report guide - northern trust 5500 schedule h, ... schedule of reportable 5% transactions – ......
TRANSCRIPT
5500 SUPPLEMENTAL STATEMENTS
US Internal Revenue Service (IRS) and Department of
Labor (DOL) regulations require administrators and
sponsors of qualified employee benefits plans to file
Form 5500 annually for each master trust or investment
pool as well as for each plan.
Northern Trust’s 5500 Supplemental Statements package
is a suite of reports designed specifically to support clients
required to file Form 5500 with the Department of Labor
annually. The 10 supplemental schedules reflect data for
both domestic and foreign investments.
Presenting a sample page from each report, this guide:
■■ Offers a key to organization and content;
■■ References each data element for clarity; and
■■ Refers to corresponding line items on Form 5500
to facilitate filing preparation
The 5500 Supplemental Statements package complements
Northern Trust’s Portfolio Statement for clients. These two
reporting packages are fully integrated, rely on the same
database and are presented in similar formats. They are
both provided to clients annually and are reported using
a base currency of USD.
If you would like more information about the 5500
Supplemental Statements package, please contact
your Northern Trust representative.
C O N T E N T S
CURRENT VALUE OF ASSETS AND LIABILITIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
SCHEDULE OF REALIZED GAINS AND LOSSES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
SUMMARY OF GAINS AND LOSSES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
SCHEDULES OF REPORTABLE 5% TRANSACTIONS . . . . . . . . . . . . . . . . . . . . . . . . . 6 - 9
SCHEDULE OF ACQUISITIONS AND DISPOSITIONS . . . . . . . . . . . . . . . . . . . . . . . . . . 10
SCHEDULE OF ASSETS HELD FOR INVESTMENT PURPOSES . . . . . . . . . . . . . . . . . . . . . 11
SCHEDULE C REPORTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 - 14
INCOME RECONCILIATION SCHEDULE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
SCHEDULE H REPORTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 - 19
TRANSFERS RECONCILIATION SCHEDULE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 - 21
SCHEDULE R REPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 -23
APPENDIX
ASSET CATEGORIZATION FOR 5500 SUPPLEMENTAL STATEMENTS . . . . . . . . . . . . . 24
SCHEDULE C SERVICE CODES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
2 of 30 | 5500 Supplemental Statements | northerntrust.com
northerntrust.com | 5500 Supplemental Statements | 3 of 30
C U R R E N T VA LU E O F A S S E T S A N D L I A B I L I T I E S
Form 5500 requires the reporting of the current
value of all assets at the beginning and end of
the plan year. The current value of realized and
unrealized gains and losses during the plan year
must be reported in Part II of Schedule H Lines
2(b)(4) through 2(b)(10). This is one of three
reports in this guide that specifically assists with
completing this information.
This report is a supporting schedule to the
Summary of Gains/Losses 5500 filing. It
provides supporting detail on the assets
and unrealized gains/losses reported in
Northern Trust’s Schedule H report at end
of the plan year.
a DOL Asset Category represents the
asset category for the underlying assets
according to the DOL guidelines.
b Security Description/Asset ID lists
the description of the asset and the
sedol or cusip number associated with
that security.
c Shares/Par Value indicates the amount
of carrying value on record.
dMarket Price lists the local market
price of the security as of the ending
report date.
eMarket Value lists the base market
value of the security.
fERISA Cost identifies the current value
cost of the security as required by the IRS
and DOL for reporting of realized and
unrealized gains/losses in Form 5500.
Current value cost is defined as market
value at the beginning of the fiscal year and
adjusted for acquisitions and dispositions
of shares or costs throughout the year.
gUnrealized Gain/Loss on Security Movement reflects the current value of
unrealized gain/loss associated with any
non-cash security movement moving
into or out of the client account.
hUnrealized Gain/Loss represents
the total of unrealized gains/losses
by security.
iTotal Unrealized Gain/Loss represents
the total of unrealized gains/losses reported.
