2024 Annual Funding Notice (AFN) Instructions

Annual Funding Notice

View Official DOL Regs | Single-Employer Cross Reference Chart | Multiemployer Cross Reference Chart

DOL Guidance

• 4/3/2025 Field Assistance Bulletin No. 2025-02
  • Appendix 1- Secure 2.0 Model Annual Funding Notice for a Single-Employer Plan
  • Appendix 2- Secure 2.0 Model Annual Funding Notice for a Multiemployer Plan

AFN Checklist Line items:

General Information

• 1. Plan Name
• 2a. Plan Year Begin Date
• 2b. Plan Year End Date
• 2c. First Plan Year for this Plan
• 3. Plan Type
• 4a. AFN Instructions
• 4b. Custom Instructions

Contact Information 

• 5. Plan Administrator's Contact Name 
• 6. Intranet Address for Annual Report
• 7. Plan Administrator Email

Single Employer Funding Percentages - 2024

• 10. Last Day of Relevant Plan Year
• 11. Plan Assets
• 12. Plan Liabilities
• 13. Funded Percentage
• 14. Are the plan liabilities for the current year an estimate?

Single Employer Funding Percentages - 2023 

• 15. Prior Year Last Day of Relevant Plan Year
• 16. Prior Year Plan Assets
• 17. Prior Year Plan Liabilities
• 18. Prior Year Funded Percentage

Single Employer Funding Percentages - 2022 

• 19. Last Day of Relevant Plan Year 2 Years Prior
• 20. Plan Assets 2 Years Prior
• 21. Plan Liabilities 2 Years Prior
• 22. Funded Percentage 2 Years Prior

Multiemployer Funding Percentages - 2024 

• 30. Current Year Valuation Date
• 31. Current Year Funded Percentage
• 32. Current Year Value of Assets
• 33. Current Year Value of Liabilities

Multiemployer Funding Percentages - 2023

• 34. Prior Year Valuation Date
• 35. Prior Year Funded Percentage
• 36. Prior Year Value of Assets
• 37. Prior Year Value of Liabilities

Multiemployer Funding Percentages - 2022 

• 38. Valuation Date 2 Years Prior
• 39. Funded percentage 2 Years Prior
• 40. Value of Assets 2 Years Prior
• 41. Value of liabilities 2 Years Prior

Multiemployer Year-End Fair Market Value (FMV) of Assets  

• 50. Last Day of the Current Plan Year
• 51. FMV Assets on the Above Date 
• 52. Last day of the Preceding Plan Year
• 53. FMV Assets on the Above Date
• 54. Last Day of the Plan Year 2 Years Preceding
• 55. FMV Assets on the Above Date

Multiemployer - Endangered, Critical, or Critical and Declining

• 60. Plan's Funding Status
• 61. Projected Insolvent Year, if Critical and Declining
• 62. Date Trustee Adopted Rehabilitation Plan, if Critical and Declining
• 63. Insolvency Prevention Action?
• 64. Summary of Insolvency Action
• 65. Summary of Status Based on Statutory Factors
• 66. Summary of Funding Improvement Strategy
• 67. Intranet Address for More information

Participant and Beneficiary Information - 2024 

• 70. Last Day of Relevant Plan Year
• 71. Number of Current Employees
• 72. Number of Retired Participants and Receiving Benefits
• 73. Number of Retired Participants Entitled to Benefits
• 74. Total Number of Participants
• 75. Are the end of year numbers an estimate?

Participant and Beneficiary Information - 2023 

• 76. Last Day of Relevant Plan Year
• 77. Number of Current Employees
• 78. Number of Retired Participants and Receiving Benefits
• 79. Number of Retired Participants Entitled to Benefits
• 80. Total Number of Participants

Participant and Beneficiary Information - 2022 

• 81. Last Day of Relevant Plan Year
• 82. Number of Current Employees
• 83. Number of Retired Participants and Receiving Benefits
• 84. Number of Retired Participants Entitled to Benefits
• 85. Total Number of Participants

Funding and Investment Policies 

• 90. Funding Policy
• 91. Investment Policy

Asset Types

• 100 - 127. Types and Value of Plan Assets
• 128 - 130. Average Return on Assets

Events with Material Effect on Assets/Liabilities

• 140. Has there been an event that has a material effect on assets/liabilities?
• 141. Beginning of Current Plan Year (year after plan year to which this notice relates).
• 142. Explanation of the Event.
• 143. Are plan liabilities expected to increase or decrease?
• 144. Amount of expected increase or decrease?
• 145. End of Current Plan Year (year after plan year to which this notice relates).

