all of lines 3b and 3c blank. 2. Enter in the second row any in care of (“C/O”) name. 3. Enter in the third row the street address. A post office box number may be entered if the Post Office does not deliver mail to the administrator's street address. 4. Enter in the fourth row the name of the city, the two character abbreviation of the U.S. state or possession and ZIP code.

Note. Although lines 4a and 4b are optional, the IRS encourages filers to provide trust information on these lines. Line 5. If the employer's name and/or EIN have changed since the last return was filed for this plan, enter the employer's name, EIN, and the plan number as it appeared on the last return filed for this plan.

Part III – Financial Information

Note. Amounts reported on lines 7a, 7b, and 7c for the beginning of the plan year must be the same as reported for the end of the plan year on the return for the preceding plan year. Use whole dollars only. Line 7a. “Total plan assets” include rollovers and transfers received from other plans, unrealized gains and losses such as appreciation/depreciation in assets. It also includes specific assets held by the plan at any time during the plan year (for example, partnership/joint venture interests, employer real property, real estate (other than employer real property), employer securities, loans (participants and non-participant loans), and tangible personal property). Enter the total amount of plan assets at the beginning of the plan year in column (1). Do not include contributions designated for the 2012 plan year in column (1). Enter the

Foreign address. For foreign addresses, enter the information in the order of the city, province or state, and the name of the country. Follow the country's practice in placing the postal code in the address. Do not abbreviate the country name. Line 3b. Enter the plan administrator's nine-digit EIN. A plan administrator must have an EIN for Form 5500-EZ reporting purposes. If the plan administrator does not -5-

5500) and forward it no later than the filing due date to the person responsible for filing Form 5500-EZ. The completed Schedule SB is subject to the records retention provisions of the Code. See the 2012 Instructions for Form 5500 for more information about Schedule SB.

total amount of plan assets at the end of the plan year in column (2). Line 7b. Liabilities include but are not limited to benefit claims payable, operating payables, acquisition indebtedness, and other liabilities. Do not include the value of future distributions that will be made to participants.

Line 12a. If a waiver of the minimum funding standard for a prior year is being amortized in the current plan year, enter the month, day, and year (MM/DD/YYYY) the letter ruling was granted. If a money purchase defined contribution plan (including a target benefit plan) has received a waiver of the minimum funding standard, and the waiver is currently being amortized, complete lines 3, 9, and 10 of Schedule MB (Form 5500). See the Instructions for Schedule MB in the Instructions for Form 5500. Do not attach Schedule MB to the Form 5500-EZ. Instead keep the completed Schedule MB in accordance with the applicable records retention requirements.

Lines 8a and b. Enter the total cash contributions received and/or receivable by the plan from employers and participants during the plan year. Line 8c. Enter the amount of all other contributions including transfers or rollovers received from other plans valued on the date of contribution.

Part IV – Plan Characteristics Line 9. Enter the two-character plan characteristics from the List of Plan Characteristics Codes found later in these instructions.

Privacy Act and Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. This form is required to be filed under section 6058(a). Section 6109 requires you to provide your identification number. If you fail to provide this information in a timely manner or if you provide false or fraudulent information, you may be subject to penalties. Section 6104(b) makes the information contained in this form publicly available. Therefore, the information will be given to anyone who asks for it and may be given to the Pension Benefit Guaranty Corporation (PBGC) for administration of ERISA, Department of Justice for civil and criminal litigation, and cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their tax laws. We may also disclose this information to other countries under a treaty, to federal and state agencies to enforce federal non-tax criminal laws, and to federal law enforcement and intelligence agencies to combat terrorism.

Note. In the case of an eligible combined plan under section 414(x) and ERISA section 210(e), the codes entered in line 9 must include any codes applicable for either the defined benefit pension features or the defined contribution pension features of the plan. New plan characteristics codes were added in the 2009 Instructions for Form 5500-EZ to identify foreign plans, one-participant plans that satisfy the minimum coverage requirements of section 410(b) only when combined with another plan of the employer, plans whose sponsors received services of leased employees (as defined in section 414(n)), and plans whose sponsors are members of a controlled group under section 414(b) or (c), or an affiliated service group under section 414(m).