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
a
b
c d
i
hgfe
S C H E D U L E O F R E A L I Z E D GA I N S A N D LO S S E S
4 of 30 | 5500 Supplemental Statements | northerntrust.com
Form 5500 requires the reporting of the current
value of all assets at the beginning and end of
the plan year. The current value of realized and
unrealized gains and losses during the plan year
must be reported in Part II of Schedule H Lines
2(b)(4) through 2(b)(10). This is one of three
reports in this guide that specifically assists with
completing this information.
This is a supporting schedule to the 5500 filing
– Summary of Gains/Losses. It indicates trans-
actions, their current value and realized gains
or losses for the reporting period.
a Denotes DOL Asset Category for
underlying assets according to DOL
guidelines.
b Security Description/Asset ID lists
the sedol or cusip number identifying
the security.
c Shares/Par Value indicates the
carrying value involved in the
transaction.
d Proceeds indicates the amounts
collected for sales of shares/par,
mark to market, principal paydowns,
net class settlements, maturities,
redemptions, calls, short sales and
other security-related principal receipts.
e ERISA Cost identifies the current value
cost of the security as required by IRS
and DOL for reporting realized/unreal-
ized gains/losses in Form 5500. Current
value cost is defined as the market value
at the beginning of period adjusted for
purchases and sales throughout the year.
f Current Value Gain/Loss indicates
the difference between proceeds and
ERISA cost.
g Total Realized Gain/Loss represents
the total of realized gains/losses reported.
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
a
b
c d
g
fe
northerntrust.com | 5500 Supplemental Statements | 5 of 30
S U M M A RY O F GA I N S A N D LO S S E S
Form 5500 requires the reporting of the current
value of all assets at the beginning and end of
the plan year. The current value of realized and
unrealized gains and losses during the plan year
must be reported in Part II of Schedule H Lines
2(b)(4) through 2(b)(10). This is one of three
reports in this guide that specifically assists with
completing this information.
This report assists with the completion of
Form 5500 Schedule H, Part II lines 2(b)(4)
through 2(b)(10). It reports the total gains
and losses as well as the market value of
assets as at the end of the plan year, grouped
by type of security.
a Asset Category denotes the asset
category for the underlying assets
according to DOL guidelines.
b Total Market Value lists the total
market value as of the end of the
period for the shares outstanding
in each category.
c Unrealized Gain/Loss indicates the
difference between the market value
and ERISA cost. The unrealized gain/
loss on security movement is also
included in this amount.
d Realized Gain/Loss indicates the
difference between the proceeds and
the ERISA cost from the sale/disposal
of a security.
e Total Gain/Loss indicates the sum of
the unrealized gain/loss and the realized
gain/loss. This amount can be reconciled
to the Change in Book & Market Value
report within Management Reporting.
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
a b c d e
S C H E D U L E O F R E P O R TA B L E 5 % T R A N S AC T I O N S – PA R T S A A N D C
6 of 30 | 5500 Supplemental Statements | northerntrust.com
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
a
b c d fe g h i j
k
l
m n o qp r s
northerntrust.com | 5500 Supplemental Statements | 7 of 30
Form 5500 requires the reporting of
certain transactions that exceed 5% of
the previous year-end market value of the
Trust. These schedules can be used for the
completion of line item 4(j) of Part IV of
Schedule H. Four reports are provided to
assist with compiling this information. A
separate 5% Report will be provided for
each plan-identified asset.
5% Report – Part A: Single transactions in excess of 5%
Includes single transactions within the plan
year that are in excess of 5% of the current
value of plan assets.
a Denotes Security Description/Asset ID
identifying the individual security.
b Shares/Par indicates the carrying
value on transaction.
c Denotes trade Date of the transactions.
d Denotes the average Acquisition Price
per share of the transaction or series of
transactions.
e Specifies the average Disposition Price
per share of the transaction or series of
transactions.
f Denotes Lease Rental expense.
g Denotes broker commissions and
any other Expenses Incurred with
transaction.
h Denotes original acquisition Cost of asset.
iCurrent Value (of Asset) on Transaction Date lists the purchase value of security
(if purchase is involved) and/or sale
proceeds (if sale is involved).
j Net Gain/Loss appears when security
is sold within the period and represents
Current Value on Transaction Date i
minus sum of Cost h of asset.
k Represents prior year-end’s Market Value Including Accruals of total
trust; transactions in report are based
on 5% of this value.