Plan Information

PBGC Guarantees

• 150. Indicate if plan includes pension benefits at normal retirement age.
• 151. Indicate if the plan includes an early retirement benefit.
• 152. Indicate if the plan includes annuity benefits for survivors of plan participants.
• 153. Indicate if the plan includes disability benefits.

PBGC Does Not Guarantee

• 154. (Single Employer Only) Indicate if the plan includes vesting schedule.
• 155. (Single Employer Only) Indicate if there have been benefit increases or new benefits in the past 5 years.
• 156. (Single Employer Only) Indicate if the plan includes early retirement payments that exceed normal retirement payments.
• 157. (Single Employer Only) Indicate if the plan includes lump-sum payments exceeding $7,000.
• 158. (Multiemployer Only) Indicate if the plan includes a participant's pension benefit or benefit increase until it has been part of the plan for 60 months.
• 159. (Multiemployer Only) Indicate if the plan includes any benefit above the normal retirement benefit.
• 160. (Multiemployer Only) Indicate if the plan includes disability benefits in non-pay status.
• 161. Indicate if the plan includes non-pension benefits (such as health, insurance, life insurance, death benefits, vacation pay, or severance pay.

Determining Guarantee Amounts:

• 162. (Single Employer Only) Indicate if benefits may commence before age 65.

Corporate and Actuarial Information on File with PBGC:

• 163. (Single Employer Only) Indicate if reporting under section 4010 was required.

Small Plan Audit Waiver 

• 170. Is plan eligible for waiver of the audit?
• 171. Include Name of Surety, (if applicable)
• 172. Financial Institution Information, (if applicable)

Custom Language 

• 180. Custom Language

HATFA Supplement

• 190. Does the AFN require a HATFA supplement?

Print Settings

• 200. Select the Font Type
• 201. Select the Font Size
• 202. Select the Line Spacing
• 203. Select the Left Margin in Inches
• 204. Select the Right Margin in Inches
• 205. Select the Top Margin in Inches
• 206. Select the Bottom Margin in Inches

Where to send AFN:

• Each participant covered under the plan on the last day of the notice year,
• Each beneficiary receiving benefits under the plan on the last day of the notice year,
• Each alternate payee under the plan on the last day of the notice year;
• Each labor organization representing participants under the plan on the last day of the notice year, 
• For a multiemployer plan, each employer, as of the last day of the notice year, that is a party to the collective bargaining agreement(s) pursuant to which the plan is maintained or who otherwise may be subject to withdrawal liability pursuant to section 4203 of the Act; and
• The Pension Benefit Guaranty Corporation (PBGC):
• 
  
  • Single-Employer Plans for plans that have at least $50 million in assets:
  • 
    
    • Email: single-employerAFN@pbgc.gov, or
    • Mail:
      PBGC
      ATTN: Single Employer AFN Coordinator
      1200 K Street NW., Suite 270
      Washington, DC 20005-4026
  • Multiemployer Plans:
  • 
    
    • Email: multiemployerprogram@pbgc.gov, or
    • Mail:
      PBGC
      ATTN: Multiemployer Program Division
      1200 K Street NW
      Washington, DC 20005-4026

When to Furnish:

• 120 days after the end of the notice year
• For small plans, a funding notice shall be provided not later than the earlier of the date on which the annual report is filed under section 104(a) of the Act or the latest date the annual report must be filed under that section (including extensions). For this purpose, a single-employer plan is a small plan if it meets the exception in section 303(g)(2)(B) of the Act, and a multiemployer plan is a small plan if it had 100 or fewer participants on each day during the plan year preceding the notice year.

1. Plan Name. Top

Plan Name pre-populates from Form 5500/SF, Part II when the Annual Funding Notice (AFN) checklist is added. If updated on the Form 5500/SF afterward, the AFN checklist must be deleted and re-added to display the change.