Part V – Compliance and Funding Questions Line 10. You must check “Yes” if the plan had any participant loans outstanding at any time during the plan year and enter the amount outstanding as of the end of the plan year. Enter on this line all loans to participants including residential mortgage loans that are subject to section 72(p). Include the sum of the value of the unpaid principal balances, plus accrued but unpaid interest, if any, for participant loans made under an individual account plan with investment experience segregated for each account made in accordance with 29 CFR 2550.408b-1 and which are secured solely by a portion of the participant's vested accrued benefit. When applicable, combine this amount with the current value of any other participant loans. Do not include a participant loan that has been deemed distributed.

You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of the Internal Revenue Code. Generally, the Form 5500 series return/ reports and some of the related schedules are open to public inspection. The time needed to complete and file this form will vary depending on individual circ*mstances. The estimated average time is: Recordkeeping . . . . . . . . . . . . . . . . . . . . . Learning about the law or the form

Line 11. Check “Yes” if this plan is a defined benefit plan subject to the minimum funding standard requirements of section 412.

3 hr., 01min.

. . . . . . . . . . . . . . . . . .

5 hr., 19 min.

Copying, assembling, and sending the form . . . . . . . . . . . . . . . . . . . . . . . . . . . .

32 min.

Preparing the form

Line 11a. Enter the amount from line 39 of Schedule SB (Form 5500). If the plan is a defined benefit plan, the enrolled actuary must complete and sign the 2012 Schedule SB (Form

19 hr., 07 min.

. . . . . . .

If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we would be happy to hear from you. You can write to the Internal Revenue Service, Tax Products -6-

Coordinating Committee, SE:W:CAR:MP:T:M:S, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send this form to this address. Instead, see Where To File earlier.

2D 2E 2J

LIST OF PLAN CHARACTERISTICS CODES FOR LINE 9 CODE 1A 1B 1C

1D 1E 1F

1I

CODE 2A

2B 2C

Defined Benefit Pension Features Benefits are primarily pay related. Benefits are primarily flat dollar (includes dollars per year of service). Cash balance or similar plan – Plan has a “cash balance” formula. For this purpose, a “cash balance” formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance). Floor-offset plan – Plan benefits are subject to offset for retirement benefits provided by an employer-sponsored defined contribution plan. Section 401(h) arrangement – Plan contains separate accounts under section 401(h) to provide employee health benefits. Section 414(k) arrangement – Benefits are based partly on the balance of the separate account of the participant (also include appropriate defined contribution pension feature codes). Frozen plan – As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation). Defined Contribution Pension Features Age/Service Weighted or New Comparability or Similar Plan – Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New Comparability or Similar Plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the threshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l). Target benefit plan. Money purchase (other than target benefit).

2K

2R 2S 2T CODE 3A 3B 3C 3D 3E 3F 3H 3J

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Offset plan – Plan benefits are subject to offset for retirement benefits provided in another plan or arrangement of the employer. Profit-sharing. Section 401(k) feature – A cash or deferred arrangement described in section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash. Section 401(m) arrangement – Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contributions to the plan. Not applicable if plan is 401(k) with only QNECs and/or QMACs. Also not applicable if section 403(b)(1), 403(b) (7), or 408 arrangement/accounts annuities. Participant-directed brokerage accounts provided as an investment option under the plan. Plan provides for automatic enrollment in plan that has elective contributions deducted from payroll. Total or partial participant-directed account plan – Plan uses default investment account for participants who fail to direct assets in their account. Other Pension Benefit Features Non-U.S. plan – Pension plan maintained outside the United States primarily for nonresident aliens. Plan covering self-employed individuals. Plan not intended to be qualified – A plan not intended to be qualified under sections 401, 403, or 408. Pre-approved pension plan – A master, prototype, or volume submitter plan that is the subject of a favorable opinion or advisory letter from the IRS. A one-participant plan that satisfies minimum coverage requirements of section 410(b) only when combined with another plan of the employer. Plan sponsor(s) received services of leased employees, as defined in section 414(n), during the plan year. Plan sponsor(s) is (are) a member(s) of a controlled group (sections 414(b), (c), or (m)). U.S.-based plan that covers residents of Puerto Rico and is qualified under both section 401 and section 1165 of Puerto Rico Code.