5% Report – Part C: Series of transactions by issue in excess of 5%
This report reflects a series of transactions of the
same issue if, when aggregated, the series exceeds
5% of the current value of the plan assets.
As permitted by DOL regulations (29 CFR
2520.103-6), Northern Trust has included an
alternative method of using a single line to
summarize each series of transactions by issue
in excess of 5%. The detail of the transactions
reflected in Part C are available upon request.
l Denotes the Security Description/Asset ID identifying individual security.
m Total Number of Transactions reflects
the total proceeds paid on purchases and
the number of sales that occurred within
the plan year.
n Acquisition Price reflects the total
proceeds paid on purchases.
o Disposition Price reflects the total net
proceeds received on sales.
p Denotes Lease Rental not populated.
q Expenses Incurred reflects broker
commissions.
r Cost of Asset reflects total of acquisition
costs minus disposition costs.
s Current Value of Asset on Transaction Date lists the purchase value of security
(if purchase) and/or sale proceeds (if sale).
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
a b c d fe g h i j
k
S C H E D U L E O F R E P O R TA B L E 5 % T R A N S AC T I O N S – PA R T S B A N D D
8 of 30 | 5500 Supplemental Statements | northerntrust.com
a b c d fe g h i j
k
northerntrust.com | 5500 Supplemental Statements | 9 of 30
5% Report – Part B Series of non-security transactions with the same party in excess of 5%
This report reflects any series of transactions
with the same party that involve property
other than securities and aggregate within
the plan year to more than 5% of the current
value of the plan assets. The typical transac-
tions excluded from this report are preferred
and common stock; government, municipal
and corporate bonds; and common, collective
and mutual funds.
5% Report – Part D Series of transactions with same party in excess of 5%
This report includes any transaction within
the plan year with a party if any prior or
subsequent single transactions within the
plan year with the same party exceeds 5% of the
current value of plan assets. This report includes
all transactions with all parties.
Please note that this report excludes the
following security types as identified
within DOL regulation 29 CFR 2520.103-6
(please note that the regulation allows other
exclusions).
■■ Debt obligations of the United States
or any US agency securities with a
maturity of not more than one year
■■ Participation in a bank common or
collective trust
■■ Interests issued by a company registered
under the Investment Act of 1940
(e.g. mutual funds)
a Denotes Security Description/Asset ID
identifying the individual security.
b Shares/Par indicates the carrying value
on transaction.
c Denotes the trade Date of transaction.
d Denotes the average Acquisition Price
per share of transaction or series of
transactions.
e Denotes the average Disposition Price
per share of transaction or series of
transactions.
f Denotes the Lease Rental expense not
populated.
g Denotes broker commission and any other
Expenses Incurred on transactions.
h Historical Cost of asset refers to original
or acquisition cost of asset.
i Current Value (of Asset) on Transaction Date lists purchase value of security
(if purchase is involved) and/or sale
proceeds (if sale is involved)
jNet Gain (Loss) appears when a
security is sold within period; Current
Value of Asset – i minus sum of Cost
of Asset – h
k Represents prior year-end’s Market Value Including Accruals of total trust; trans-
actions in this report are based on 5% of
this value.
Note:
A separate 5% Report will be provided for
each plan-identified asset.
S C H E D U L E O F AC Q U I S I T I O N S A N D D I S P O S I T I O N S
10 of 30 | 5500 Supplemental Statements | northerntrust.com
Form 5500 requires the reporting of select
investment assets held during the plan year
and disposed of before the end of the plan
year. This report, provided for each trust
or account, lists securities acquired and
disposed of during the year. The Schedule
of Acquisitions and Dispositions can assist
in completing Line 4(i) on Part IV of
Schedule H.
This schedule will exclude the following
security types as identified within DOL
regulation 29 CFR 2520.103-11 (please
note that the regulations allow for other
exclusions).
