Self-Funded Defined Benefit Plan

Report a self-funded defined benefit plan and the underlying assets in Schedule A.



For You and Your Spouse

Schedule A

Reporting the Plan

Report a self-funded defined benefit pension plan if the value of the plan was more than $1,000 at the end of the reporting period, or if the plan produced more than $200 in income during the reporting period.

Block A: Write your name (or “spouse” for a spouse’s plan) and describe the type of plan. Provide the name of financial institution through which the plan is held.

Block B: Do not mark a column in this Block.

Block C: Do not mark a column in this Block.

Reporting the Underlying Assets

Below the entry for the overall plan, report as a separate line item each underlying asset of the plan that individually was worth more than $1,000 at the end of the reporting period or that individually produced more than $200 in income during the reporting period.

This guide contains specific instructions for each type of asset that you hold. For example, this guide contains instructions for mutual funds, exchange-traded funds, stocks, corporate bonds, cash deposit accounts such as certificates of deposit, and other financial instruments.

 

This guide is not intended to provide investment advice, and you should not rely on statements in this guide when making investment decisions.