2a-b. Plan Year Begin and End Dates. Top

Plan Year Begin and End Dates pre-populate from Form 5500/SF, Part I when the AFN checklist is added. If updated on the Form 5500/SF afterward, the AFN checklist must be deleted and re-added to display the changes.

2c. First Plan Year. Top

First Plan Year selection determines whether the Plan is Current, Prior, or at least three years old:

• If Current (created in 2024), the AFN does not require information for 2023 or 2022 Plan Years.
• If Prior (created in 2023), the AFN does not require information for the 2022 Plan Year.
• If at least three years old, the AFN requires information for the 2022, 2023, and 2024 Plan Years.

3. Plan Type. Top

Plan Type pre-populates from Form 5500/SF, Part I when the Annual Funding Notice (AFN) checklist is added. If updated on the Form 5500/SF afterward, the AFN checklist must be deleted and re-added to display the change.

4a. AFN Instructions. Top

Indicate if there will be instructions to the AFN as the Cover Page

4b. Custom Instructions. Top

If Custom, on Line 4a, is selected, enter the custom text to appear as the first page of the AFN. The page will include a heading of "ANNUAL FUNDING NOTICE INSTRUCTIONS" above the Custom text.

5. Admin Contact Name Top

If left blank, the Plan Administrator listed on Line 2a or 3a of the Form 5500/SF will be the contact in the Annual Funding Notice. To list a different contact, enter the new contact information in Line item 5.

6. Intranet Address Top

Insert an intranet address where employees may access the annual report (if left blank, intranet address will not print

7. Plan Administrator E-mail Top

Insert the e-mail address of the Plan Administrator (if left blank, e-mail address will not print).

10 - 22. Single-Employer Funded Percentages Top

Single-Employer Plans Only

Percentage of Plan Liabilities Funded Table (Line items 10-22) will pre-populate from the AFN Checklist, Form 5500/SF, or prior year filing data. If the AFN checklist is left blank, the table will pre-populate from the applicable available form or schedules listed below.

Note: Starting with the 2024 notice year, the annual funding notice must reflect the “percentage of plan liabilities funded” which is the ratio between the fair market value of the assets on the last day of the plan year and the value of the liabilities determined as of the last day of the plan year using a market-related interest assumption. 

For this purpose, year-end plan liabilities are determined using the standard in 29 CFR 2520.101-5(b)(3)(i). Plan administrators may use reasonable estimates, based on standard actuarial techniques, to determine year-end plan liabilities for the notice year, but not the 2 preceding years. The fair market value of plan assets on the last day of the 2 preceding plan years should be as reported on the Form 5500 Annual Report/Return of Employee Benefit Plan for the relevant year, unless the plan administrator knows or has reason to know that the value of assets reported is not correct.

14. Are the Plan liabilities for the current year an estimate? Top

The following language will be included if checklist Line 14, (Are the Plan liabilities for the current year an estimate?) is answered Yes:

Plan liabilities for the Plan Year in Line 3 of the chart reflect the plan administrator’s reasonable, good faith estimate. 

30 - 41. Multiemployer Funding Percentages Top

Multiemployer Plans Only

The Funded Percentage Table (items 30-41) will be pre-populated information from the AFN checklist or Schedule MB. The following chart describes how the table is pre-populated:

51. Multiemployer Fair Market Value of Assets as of Last Day of the Current Plan Year Top

Enter the plan's assets as of the last day of the plan year. The Fair Market Value of the plan's assets will pre-populate from:

• Current Year Schedule H Line 1l(b); or 
• Current Year Schedule I Line 1c(b).

NOTE: Users may (but are not required to)  include contributions made after the end of the notice year and before the date the notice is timely furnished but only if those contributions are attributable to the notice year for funding purposes. Single-Employer plans including these contributions must discount them back to the last day of the notice year, but multiemployer plans do not need to discount them. See Year-end Statement of Plan Assets--Contributions Receivable to the Final Rule for more information.

NOTE: Pre-populated information actually relates to the first day of the following plan year - figures may need to be adjusted back to the last day of the notice year.

52 - 55. Multiemployer - Asset FMV in Prior Plan Years Top

Multiemployer plans  must enter asset information for the preceding plan year and the plan year two years prior. Plan year ends are imported from the 2023 and 2022 Form 5500, if available, or calculated based on the current 5500 plan year ends. The Fair Market Value of the plan's assets will pre-populate from Line 1l(b) of Schedule H or Line 1c(b) of Schedule I (for each year), as applicable.