Forms 5500, 5500-SF, and 5500-EZ Codes for Principal Business Activity Agriculture, Forestry, Fishing and Hunting Crop Production 111100 Oilseed & Grain Farming 111210 Vegetable & Melon Farming (including potatoes & yams) 111300 Fruit & Tree Nut Farming 111400 Greenhouse, Nursery, & Floriculture Production 111900 Other Crop Farming (including tobacco, cotton, sugarcane, hay, peanut, sugar beet, & all other crop farming) Animal Production 112111 Beef Cattle Ranching & Farming 112112 Cattle Feedlots 112120 Dairy Cattle & Milk Production 112210 Hog & Pig Farming 112300 Poultry & Egg Production 112400 Sheep & Goat Farming 112510 Aquaculture (including shellfish & finfish farms & hatcheries) 112900 Other Animal Production Forestry and Logging 113110 Timber Tract Operations 113210 Forest Nurseries & Gathering of Forest Products 113310 Logging Fishing, Hunting and Trapping 114110 Fishing 114210 Hunting & Trapping Support Activities for Agriculture and Forestry 115110 Support Activities for Crop Production (including cotton ginning, soil preparation, planting, & cultivating) 115210 Support Activities for Animal Production 115310 Support Activities For Forestry

Mining 211110 212110 212200 212310 212320

Oil & Gas Extraction Coal Mining Metal Ore Mining Stone Mining & Quarrying Sand, Gravel, Clay, & Ceramic & Refractory Minerals Mining & Quarrying 212390 Other Nonmetallic Mineral Mining & Quarrying 213110 Support Activities for Mining

Utilities 221100 Electric Power Generation, Transmission & Distribution 221210 Natural Gas Distribution 221300 Water, Sewage, & Other Systems 221500 Combination Gas and Electric

Construction Construction of Buildings 236110 Residential Building Construction 236200 Nonresidential Building Construction Heavy and Civil Engineering Construction 237100 Utility System Construction 237210 Land Subdivision 237310 Highway, Street, & Bridge Construction

This list of principal business activities and their associated codes is designed to classify an enterprise by the type of activity in which it is engaged. These principal activity codes are based

237990 Other Heavy & Civil Engineering Construction Specialty Trade Contractors 238100 Foundation, Structure, & Building Exterior Contractors (including framing carpentry, masonry, glass, roofing, & siding) 238210 Electrical Contractors 238220 Plumbing, Heating, & Air-Conditioning Contractors 238290 Other Building Equipment Contractors 238300 Building Finishing Contractors (including drywall, insulation, painting, wallcovering, flooring, tile, & finish carpentry) 238900 Other Specialty Trade Contractors (including site preparation)

Manufacturing Food Manufacturing 311110 Animal Food Mfg 311200 Grain & Oilseed Milling 311300 Sugar & Confectionery Product Mfg 311400 Fruit & Vegetable Preserving & Specialty Food Mfg 311500 Dairy Product Mfg 311610 Animal Slaughtering and Processing 311710 Seafood Product Preparation & Packaging 311800 Bakeries, Tortilla & Dry Pasta Mfg 311900 Other Food Mfg (including coffee, tea, flavorings & seasonings) Beverage and Tobacco Product Manufacturing 312110 Soft Drink & Ice Mfg 312120 Breweries 312130 Wineries 312140 Distilleries 312200 Tobacco Manufacturing Textile Mills and Textile Product Mills 313000 Textile Mills 314000 Textile Product Mills Apparel Manufacturing 315100 Apparel Knitting Mills 315210 Cut & Sew Apparel Contractors 315220 Men's & Boys' Cut & Sew Apparel Mfg 315240 Women's, Girls' and Infants' Cut & Sew Apparel Mfg 315280 Other Cut & Sew Apparel Mfg 315990 Apparel Accessories & Other Apparel Mfg Leather and Allied Product Manufacturing 316110 Leather & Hide Tanning & Finishing 316210 Footwear Mfg (including rubber & plastics) 316990 Other Leather & Allied Product Mfg Wood Product Manufacturing 321110 Sawmills & Wood Preservation 321210 Veneer, Plywood, & Engineered Wood Product Mfg 321900 Other Wood Product Mfg Paper Manufacturing 322100 Pulp, Paper, & Paperboard Mills

on the North American Industry Classification System.

