SFA 208 SFA Template 8

Special Financial Assistance by PBGC

Template 8 v20220701p.xlsx

Application for Special Financial Assistance

OMB: 1212-0074

Document [xlsx]
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Overview

Version Updates
8 Cont and WDL Details


Sheet 1: Version Updates

Version Updates










v20220701p
Version
Date updated









v20220701p 7/1/2022

Sheet 2: 8 Cont and WDL Details

TEMPLATE 8


File name: Template 8 Plan Name, where "Plan Name" is an abbreviated version of the plan name. v20220701p
Contribution and Withdrawal Liability Details




















Provide details of the projected contributions and withdrawal liability payments used to calculate the requested SFA amount. This should include total contributions, contribution base units (including identification of the base unit used (i.e., hourly, weekly)), average contribution rate(s), reciprocity contributions (if applicable), additional contributions from the rehabilitation plan (if applicable), and any other identifiable contribution streams. For withdrawal liability, separately show amounts for currently withdrawn employers and for future assumed withdrawals. Also provide the projected number of active participants at the beginning of each plan year.

The first row in the projection period is for the period beginning on the SFA measurement date and ending on the last day of the plan year containing the SFA measurement date. For all other periods, provide the full plan year of information up to the plan year ending in 2051.











PLAN INFORMATION









Abbreviated
Plan Name:








EIN:









PN:




















Unit (e.g. hourly, weekly)














All Other Sources of Non-Investment Income
SFA Measurement Date / Plan Year Start Date Plan Year End Date Total Contributions* Total Contribution Base Units Average Contribution Rate Reciprocity Contributions (if applicable) Additional Rehab Plan Contributions (if applicable) Other - Explain if Applicable Withdrawal Liability Payments for Currently Withdrawn Employers Withdrawal Liability Payments for Projected Future Withdrawals Projected Number of Active Participants (Including New Entrants) at the Beginning of the Plan Year






















































































































































































































































































































































































* Total contributions shown here should be contributions based upon CBUs and should not include items separately shown in any columns under "All Other Sources of Non-Investment Income."


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