■■ Debt obligations of the United States
or any of its agencies
■■ Participation in Bank Common or
collective trusts
■■ Interests issued by a company
registered under the Investment
Company Act of 1940
a Asset ID lists the sedol or cusip number
identifying the security.
b Denotes the Security Description identi-
fying security.
c Denotes type of Transaction represented.
d Shares/Par identifies the amount of
carrying value on transactions.
e Cost of Acquisitions represents the
historical cost on purchase or acquisition.
f Proceeds of Dispositions reflects cash
received on sale or disposition.
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
a b c dfe
northerntrust.com | 5500 Supplemental Statements | 11 of 30
S C H E D U L E O F A S S E T S H E L D F O R I N V E S T M E N T P U R P O S E S
A Schedule of Assets Held for Investment
Purposes must report all investment assets
held by the plan on the last day of the plan
year. This report assists with the completion
of Line 4(i) on Part IV of Schedule H.
Note:
■■ 5500 reports are derived on a trade date
basis and will reflect market value and
cost of pending share positions.
■■ Information about securities loaned, and
about collateral, is available separately.
a DOL Asset Category represents the
asset category for the underlying assets
according to DOL guidelines.
b Security Description/Asset ID lists
a description of asset and sedol or
cusip number.
c Shares/Par Value identifies the amount
of carrying value on record.
d Denotes the Historical Cost of the security.
e Current Value lists the base market value
of the shares on record.
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
a
b
c d e
S C H E D U L E C – PA R T S A A N D B
12 of 30 | 5500 Supplemental Statements | northerntrust.com
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
a
b c d
a
bc
d
fe
northerntrust.com | 5500 Supplemental Statements | 13 of 30
These schedules include information regard-
ing payments to service providers from the
master trust. Parts A and B assist in compiling
information for Schedule C of Form 5500. Part
C provides information to assist you with the
reconciliation of your total fees to the annual
accounting reports. For master trusts, the
Schedule C payments can be grouped either
by master trust account or plan.
PART A
■■ Lists vendors that received fees greater
than or equal to $5,0001 and all vendors
that received fees less than $5,000. This
assists in the completion of Part I, Line 2
of Schedule C of Form 5500.
■■ Lists all allocated fees for payments to
federal, state, local governments and
agencies, simplifying the process of
balancing total fees to accounting
statements. (This information is
not requested by Schedule C of the
Form 5500.)
■■ Lists all remaining fees posted without
EINs and other expenses.
PART B
Lists vendors that received fees by plan. This
assists in completing Part I, Line 1 and 2 of
Schedule C, Form 5500.
a Vendor Name to whom fees were paid.
b Employer Identification Number
of each vendor whom fees were paid.
99-9999999 denotes EIN was not
available, 44-4444444 denotes notional
interest payments and 77-7777777
denotes foreign vendor payments. The
EINs listed above are not actual EINs
and are Northern Trust assigned as a
way to aggregate transaction activity.
c Denotes the amount of Fees and Expenses Paid to each vendor.
d Service Code identifies the type of
service provided in accordance with
Form 5500 classifications. Service codes
are assigned to vendors based on a
primary service provided, as indicated
by each vendor. A list of service codes
is included in the appendix.
e Total Fees and Expenses paid during
the plan year.
f Plan Number of each plan participating
in a master trust will be identified and the
fees related to that plan will be reported.
Note:
■■ Schedule C nets most fees on real estate
transactions.
■■ Schedule C is provided for master
trusts, investment pools and plans
where applicable.
■■ Transactions without an EIN are catego-
rized at the end of the reports and under
the following specific categories.
— American Depository Receipt (ADR)/
Global Depository Receipt (GDR) Fees
— Delivery and Receipt Fees
— Tax Reclaim Fees
— Issuance Fees
— Legal Entity Identifier (LEI)
Registration Fees
— Foreign Market Taxes
— Notional Interest Payments
— Vendor Name Not Provided
— Swap Related Fees and Expenses
— Other Market Associated Costs
— Other Fees and Expenses
Foreign Exchange
Northern Trust will conduct foreign exchange
transaction services at exchange rates estab-
lished at its discretion, based on exchange
rates available in the foreign exchange market
on the global trading day. Northern Trust
retains any profit derived from such service.
1 A contract administrator fee greater than or equal to $5,000 should be reported as in the first item in Part I on Line 2 when completing Schedule C of your Form 5500.