NOTE: Pre-populated information reflects the first day of the following plan year. Figures may need to be adjusted to the last day of the applicable year.

60 - 67. Multiemployer - Endangered, Critical or Critical and Declining Top

Multiemployer Plans only The status will pre-populate to Endangered, Critical, or Critical and Declining based on Line 4b of the Schedule MB. If the plan is in endangered, critical, or critical and declining status (Line 4b of the MB is not "N"), the user must include a summary description of why the plan was in this status and a funding improvement or rehabilitation plan.

See Endangered, Critical, or Critical and Declining Status (Sec. 2520.101-5(b)(6)) under the Final Rule for more information.

The following language will be placed in the annual funding notice depending on the answers to Lines 60 - 67 of the checklist.

If Line item 60 is Not Applicable, Endangered, Critical or Critical and Declining:

Endangered, Critical or Critical and Declining Status
Under federal pension law, a plan’s funding status determines the steps a plan must take to strengthen its finances and continue paying benefits:

• Endangered: The plan’s funded percentage drops below 80 percent. The plan’s trustees must adopt a funding improvement plan.
• Critical: The plan’s funded percentage falls below 65 percent or meets other financial distress criteria. The plan’s trustees must implement a rehabilitation plan.
• Critical and Declining: A plan in critical status is also designated as critical and declining if projected to become insolvent - meaning it will no longer have enough assets to pay out benefits - within 15 years (or within 20 years under a special rule). The plan’s trustees must continue to implement the rehabilitation plan. The plan’s sponsor may seek approval to amend the plan, including reducing current and future benefits.

[If Not Applicable:]
 The Plan was not in endangered, critical, or critical and declining status in the Plan Year.

[If Endangered or Critical:]
The Plan was in [Line Item 60.] status in the Plan Year because [Line Item 65].

To improve the Plan's funding situation, the trustees adopted [Line Item 66].
[If Line 60 is Endangered:] You may request a copy of the Plan's funding improvement plan by contacting the plan administrator.  You can also ask for any updates to the funding improvement plan and the actuarial and financial data showing actions taken to improve the Plan’s finances.

[If Line 60 is Critical:] You may request a copy of the Plan's rehabilitation plan, by contacting the plan administrator.  You can also ask for any updates to the rehabilitation plan, and the actuarial and financial data showing actions taken to improve the Plan’s finances.

[If Critical and Declining:]
The Plan was in critical and declining status in the Plan Year because [Line Item 65].
The Plan is projected to be insolvent in [Line Item 61], which may lead to benefit reductions.

To improve the Plan's funding situation, the trustees adopted a rehabilitation plan on [Line Item 62]. The rehabilitation plan [Line Item 66].

[If Line 64 is Yes:] The plan sponsor has taken the following legally permitted actions to prevent insolvency: [Line 65].

 You may request a copy of the Plan’s rehabilitation plan by contacting the plan administrator. You can also ask for any updates to the rehabilitation plan and the actuarial and financial data showing actions taken to improve the Plan’s funding.

 NOTE: If a response it provided on Line 60, the following sentence will also be included in the annual funding notice:

If the Plan is in endangered, critical or critical and declining status for the plan year ending [last day of the plan year following the Plan Year], separate notification of that status has or will be provided.

70 - 85. Participant and Beneficiary Information Top

The information for the number of participants and beneficiaries covered by the plan on the last day of the plan year auto populate from values on the Form 5500. The following chart describes how the table is pre-populated:

NOTE: A plan administrator of a large plan will not be considered in violation of section 101(f)(2)(B)(iii) of ERISA if it uses a reasonable, good faith estimate of the number of participants and beneficiaries for the counts for the current notice year. With respect to the 2 preceding plan years, however, the plan administrator of a plan of any size must enter the actual number of participants and beneficiaries as of the last day of those plan years in the table.

90 and 91. Funding and Investment Policies Top

Insert a summary statement of the plan's Funding and Investment policies.

100 - 127. Types and Value of Plan Assets Top

Plan asset amounts will pre-populate based on the selected alternative:

• For Alternative 1, asset information will pre-populate from Schedule H if the plan filed a full Form 5500 with Schedule H or Schedule I.  NOTE: If the plan filed a 5500-SF asset information will not pre-populate.