322200 Converted Paper Product Mfg Printing and Related Support Activities 323100 Printing & Related Support Activities Petroleum and Coal Products Manufacturing 324110 Petroleum Refineries (including integrated) 324120 Asphalt Paving, Roofing, & Saturated Materials Mfg 324190 Other Petroleum & Coal Products Mfg Chemical Manufacturing 325100 Basic Chemical Mfg 325200 Resin, Synthetic Rubber, & Artificial & Synthetic Fibers & Filaments Mfg 325300 Pesticide, Fertilizer, & Other Agricultural Chemical Mfg 325410 Pharmaceutical & Medicine Mfg 325500 Paint, Coating, & Adhesive Mfg 325600 Soap, Cleaning Compound, & Toilet Preparation Mfg 325900 Other Chemical Product & Preparation Mfg Plastics and Rubber Products Manufacturing 326100 Plastics Product Mfg 326200 Rubber Product Mfg Nonmetallic Mineral Product Manufacturing 327100 Clay Product & Refractory Mfg 327210 Glass & Glass Product Mfg 327300 Cement & Concrete Product Mfg 327400 Lime & Gypsum Product Mfg 327900 Other Nonmetallic Mineral Product Mfg Primary Metal Manufacturing 331110 Iron & Steel Mills & Ferroalloy Mfg 331200 Steel Product Mfg from Purchased Steel 331310 Alumina & Aluminum Production & Processing 331400 Nonferrous Metal (except Aluminum) Production & Processing 331500 Foundries Fabricated Metal Product Manufacturing 332110 Forging & Stamping 332210 Cutlery & Handtool Mfg 332300 Architectural & Structural Metals Mfg 332400 Boiler, Tank, & Shipping Container Mfg 332510 Hardware Mfg 332610 Spring & Wire Product Mfg 332700 Machine Shops; Turned Product; & Screw, Nut, & Bolt Mfg 332810 Coating, Engraving, Heat Treating, & Allied Activities 332900 Other Fabricated Metal Product Mfg Machinery Manufacturing 333100 Agriculture, Construction, & Mining Machinery Mfg 333200 Industrial Machinery Mfg 333310 Commercial & Service Industry Machinery Mfg 333410 Ventilation, Heating, Air-Conditioning, & Commercial Refrigeration Equipment Mfg

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333510 Metalworking Machinery Mfg 333610 Engine, Turbine & Power Transmission Equipment Mfg 333900 Other General Purpose Machinery Mfg Computer and Electronic Product Manufacturing 334110 Computer & Peripheral Equipment Mfg 334200 Communications Equipment Mfg 334310 Audio & Video Equipment Mfg 334410 Semiconductor & Other Electronic Component Mfg 334500 Navigational, Measuring, Electromedical, & Control Instruments Mfg 334610 Manufacturing & Reproducing Magnetic & Optical Media Electrical Equipment, Appliance, and Component Manufacturing 335100 Electric Lighting Equipment Mfg 335200 Household Appliance Mfg 335310 Electrical Equipment Mfg 335900 Other Electrical Equipment & Component Mfg Transportation Equipment Manufacturing 336100 Motor Vehicle Mfg 336210 Motor Vehicle Body & Trailer Mfg 336300 Motor Vehicle Parts Mfg 336410 Aerospace Product & Parts Mfg 336510 Railroad Rolling Stock Mfg 336610 Ship & Boat Building 336990 Other Transportation Equipment Mfg Furniture and Related Product Manufacturing 337000 Furniture & Related Product Manufacturing Miscellaneous Manufacturing 339110 Medical Equipment & Supplies Mfg 339900 Other Miscellaneous Manufacturing