S C H E D U L E C – B R O K E R C O M M I S S I O N S
14 of 30 | 5500 Supplemental Statements | northerntrust.com
This schedule provides broker commission data.
a The Broker Name to whom commission
was paid.
b Denotes Amount of Commission paid
to each broker.
c Service Code identifies the type of
service provided in accordance with
Form 5500 classifications. Service
codes are assigned to vendors based on
a primary service provided, as indicated
by each vendor. A list of service codes
is included in the appendix.
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
a
bc
northerntrust.com | 5500 Supplemental Statements | 15 of 30
I N C O M E R E C O N C I L I AT I O N S C H E D U L E
The Income Reconciliation Schedule does not
contain specific information required on the
Form 5500. It is a report designed to assist with
the reconciliation of Northern Trust annual
accounting reports and the 5500 Supplemental
Statements. It specifically assists in reconciling
income related information required for comple-
tion of Schedule H and provides the breakdown
for the total reported on Schedule H – Part II
Line items 2(b) through 2(c).
a Denotes the Income Category according
to DOL guidelines.
b Denotes the DOL Asset Category for
underlying assets according to DOL
guidelines.
c Income Received/Expense Paid identifies income received/paid
during the reporting period.
d Current Year Accruals identifies current
accrual amounts as of the report period’s
end date.
e Prior Year Accruals identifies prior
year’s accrual amounts as of the prior
reporting period’s end date.
f Accrual Receipts/Deliveries identifies
accrual amounts received and delivered
during the reporting period.
g Amortization/Accretion identifies
current amounts during the reporting
period.
h Denotes Total Income/Expense for the
plan year. This amount will equal Income
Received c plus Current Year Accruals
d minus Prior Year Accruals e
i Denotes the current value Unrealized Gain/Loss amounts as of the report
ending date.
j Denotes the Realized Gain/Loss amounts recognized during the
reporting period.
k Denotes the Net Investment Gain/Loss for the DOL category. This amount
is equal to Total Income f plus
Unrealized Gain or Loss g plus
Realized Gain or Loss h.
a
b
cd
fe
g h
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
h j ki
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
a
b c
d
f
e
S C H E D U L E H R E P O R T S
16 of 30 | 5500 Supplemental Statements | northerntrust.com
northerntrust.com | 5500 Supplemental Statements | 17 of 30
Form 5500 requests an Asset and Liability
Statement for the beginning of the plan
year and the end of the plan year to provide
the current value of the plan assets and
liabilities according to DOL categorizations.
For each master trust or account, a Schedule H
report will be provided for each plan-identified
asset. Per DOL regulations, when filing as
a master trust investment pool, the transfer
section of Schedule H should reflect certain
transactions.
If a reporting entity transacts many repurchase
agreements, the total reported proceeds and
aggregate carrying amounts will naturally be
large compared to the total value of the trust. The
large values themselves are expected and will be
reflected as such on the Schedule H report.
Part 1 should reflect the market value (to the
penny) for the following categories as of the end
of the previous plan year in column 2 and as of
the end of the current plan year in column 2.
This information is broken out by assets and
liabilities.
AThe Category used to identify the
underlying assets according to DOL
guidelines.
BDenotes the Market Value as of the
beginning of the current plan year.
CDenotes the Market Value as of the
end of the current plan year.
DTotal Assets reflects the total market
value as of the beginning and end of
the current plan year.
ETotal Liabilities reflects the total market
value of liabilities as of the beginning
and end of the current plan year.
FNet Assets represents Total Assets D
minus Total Liabilities e
18 of 30 | 5500 Supplemental Statements | northerntrust.com
S C H E D U L E H R E P O R T S
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
a
b
c
d
f
e
g
hi
northerntrust.com | 5500 Supplemental Statements | 19 of 30
This statement is an Income Statement
for the plan year, including information
regarding contributions, earnings on
investments, other income, benefit payments,
administrative expenses and transfers to
and from the plan. Earnings on investments
include income and gains/losses on a current
value basis as required by Form 5500.