• For Alternative 2, asset information will pre-populate from Schedule R if the plan completed Schedule R.

The Annual Funding Notice will display a chart showing asset allocation percentages, calculated by dividing each asset type amount by the total plan assets entered.

See Year-End Asset Allocation of Investments under the Final Rule for more information.

128 - 130. Average Return on Assets Top

Pending further guidance, plan administrators of both single-employer and multiemployer defined benefit plan may use either Method 1 or 2, described below, to determine the “average return on assets.” Other methods besides these two may also fulfill the requirements of section 101(f)(2)(B)(iv).

Method 1: The plan administrator may use the “actual rate of return” for the notice year determined by the plan’s actuary based on the methodology of 26 CFR 1.430(f)-1(b)(3)(i), except that the determination must be for the notice year and not the preceding plan year. This is the same methodology used to determine the “actual rate of return” on Line 10 of Schedule SB of Form 5500 Annual Return/Report of Employee Benefit Plan (Form 5500), but, applied to the notice year rather than the preceding plan year. For example, the average rate of return reported in the annual funding notice of single-employer defined benefit plan X for the 2024 notice year should be essentially equal to the “actual rate of return” that will be reported on Line 10 of Schedule SB of plan X’s 2025 Form 5500. If using Method 1, round the rate to the nearest 0.01%. If the rate of return is a negative number, include a minus sign (“–”) to the left of the number.

Method 2: The plan administrator may use the rate of return for the notice year determined by the plan’s actuary using the following formula:

2I ÷ (A + B – I), where:

“I” is the dollar amount of the investment return determined in the same manner as Line 6h of Schedule MB to Form 5500;

“A” is the fair market value of plan assets on the last day of the plan year preceding the notice year; and

“B” is the fair market value of plan assets on the last day of the notice year

The above formula is similar to the formula used to calculate the Estimated Investment Return – Current (Market) Value on Line 6h of Schedule MB to Form 5500, except that the calculation used under this method is based on the one-year period ending on the last day of the notice year rather than the one-year period ending on the valuation date.

Regardless of the Method selected (Method 1 or Method 2) on Line 128, the following language will appear in the AFN:

The average return on assets for the Plan Year was [insert percentage].

NOTE: If Method 1 is selected values will be rounded to the nearest 0.01%. If Method 2 is selected, values will be rounded to the nearest 0.1%.  If the rate of return is a negative number, include a minus sign (–) to the left of the number.

140. Events with Material Effect on Assets/Liabilities Top

A plan amendment, scheduled benefit increase (or reduction), or other known event has a material effect on plan liabilities or assets for the current plan year if it results, or is projected to result, in an increase or decrease of five percent or more in the value of assets or liabilities from the valuation date of the notice year.

See Material Effect Events (Sec. 2520.101-5(b)(7) and Sec. 2520.101-5(g)) under the Final Rule for more information.

The following language will appear on the annual funding notice if checklist Line 140, is answered Yes:

Events Having a Material Effect on Assets or Liabilities

By law, this notice must include an explanation of any new events that materially affect the Plan’s liabilities or assets. These events could affect the Plan’s financial health or its ability to meet its obligations.

For the plan year beginning on [Line item 141], the following events have such an effect:

•  [Line item 142].

If a response is entered on checklist Line 143 (Are Plan liabilities disclosed in the Funded Percentage expected to increase or decrease by the end of the current Plan year?)  the following language will appear on the annual funding notice:

We expect Plan liabilities disclosed in the Funded Percentage chart for the Plan Year to [Line 143] by approximately [Line 144] by [Line145] because of the event(s) having a material effect on Plan liabilities.

150 - 162. Plan Information Top

NOTE: The following Plan information details are broken into Single Employer and Multiemployer sections for clarity.

Single Employer Plans:

The answers to Line items 150-162 will pre-populate based on Defined Benefit or Cash Balance checklist answers for each plan type. More information about how each item is pre-populated for a Single Employer Plan  and the corresponding annual funding notice language is provided below.