Wholesale Trade Merchant Wholesalers, Durable Goods 423100 Motor Vehicle & Motor Vehicle Parts & Supplies 423200 Furniture & Home Furnishings 423300 Lumber & Other Construction Materials 423400 Professional & Commercial Equipment & Supplies 423500 Metals & Minerals (except Petroleum) 423600 Household Appliances and Electrical & Electronic Goods 423700 Hardware, Plumbing & Heating Equipment & Supplies 423800 Machinery, Equipment, & Supplies 423910 Sporting & Recreational Goods & Supplies 423920 Toy & Hobby Goods & Supplies 423930 Recyclable Materials 423940 Jewelry, Watches, Precious Stones, & Precious Metals 423990 Other Miscellaneous Durable Goods

Forms 5500, 5500-SF, and 5500-EZ Codes for Principal Business Activity (Continued) Merchant Wholesalers, Nondurable Goods 424100 Paper & Paper Products 424210 Drugs & Druggists' Sundries 424300 Apparel, Piece Goods, & Notions 424400 Grocery & Related Products 424500 Farm Product Raw Materials 424600 Chemical & Allied Products 424700 Petroleum & Petroleum Products 424800 Beer, Wine, & Distilled Alcoholic Beverages 424910 Farm Supplies 424920 Books, Periodicals, & Newspapers 424930 Flower, Nursery Stock, & Florists' Supplies 424940 Tobacco & Tobacco Products 424950 Paint, Varnish, & Supplies 424990 Other Miscellaneous Nondurable Goods Wholesale Electronic Markets and Agents and Brokers 425110 Business to Business Electronic Markets 425120 Wholesale Trade Agents & Brokers

Retail Trade Motor Vehicle and Parts Dealers 441110 New Car Dealers 441120 Used Car Dealers 441210 Recreational Vehicle Dealers 441228 Motorcycle, ATV, and All Other Motor Vehicle Dealers 441222 Boat Dealers 441300 Automotive Parts, Accessories, & Tire Stores Furniture and Home Furnishings Stores 442110 Furniture Stores 442210 Floor Covering Stores 442291 Window Treatment Stores 442299 All Other Home Furnishings Stores Electronics and Appliance Stores 443141 Household Appliance Stores 443142 Electronics Stores (including Audio, Video, Computer, and Camera Stores) Building Material and Garden Equipment and Supplies Dealers 444110 Home Centers 444120 Paint & Wallpaper Stores 444130 Hardware Stores 444190 Other Building Material Dealers 444200 Lawn & Garden Equipment & Supplies Stores Food and Beverage Stores 445110 Supermarkets and Other Grocery (except Convenience) Stores 445120 Convenience Stores 445210 Meat Markets 445220 Fish & Seafood Markets 445230 Fruit & Vegetable Markets 445291 Baked Goods Stores 445292 Confectionery & Nut Stores 445299 All Other Specialty Food Stores 445310 Beer, Wine, & Liquor Stores Health and Personal Care Stores 446110 Pharmacies & Drug Stores 446120 Cosmetics, Beauty Supplies, & Perfume Stores 446130 Optical Goods Stores 446190 Other Health & Personal Care Stores Gasoline Stations 447100 Gasoline Stations (including convenience stores with gas)

Clothing and Clothing Accessories Stores 448110 Men's Clothing Stores 448120 Women's Clothing Stores 448130 Children's & Infants' Clothing Stores 448140 Family Clothing Stores 448150 Clothing Accessories Stores 448190 Other Clothing Stores 448210 Shoe Stores 448310 Jewelry Stores 448320 Luggage & Leather Goods Stores Sporting Goods, Hobby, Book, and Music Stores 451110 Sporting Goods Stores 451120 Hobby, Toy, & Game Stores 451130 Sewing, Needlework, & Piece Goods Stores 451140 Musical Instrument & Supplies Stores 451211 Book Stores 451212 News Dealers & Newsstands General Merchandise Stores 452110 Department Stores 452900 Other General Merchandise Stores Miscellaneous Store Retailers 453110 Florists 453210 Office Supplies & Stationery Stores 453220 Gift, Novelty, & Souvenir Stores 453310 Used Merchandise Stores 453910 Pet & Pet Supplies Stores 453920 Art Dealers 453930 Manufactured (Mobile) Home Dealers 453990 All Other Miscellaneous Store Retailers (including tobacco, candle, & trophy shops) Nonstore Retailers 454110 Electronic Shopping & Mail-Order Houses 454210 Vending Machine Operators 454310 Fuel dealers (including Heating Oil and Liquefied Petroleum) 454390 Other Direct Selling Establishments (including door-to-door retailing, frozen food plan providers, party plan merchandisers, & coffee-break service providers)