As per DOL regulations, the transfer section
of Schedule H when filing as a master trust
investment pool should reflect certain
transactions. Northern Trust reflects various
activity on lines 2(l)(1) and 2(l)(2).
a Contributions: Employer, participant
and other contributions reported in
the current plan year.
b Earnings on Investments identifies
Income, Realized Gains/Losses, and
Unrealized Gains/Losses reported in
the current year.
c Denotes any Other Income.
d Total Income equals the sum of
Contributions a plus Earnings on
Investments b plus Other Income c
e Benefit Payments and Payments
provides benefits reported for the
current plan year.
f Administrative Expenses identifies
expenses incurred during the plan year.
Expenses are categorized according
to DOL guidelines and the service
codes reported in the Schedule C. For
explanation of categorization, refer to
the Schedule C insert.
g Total Expenses equals the sum
of Benefit Payments, Corrective
Distributions, Deemed Distributions
of Participant Loans, Interest Expense
and Administrative Expenses.
h Net Income reflects the difference
between Total Income D and Total
Expenses g
i Transfer of Assets to and from the
plan are reflected here.
Note:
Contributions and benefit payments are
also reflected here. Please refer to the
Transfers Reconciliation Schedule for a
detailed breakdown by transaction type.
T R A N S F E R S R E C O N C I L I AT I O N S C H E D U L E
20 of 30 | 5500 Supplemental Statements | northerntrust.com
The Transfers Reconciliation Schedule assists
with reconciling transfers to and from the
plan as reported on Schedule H – Part II,
Line items 2(l)(1) and 2(l)(2). It provides a
detailed breakdown of the financial information
included on the transfers to and from lines of
Northern Trust’s Schedule H report. This is
not a required Form 5500 schedule.
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
a b c d e
northerntrust.com | 5500 Supplemental Statements | 21 of 30
Please note that when filing Form 5500
at the plan level, these transactions should
be entered on the appropriate line of
Schedule H according to Form 5500
instructions. Information about securities
loaned, and collateral is available separately.
Transfers to the plan:
■■ Sponsor contributions
■■ Participant contributions
■■ Insurance contract receipts
■■ Plan rollover receipts
■■ Lump sum re-deposits
■■ Participant loan repayments
■■ Redeposit of refunds
■■ Security receipts
■■ Miscellaneous cash receipts
■■ Inter-portfolio transfers
Transfers from the plan:■■ Benefit payments
■■ Participant loans
■■ Lump sum payments
■■ Participant deposit refunds
■■ Plan rollover disbursements
■■ Miscellaneous cash disbursements
■■ Security disbursements
■■ Inter-portfolio transfers
a Transaction Type denotes the category
used to identify the type of transaction.
b Receipts denotes transactions resulting
in cash/securities received.
c Disbursements denotes transactions
resulting in cash/securities disbursed.
d Market Value denotes the market value
of securities transferred in and out.
e Total Transfers denotes receipts minus
disbursements.
S C H E D U L E R
22 of 30 | 5500 Supplemental Statements | northerntrust.com
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
d
a
ej k m
Northern =ust *Generated by Northern Trust from periodic data on 31 Jan XX
a
b
c jd fe g h i lk
northerntrust.com | 5500 Supplemental Statements | 23 of 30
This report assists clients in completing the
(Schedule R) Distribution of Assets Information
required by the DOL Form 5500. Defined
benefit plans with over 1,000 participants
need to include additional asset breakdowns on
an attachment to the Form 5500 Schedule R.
This information is requested by the Pension
Benefit Guarantee Corporation (PBGC) and
will require you to:
■■ Provide the percentage of plan assets
by five specific asset categories
■■ Disclose the weighted average duration
for the plan’s debt securities
As required, the Schedule R report provides
the beginning-of-year distribution of assets
for the following categories, along with
the weighted average of effective durations
based on ratings from S&P, Moody’s and
Fitch (as available): stocks, investment-
grade debt instruments, high-yield debt
instruments, real estate, and other asset
classes. Please consult with your auditors
and tax advisors regarding your Form 5500
filing requirements.
a DOL Asset Category* represents the
asset category for the underlying assets
according to PBGC guidelines.
b Description/Asset ID lists a description
of asset and sedol or cusip number.