If all responses are Yes, for a Single Employer Plan the Annual Funding Notice will populate as follows:

Benefit Payments Guaranteed by the PBGC

When PBGC takes over a single-employer plan, it pays pension benefits through its insurance program. Only vested benefits - those you’ve earned and cannot forfeit - are guaranteed. Most participants and beneficiaries receive their full pension benefits, but some people may lose some, or all, non-guaranteed benefits.

What PBGC Guarantees

PBGC guarantees the following “basic benefits” up to limits sets by law:

• Pension benefits at normal retirement age.
• Most early retirement benefits.
• Annuity benefits for survivors of plan participants.
• Disability benefits for disabilities that occurred before the earlier of the date the plan terminated or the sponsor’s bankruptcy date. 

What PBGC Does Not Guarantee

PBGC does not guarantee certain types of benefits, including:

• Non-vested benefits, which depend on meeting specific age, service, or other eligibility requirements.
•  Benefit increases and new benefits in place for less than one year before a plan’s termination date, while those in place for less than five years are only partly covered.
• Early retirement payments that exceed normal retirement payments, such as supplemental benefits that end when you become eligible for Social Security.
• Non-pension benefits, such as health insurance, life insurance, death benefits, vacation pay, or severance pay.
• Lump-sum payments exceeding $7,000.

Determining Guarantee Amounts

The amount PBGC guarantees is determined as of the plan’s termination date. If the plan terminates during the plan sponsor’s bankruptcy, the guarantee amount is determined as of the date the sponsor entered bankruptcy.

The maximum benefit PBGC guarantees is set by law and updated annually. Participants and beneficiaries may receive benefits above the PBGC guaranteed amount, but only if the plan has enough funds to pay them.

For a plan with a termination date or sponsor bankruptcy date, as applicable in [insert current calendar year], the maximum guarantee is [ Current PBGC Monthly value] per month, or [Current PBGC Annual Value] per year, for a benefit paid to a 65-year-old retiree with no survivor benefit. If a plan terminates during a plan sponsor’s bankruptcy, the maximum guarantee is fixed as of the calendar year in which the sponsor entered bankruptcy.

[If  Line 163 is  Yes:]

If benefits begin:

• Before age 65, the maximum guarantee is lower, reflecting the longer expected payment period for younger retirees.

• After age 65, the maximum guarantee is higher.

[If  Line 163 is  No:]

If benefits begin after age 65, the maximum guarantee is higher.

The guaranteed amount is reduced if a benefit will be paid to a survivor upon the participant’s death. Maximum guarantee amounts by age can be found on PBGC’s website, https://www.pbgc.gov/wr/benefits/guaranteed-benefits/maximum-guarantee.

In determining whether the plan has enough assets to pay benefits above the guaranteed amount, PBGC uses different assumptions than those used to calculate the funded percentage shown in the “How Well Funded Is Your Plan?” section of this notice. As a result, the additional benefits participants receive may not align with the Plan’s reported funded percentage. For example, a plan that reports 80 percent funding based on its own calculations does not mean its participants will receive 80 percent of their vested benefits.

Multiemployer Plans:

The answers to Line items 150-162 will pre-populate based on Defined Benefit or Cash Balance checklist answers for each plan type. More information about how each item is pre-populated for a Multiemployer Plan and the corresponding annual funding notice language is provided below.

If all responses are Yes, for a Multiemployer Plan the Annual Funding Notice will populate as follows:

Benefit Payments Guaranteed by the PBGC

Only vested benefits - those that you’ve earned and cannot forfeit - are guaranteed.

What PBGC Guarantees

PBGC guarantees the following “basic benefits” up to limits sets by law:

• Pension benefits at normal retirement age.
• Most early retirement benefits.
• Annuity benefits for survivors of plan participants.
• Disability benefits for disabilities that occurred before the earlier of the date the plan terminated or the sponsor’s bankruptcy date. 

What PBGC Does Not Guarantee

PBGC does not guarantee certain types of benefits, including:

• A participant’s pension benefit or benefit increase until it has been part of the plan for 60 full months. Any month in which the multiemployer plan was insolvent or terminated due to mass withdrawal does not count toward this 60-month requirement.
• Any benefits above the normal retirement benefit.
• Disability benefits in non-pay status.
• Non-pension benefits, such as health insurance, life insurance, death benefits, vacation pay, or severance pay.