Transportation and Warehousing Air, Rail, and Water Transportation 481000 Air Transportation 482110 Rail Transportation 483000 Water Transportation Truck Transportation 484110 General Freight Trucking, Local 484120 General Freight Trucking, Long-distance 484200 Specialized Freight Trucking Transit and Ground Passenger Transportation 485110 Urban Transit Systems 485210 Interurban & Rural Bus Transportation 485310 Taxi Service 485320 Limousine Service 485410 School & Employee Bus Transportation 485510 Charter Bus Industry 485990 Other Transit & Ground Passenger Transportation Pipeline Transportation 486000 Pipeline Transportation Scenic & Sightseeing Transportation 487000 Scenic & Sightseeing Transportation

Support Activities for Transportation 488100 Support Activities for Air Transportation 488210 Support Activities for Rail Transportation 488300 Support Activities for Water Transportation 488410 Motor Vehicle Towing 488490 Other Support Activities for Road Transportation 488510 Freight Transportation Arrangement 488990 Other Support Activities for Transportation Couriers and Messengers 492110 Couriers 492210 Local Messengers & Local Delivery Warehousing and Storage 493100 Warehousing & Storage (except lessors of miniwarehouses & self-storage units)

Information Publishing Industries (except Internet) 511110 Newspaper Publishers 511120 Periodical Publishers 511130 Book Publishers 511140 Directory & Mailing List Publishers 511190 Other Publishers 511210 Software Publishers Motion Picture and Sound Recording Industries 512100 Motion Picture & Video Industries (except video rental) 512200 Sound Recording Industries Broadcasting (except Internet) 515100 Radio & Television Broadcasting 515210 Cable & Other Subscription Programming Telecommunications 517000 Telecommunications (including paging, cellular, satellite, cable & other program distribution, resellers, other telecommunications, & internet service providers) Data Processing Services 518210 Data Processing, Hosting, & Related Services Other Information Services 519100 Other Information Services (including news syndicates, libraries, internet publishing & broadcasting)

Finance and Insurance Depository Credit Intermediation 522110 Commercial Banking 522120 Savings Institutions 522130 Credit Unions 522190 Other Depository Credit Intermediation Nondepository Credit Intermediation 522210 Credit Card Issuing 522220 Sales Financing 522291 Consumer Lending 522292 Real Estate Credit (including mortgage bankers & originators) 522293 International Trade Financing 522294 Secondary Market Financing 522298 All Other Nondepository Credit Intermediation Activities Related to Credit Intermediation 522300 Activities Related to Credit Intermediation (including loan brokers, check clearing, & money transmitting)

-9-

Securities, Commodity Contracts, and Other Financial Investments and Related Activities 523110 Investment Banking & Securities Dealing 523120 Securities Brokerage 523130 Commodity Contracts Dealing 523140 Commodity Contracts Brokerage 523210 Securities & Commodity Exchanges 523900 Other Financial Investment Activities (including portfolio management & investment advice) Insurance Carriers and Related Activities 524130 Reinsurance Carriers 524140 Direct Life, Health, & Medical Insurance Carriers 524150 Direct Insurance (except Life, Health & Medical) Carriers 524210 Insurance Agencies & Brokerages 524290 Other Insurance Related Activities (including third-party administration of insurance and pension funds) Funds, Trusts, and Other Financial Vehicles 525100 Insurance & Employee Benefit Funds 525910 Open-End Investment Funds (Form 1120-RIC) 525920 Trusts, Estates, & Agency Accounts 525990 Other Financial Vehicles (including mortgage REITs & closed-end investment funds) “Offices of Bank Holding Companies” and “Offices of Other Holding Companies” are located under Management of Companies (Holding Companies).