c Shares identifies the amount of carrying
value on record.
d Denotes the Market Value of the
security as of previous year end without
accruals.
e % of Total represents the market value
percentage on the total market value of
included assets.
f S&P Rating represents the credit rating
that was received for debt security.
g Moody Rating represents the credit
rating that was received for debt security.
h Fitch Rating represents the credit rating
that was received for debt security.
i Denotes the Effective Duration of the
security represented in years.
j Market Value Included represents the
market value of a security where we have
duration information.
k Market Value Excluded represents the
market value of a security where duration
information is not available.
l Effective Duration Factor represents
the Effective Duration multiplied by the
Market Value of the Security, divided by
the Market Values of all debt securities
for which effective duration values are
available.
m Weighted Average Effective Duration
for the portfolio debt instruments
(where an effective duration value is
available) is the sum of all the Effective
Duration Factors.
* The PBGC’s draft FAQs state “investment-grade debt” includes debt instruments with S&P ratings of BBB- or higher, Moody’s ratings of Baa3 or higher, or equivalent ratings from another rating agency. According to information from Fitch’s website, “investment-grade debt” instruments are those with ratings of BBB- or higher.
A P P E N D I X : A S S E T C AT E G O R I Z AT I O N F O R 5 5 0 0 S U P P L E M E N TA L S TAT E M E N T S
24 of 30 | 5500 Supplemental Statements | northerntrust.com
These are the categories reflected on holdings
reports including Current Value of Assets and
Liabilities, Assets Held for Investment Purposes
and the Schedule H reports.
Total Non-Interest Bearing Cash: Cash
on hand or cash in a non-interest bearing
checking account.
Receivables:
■■ Employer contributions due but not
yet received
■■ Participant contributions due but not
yet received.
■■ Income: Income due but not yet received.
■■ Other: Income and other items due but
not yet received, including the net of
receivables/payables for pending trades
when filing on a trade date basis.
General Investments:
■■ Interest Bearing Cash: All assets that
earn interest in a financial institution
account or money market fund, including
interest-bearing checking accounts.
■■ Certificates of Deposit: Denotes all
certificates of deposit.
■■ US Government Securities: Securities
issued or guaranteed by the US
government or its designated agencies,
such as US savings bonds, Treasury
bonds, Treasury bills, GNMAs, FNMAs,
FHLMCs and FHAs.
■■ Corporate Debt Instruments: Investment
securities issued by a corporate entity
at a stated interest rate payable on a
particular future date, such as most
bonds, debentures, convertible bonds,
commercial paper, zero coupon bonds
and CMOs.
■■ Preferred: All corporate debt instruments
with a rating of “A” or above, as provided
by the rating services used by The
Northern Trust Company.
■■ Other: All corporate debt instruments
with a rating below “A”.
Corporate Stock:
■■ Preferred: Stock issued by corporations
accompanied by preferential rights or
warrants convertible into preferred stock.
■■ Common: Any holding that represents
regular ownership in stock.
Partnership/Joint Venture Interests: Denotes any limited partnership or
joint venture.
Real Estate:
■■ Income Producing: Real property that
received or accrued for income.
■■ Non-Income Producing: Real property
that did not receive or accrue for income.
Loans To Participants – Other: All loans
made to participants.
Other Loans: Any loan not reported in loans
to participants.
Value of Interest in Common/Collective Trusts: Any holding in common or collective
funds. These funds are maintained by a bank,
trust company or similar institution that is
regulated, supervised, and subject to periodic
examination by a state or federal agency.
Value of Interest in Pooled Separate Accounts: Denotes any holdings in insurance
carrier pooled separate accounts.
Value of interest In Master Trusts: Denotes
any allocated participation in a master trust
or participation represented by ownership of
master trust units.
Value of Interest in 103-12 Entities: Denotes any participation in a 103-12 entity.
Value of Interest in Registered Investment Companies: Denotes any holdings of unallo-
cated registered investment companies, such
as mutual funds.
Value of Funds Held in Insurance Company General Accounts: Denotes
any holdings of insurance contracts such
as GICs, GACs and general funds.