Determining Guarantee Amounts

The maximum benefit PBGC guarantees is set by law. Your plan is covered by PBGC’s multiemployer program. The maximum PBGC guarantee is $35.75 per month, multiplied by a participant's years of credited service.

PBGC guarantees a monthly benefit based on the plan’s monthly benefit accrual rate and your years of credited service. The guarantee is calculated as follows: [a description and example are provided of the calculation.}

163. Plan Information: Single-Employer Plan Information - 4010 Top

Single-Employer Plans only

Select Yes if a reporting under section 4010 was required for the plan year. See Information Disclosed to PBGC (Sec. 2520.101-5(b)(11)) under the Final Rule for more information.

If Yes is selected, the following paragraph will appear in the Annual Funding Notice:

Corporate and Actuarial Information on File with PBGC

In some cases, a plan sponsor must submit financial and actuarial information to PBGC. This is generally required if the plan - or another plan maintained by your employer or a related employer - is less than 80 percent funded using PBGC’s assumptions, which differ from those in “How Well Funded Is Your Plan” section of this notice. PBGC uses this information for monitoring and other purposes.

170-172. Small Plan Audit Waiver Top

Indicate whether the plan is eligible for waiver of the audit requirement (small plan audit addendum will be used). If 170 is "Yes" and 171 and 172 are blank, the following will be added to the AFN:

Information Regarding Plan Assets

The U.S. Department of Labor's regulations require that an independent qualified public accountant audit the plan's financial statements unless certain conditions are met for the audit requirement to be waived. This plan met the audit waiver conditions for the plan year beginning [Form 5500/SF, Part I] and therefore has not had an audit performed.

General information regarding the audit waiver conditions applicable to the plan can be found on the U.S. Department of Labor Web site at http://www.dol.gov/ebsa under the heading "Frequently Asked Questions."

If 170 is "Yes" 171 is not blank and 172 is blank: 

Information Regarding Plan Assets

The U.S. Department of Labor's regulations require that an independent qualified public accountant audit the plan's financial statements unless certain conditions are met for the audit requirement to be waived. This plan met the audit waiver conditions for the plan year beginning [Form 5500/SF, Part I] and therefore has not had an audit performed.

[The following paragraph will appear if at least one of the asset types are used:]

The plan's assets were held in individual participant accounts with investments directed by participants and beneficiaries and with account statements from regulated financial institutions furnished to the participant or beneficiary at least annually [Form 5500/SF Pension Code 2G or 2H], loans to participants [Schedule I, Line 3e/Form 5500-SF, Line 10g] and other assets covered by a fidelity bond at least equal to the value of the assets and issued by [171 text], an approved surety company.

Plan participants and beneficiaries have a right, on request and free of charge, to get copies of the financial institution year-end statements and evidence of the fidelity bond. If you want to examine or get copies of the financial institution year-end statements or evidence of the fidelity bond, please contact [Line item 125 or if blank, Form 5500/SF Line 2a or 3a], who is a representative of the plan administrator at [Form 5500/SF, Line 2a or 3a] and phone number, [Form 5500/SF, Line 2c or 3c].

If you are unable to obtain or examine copies of the regulated financial institution statements or evidence of the fidelity bond, you may contact the regional office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) for assistance by calling toll-free 1.866.444.EBSA (3272). A listing of EBSA regional offices can be found at http://www.dol.gov/ebsa.

General information regarding the audit waiver conditions applicable to the plan can be found on the U.S. Department of Labor Web site at http://www.dol.gov/ebsa under the heading "Frequently Asked Questions."

If 170 is "Yes" 171 is blank and 172 is not blank:

Information Regarding Plan Assets

The U.S. Department of Labor's regulations require that an independent qualified public accountant audit the plan's financial statements unless certain conditions are met for the audit requirement to be waived. This plan met the audit waiver conditions for the plan year beginning [Form 5500/SF, Part I] and therefore has not had an audit performed. Instead, the following information is provided to assist you in verifying that the assets reported on the Form 5500 were actually held by the plan.

At the end of the plan year, the plan had the following assets, including qualifying plan assets:

[172 text]

The plan receives year-end statements from these regulated financial institutions that confirm the above information.