Real Estate and Rental and Leasing Real Estate 531110 Lessors of Residential Buildings & Dwellings (including equity REITs) 531120 Lessors of Nonresidential Buildings (except Miniwarehouses) (including equity REITs) 531130 Lessors of Miniwarehouses & Self-Storage Units (including equity REITs) 531190 Lessors of Other Real Estate Property (including equity REITs) 531210 Offices of Real Estate Agents & Brokers 531310 Real Estate Property Managers 531320 Offices of Real Estate Appraisers 531390 Other Activities Related to Real Estate Rental and Leasing Services 532100 Automotive Equipment Rental & Leasing 532210 Consumer Electronics & Appliances Rental 532220 Formal Wear & Costume Rental 532230 Video Tape & Disc Rental 532290 Other Consumer Goods Rental 532310 General Rental Centers 532400 Commercial & Industrial Machinery & Equipment Rental & Leasing Lessors of Nonfinancial Intangible Assets (except copyrighted works) 533110 Lessors of Nonfinancial Intangible Assets (except copyrighted works)

Forms 5500, 5500-SF, and 5500-EZ Codes for Principal Business Activity (Continued) Professional, Scientific, and Technical Services Legal Services 541110 Offices of Lawyers 541190 Other Legal Services Accounting, Tax Preparation, Bookkeeping, and Payroll Services 541211 Offices of Certified Public Accountants 541213 Tax Preparation Services 541214 Payroll Services 541219 Other Accounting Services Architectural, Engineering, and Related Services 541310 Architectural Services 541320 Landscape Architecture Services 541330 Engineering Services 541340 Drafting Services 541350 Building Inspection Services 541360 Geophysical Surveying & Mapping Services 541370 Surveying & Mapping (except Geophysical) Services 541380 Testing Laboratories Specialized Design Services 541400 Specialized Design Services (including interior, industrial, graphic, & fashion design) Computer Systems Design and Related Services 541511 Custom Computer Programming Services 541512 Computer Systems Design Services 541513 Computer Facilities Management Services 541519 Other Computer Related Services Other Professional, Scientific, and Technical Services 541600 Management, Scientific, & Technical Consulting Services 541700 Scientific Research & Development Services 541800 Advertising & Related Services 541910 Marketing Research & Public Opinion Polling 541920 Photographic Services 541930 Translation & Interpretation Services 541940 Veterinary Services 541990 All Other Professional, Scientific, & Technical Services

Management of Companies (Holding Companies) 551111 Offices of Bank Holding Companies 551112 Offices of Other Holding Companies

Administrative and Support and Waste Management and Remediation Services Administrative and Support Services 561110 Office Administrative Services

561210 Facilities Support Services 561300 Employment Services 561410 Document Preparation Services 561420 Telephone Call Centers 561430 Business Service Centers (including private mail centers & copy shops) 561440 Collection Agencies 561450 Credit Bureaus 561490 Other Business Support Services (including repossession services, court reporting, & stenotype services) 561500 Travel Arrangement & Reservation Services 561600 Investigation & Security Services 561710 Exterminating & Pest Control Services 561720 Janitorial Services 561730 Landscaping Services 561740 Carpet & Upholstery Cleaning Services 561790 Other Services to Buildings & Dwellings 561900 Other Support Services (including packaging & labeling services, & convention & trade show organizers) Waste Management and Remediation Services 562000 Waste Management & Remediation Services

Educational Services 611000 Educational Services (including schools, colleges, & universities)