Other: Denotes any other assets, such as
futures, options, non-U.S. government
securities, REITs, swaps, repurchase agree-
ments, hedge funds and municipal bonds.
Other Liabilities: Denotes any other
liabilities, such as other payables, pending
trade purchases, pending foreign exchange
sales and derivative liabilities.
northerntrust.com | 5500 Supplemental Statements | 25 of 30
A P P E N D I X : S C H E D U L E C S E RV I C E C O D E S
Service Code Service Code NameNorthern Trust’s Schedule C Abbreviations
Northern Trust’s Schedule H Mapping
10 Accounting (Including Auditing) ACCNTG 2(i)1
11 Actuarial ACTURAL 2(i)1
12 Claims Processing CLM-PROC 2(i)2
13 Contract Administrator CONTRACT 2(i)2
14 Plan Administrator PLN-ADMR 2(i)2
15 Recordkeeping and Information Management (computing, tabulating data processing) RDKPINMT 2(i)2
16 Consulting General CONSULTG 2(i)1
17 Consulting Pension CONSULTP 2(i)1
18 Custodial (other than securities) CUSTDYNS 2(i)1
19 Custodial CUSTODY 2(i)1
20 Trustee (individual) TRUSTEIN 2(i)1
21 Trustee (bank, trust company or other similar institution TRUSTECO 2(i)1
22 Insurance Agents and Brokers INSAGT 2(i)4
23 Insurance Services INSRNCSV 2(i)4
24 Trustee (discretionary) TRTE-DIS 2(i)1
25 Trustee (directed) TRTE-DIR 2(i)1
26 Investment Advisory (participants) INADV-PA 2(i)3
27 Investment Advisory (plan) INADV-PL 2(i)3
28 Investment Management INV-MGMT 2(i)3
29 Legal LEGAL 2(i)1
30 Employee (plan) EMPLOYEE 2(i)4
31 Named Fiduciary NMD-FIDY 2(i)3
32 Real Estate Brokerage RE-BRKR 2(i)3
33 Securities Brokerage SEC-BRKR 2(i)3
34 Valuations VALUTN 2(i)1
35 Employee (Plan Sponsor) EMPLOYER 2(i)2
36 Copying and Duplicating COP-DUPL 2(i)4
37 Participant Loan Processing PARTLOAN 2(i)4
38 Participant Communication PART-COM 2(i)4
40 Foreign Entity (e.g. agent, broker, bank or insurance company not operating in the jurisdiction of the US) FORGN-EN 2(i)4
49 Other OTHER 2(i)4
IRS CIRCULAR 230 NOTICE: To the extent that this message or any attachment concerns tax matters, it is not intended to be used and
cannot be used by a taxpayer for the purpose of avoiding penalties that may be imposed by law. For more information about this notice,
see http://www.northerntrust.com/circular230.
This material is directed to professional clients only and is not intended for retail clients. For Asia-Pacific markets, it is directed to institutional investors, expert
investors and professional investors only and should not be relied upon by retail investors. For legal and regulatory information about our offices and legal entities,
visit northerntrust.com/disclosures. The following information is provided to comply with local disclosure requirements: The Northern Trust Company, London
Branch; Northern Trust Global Services Limited; Northern Trust Global Investments Limited. The following information is provided to comply with Article 9(a)
of The Central Bank of the UAE’s Board of Directors Resolution No 57/3/1996 Regarding the Regulation for Representative Offices: Northern Trust Global Services
Limited, Abu Dhabi Representative Office. Northern Trust Global Services Limited Luxembourg Branch, 2 rue Albert Borschette, L-1246, Luxembourg, Succursale
d’une société de droit étranger RCS B129936. Northern Trust Luxembourg Management Company S.A., 2 rue Albert Borschette, L-1246, Luxembourg, Société
anonyme RCS B99167. Northern Trust (Guernsey) Limited (2651)/Northern Trust Fiduciary Services (Guernsey) Limited (29806)/Northern Trust International
Fund Administration Services (Guernsey) Limited (15532) Registered Office: Trafalgar Court Les Banques, St Peter Port, Guernsey GY1 3DA.
© 2014 Northern Trust Corporation