[The following paragraph will appear if at least one of the asset types are used:]

The remainder of the plan's assets were held in individual participant accounts with investments directed by participants and beneficiaries and with account statements from regulated financial institutions furnished to the participant or beneficiary at least annually [Form 5500/SF Pension Code 2G or 2H], loans to participants [Schedule I, Line 3e/Form 5500-SF, Line 10g] and other qualifying assets.

Plan participants and beneficiaries have a right, on request and free of charge, to get copies of the financial institution year-end statements and evidence of the fidelity bond. If you want to examine or get copies of the financial institution year-end statements or evidence of the fidelity bond, please contact [Line item 125 or if blank, Form 5500/SF Line 2a or 3a], who is a representative of the plan administrator at [Form 5500/SF, Line 2a or 3a] and phone number, [Form 5500/SF, Line 2c or 3c].

If you are unable to obtain or examine copies of the regulated financial institution statements or evidence of the fidelity bond, you may contact the regional office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) for assistance by calling toll-free 1.866.444.EBSA (3272). A listing of EBSA regional offices can be found at http://www.dol.gov/ebsa.

General information regarding the audit waiver conditions applicable to the plan can be found on the U.S. Department of Labor Web site at http://www.dol.gov/ebsa under the heading "Frequently Asked Questions."

If 170 is "Yes" 171 is not blank and 172 is not blank:

Information Regarding Plan Assets

The U.S. Department of Labor's regulations require that an independent qualified public accountant audit the plan's financial statements unless certain conditions are met for the audit requirement to be waived. This plan met the audit waiver conditions for the plan year beginning [Form 5500/SF, Part I] and therefore has not had an audit performed. Instead, the following information is provided to assist you in verifying that the assets reported on the Form 5500 were actually held by the plan.

At the end of the plan year, the plan had the following assets, including qualifying plan assets:

[172 text]

The plan receives year-end statements from these regulated financial institutions that confirm the above information.

[The following paragraph will appear if at least one of the asset types are used:]

The remainder of the plan's assets were held in individual participant accounts with investments directed by participants and beneficiaries and with account statements from regulated financial institutions furnished to the participant or beneficiary at least annually [Form 5500/SF Pension Code 2G or 2H], loans to participants [Schedule I, Line 3e/Form 5500-SF, Line 10g] and other assets covered by a fidelity bond at least equal to the value of the assets and issued by [171 text], an approved surety company.

Plan participants and beneficiaries have a right, on request and free of charge, to get copies of the financial institution year-end statements and evidence of the fidelity bond. If you want to examine or get copies of the financial institution year-end statements or evidence of the fidelity bond, please contact [Line item 125 or if blank, Form 5500/SF Line 2a or 3a], who is a representative of the plan administrator at [Form 5500/SF, Line 2a or 3a] and phone number, [Form 5500/SF, Line 2c or 3c].

If you are unable to obtain or examine copies of the regulated financial institution statements or evidence of the fidelity bond, you may contact the regional office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) for assistance by calling toll-free 1.866.444.EBSA (3272). A listing of EBSA regional offices can be found at http://www.dol.gov/ebsa.

General information regarding the audit waiver conditions applicable to the plan can be found on the U.S. Department of Labor Web site at http://www.dol.gov/ebsa under the heading "Frequently Asked Questions."

180. Custom Language Top

Information entered here will appear as text at the end of the AFN.

190 - 193f. HATFA Supplement Top

If item 190 is "Yes" (the AFN requires a HATFA supplement). The HATFA Information Table (items 191 - 193) will be populated as follows:

For more information about the Supplement, see the Field Assistance Bulletin 2015-1 and the Model Supplement.

200 - 206. Print Settings Top

Plan Level Changes:

Individual plan-level print settings can be adjusted, including:

• Font type
• Font size
• Line spacing
• Margins

 These settings apply only to the specific plan being edited.

Global Changes:

At the top of the AFN Checklist, there’s an option to update the SAR/AFN Print Settings for all plans going forward.

Only the Master user or users with Designated Admin access can change these settings. When updated, these settings will apply only to newly added SARs or AFNs.

NOTE:

• Existing SARs/AFNs will keep their original print settings unless you delete and re-add them.
• If a prior year SAR/AFN exists and the SAR/AFN/8955-SSA Defaults are set to bring forward prior year defaults, the new global print settings will not apply. Instead, the system will use the prior year's print settings.

Single Employer Cross Reference Top

Multiemployer Cross Reference Top