Health Care and Social Assistance Offices of Physicians and Dentists 621111 Offices of Physicians (except mental health specialists) 621112 Offices of Physicians, Mental Health Specialists 621210 Offices of Dentists Offices of Other Health Practitioners 621310 Offices of Chiropractors 621320 Offices of Optometrists 621330 Offices of Mental Health Practitioners (except Physicians) 621340 Offices of Physical, Occupational & Speech Therapists, & Audiologists 621391 Offices of Podiatrists 621399 Offices of All Other Miscellaneous Health Practitioners Outpatient Care Centers 621410 Family Planning Centers 621420 Outpatient Mental Health & Substance Abuse Centers 621491 HMO Medical Centers 621492 Kidney Dialysis Centers 621493 Freestanding Ambulatory Surgical & Emergency Centers

621498 All Other Outpatient Care Centers Medical and Diagnostic Laboratories 621510 Medical & Diagnostic Laboratories Home Health Care Services 621610 Home Health Care Services Other Ambulatory Health Care Services 621900 Other Ambulatory Health Care Services (including ambulance services & blood & organ banks) Hospitals 622000 Hospitals Nursing and Residential Care Facilities 623000 Nursing & Residential Care Facilities Social Assistance 624100 Individual & Family Services 624200 Community Food & Housing, & Emergency & Other Relief Services 624310 Vocational Rehabilitation Services 624410 Child Day Care Services

Arts, Entertainment, and Recreation Performing Arts, Spectator Sports, and Related Industries 711100 Performing Arts Companies 711210 Spectator Sports (including sports clubs & racetracks) 711300 Promoters of Performing Arts, Sports, & Similar Events 711410 Agents & Managers for Artists, Athletes, Entertainers, & Other Public Figures 711510 Independent Artists, Writers, & Performers Museums, Historical Sites, and Similar Institutions 712100 Museums, Historical Sites, & Similar Institutions Amusem*nt, Gambling, and Recreation Industries 713100 Amusem*nt Parks & Arcades 713200 Gambling Industries 713900 Other Amusem*nt & Recreation Industries (including golf courses, skiing facilities, marinas, fitness centers, & bowling centers)

Accommodation and Food Services Accommodation 721110 Hotels (except Casino Hotels) & Motels 721120 Casino Hotels 721191 Bed & Breakfast Inns 721199 All Other Traveler Accommodation 721210 RV (Recreational Vehicle) Parks & Recreational Camps 721310 Rooming & Boarding Houses Food Services and Drinking Places 722300 Special Food Services (including food service contractors & caterers)

-10-

722410 Drinking Places (Alcoholic Beverages) 722511 Full-Service Restaurants 722513 Limited-Service Restaurants 722514 Cafeterias and Buffets 722515 Snack and Non-alcoholic Beverage Bars

Other Services Repair and Maintenance 811110 Automotive Mechanical & Electrical Repair & Maintenance 811120 Automotive Body, Paint, Interior, & Glass Repair 811190 Other Automotive Repair & Maintenance (including oil change & lubrication shops & car washes) 811210 Electronic & Precision Equipment Repair & Maintenance 811310 Commercial & Industrial Machinery & Equipment (except Automotive & Electronic) Repair & Maintenance 811410 Home & Garden Equipment & Appliance Repair & Maintenance 811420 Reupholstery & Furniture Repair 811430 Footwear & Leather Goods Repair 811490 Other Personal & Household Goods Repair & Maintenance Personal and Laundry Services 812111 Barber Shops 812112 Beauty Salons 812113 Nail Salons 812190 Other Personal Care Services (including diet & weight reducing centers) 812210 Funeral Homes & Funeral Services 812220 Cemeteries & Crematories 812310 Coin-Operated Laundries & Drycleaners 812320 Drycleaning & Laundry Services (except Coin-Operated) 812330 Linen & Uniform Supply 812910 Pet Care (except Veterinary) Services 812920 Photofinishing 812930 Parking Lots & Garages 812990 All Other Personal Services Religious, Grantmaking, Civic, Professional, and Similar Organizations 813000 Religious, Grantmaking, Civic, Professional, & Similiar Organizations (including condominium and homeowners associations) 813930 Labor Unions and Similar Labor Organizations 921000 Governmental Instrumentality or Agency

[PDF] Instructions for Form 5500-EZ - Free Download PDF (2024)
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