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  • Sample Annual Trust Report Sample Annual Trust Report 401k Attn: Plan Sponsor 123 MAIN STREET NORTHEAST SUITE ABC ANYWHERE, USA 12345-67890

  • ANNUAL REPORT January 01, 2019 through December 31, 2019

    Case Number abc-12345

    Report Explanations

    Market Value Reconciliation This schedule reports all market value activity for the reporting period. The activity reported includes all investment vehicles offered in the plan, uninvested cash and loans as reported.

    Schedule of Assets Held for Investment This schedule reports the ending values of all investment vehicles in the plan, the shares or units for each fund that has a balance, and the cost basis.

    Statement of Changes in Net Assets Available for Benefits These schedules detail activity for each of the funds and/or investment vehicles in the plan. The Total for All Investments schedule includes activity across all investment vehicles in the plan. If applicable, a Total for All Collective Investment Funds (CIFs) page will also be provided.

    Cash Earnings Transaction Summary This schedule lists the cash earnings for assets that generated cash income during the reporting period. This report includes interest on uninvested cash, loan interest as reported, and money market interest.

    Dividends/Capital Gains/Corporate Actions Transaction Summary This schedule lists dividends, capital gains and corporate actions by fund and date as occurred during the reporting period.

    Employer Contributions Transaction Summary This schedule lists all employer contributions by source, fund, and date for the reporting period.

    Employee Contributions Transaction Summary This schedule lists all employee contributions by source, fund, and date for the reporting period.

    Rollover Contributions Transaction Summary This schedule lists all rollover contributions by fund and date for the reporting period.

    Catch-Up Contributions Transaction Summary This schedule lists all catch-up contributions by fund and date for the reporting period.

    Unallocated Contributions Transaction Summary This schedule lists all contributions made to an unallocated account by fund and date.

    Loan Principal Repayments Transaction Summary This schedule lists all loan principal payments by fund and date. Loan interest payments are reported on the Cash Earnings Transaction Summary schedule.

    Employee Forfeiture Allocations Transaction Summary This schedule lists forfeitures allocated into employee accounts by fund and date.

    Benefit Payments/Non-Cash Benefit Disbursements Transaction Summary This schedule lists all taxable benefit withdrawals during the reporting period including participant social security information.

    Loan Issues Transaction Summary This schedule lists all loans issued during the reporting period including participant social security information.

    Fees Transaction Summary This schedule lists all fee transactions. The asset fee and asset based plan administration fee, although deducted daily, are totaled and each is reported as one line item on this report.

  • Report Explanations (continued)

    Exchanges Transaction Summary This schedule lists all fund exchanges that occur during the reporting period.

    Other Deductions Transaction Summary This schedule lists non-taxable refunds, allocations withdrawn from the forfeiture and retainer accounts and amounts forfeited from participant accounts.

    Other Additions Transaction Summary This schedule lists transfers from a prior funding provider, reallocated gain/loss, expense credits and forfeitures transferred into the forfeiture account.

    Conversion Debits Transaction Summary This schedule lists transfers to a new funding provider.

    Series of Transactions that Amount to More than 5% of Plan Assets This schedule lists any series of transactions processed during the reporting period that are non-participant directed and total more than 5% of the beginning balance of plan assets. If the beginning plan balance is zero, the transactions will be compared to the ending market value of the plan. Reporting, for purposes of this schedule, is based on the manner in which the transactions are submitted to Nationwide for processing. Therefore, transactions captured in the schedule may include certain participant directed transfers-in or corrective processing that are not required to be reported on Schedule H of the 5500 form. For more information about the transactions included in this schedule, a detailed transaction report is provided to your third party administrator to help in determining whether the items are reportable.

    Single Transactions in Excess of 5% of Plan Assets This schedule lists any single transaction processed during the reporting period that is non-participant directed and that exceeds 5% of the beginning balance of plan assets. If the beginning plan balance is zero, the transaction will be compared to the ending market value of the plan. Reporting, for purposes of this schedule, is based on the manner in which the transactions are submitted to Nationwide for processing. Therefore, transactions captured in the schedule may include certain participant directed transfers-in or corrective processing that are not required to be reported on Schedule H of the 5500 form. For more information about the transaction(s) included in this schedule, a detailed transaction report is provided to your third party administrator to help in determining whether the items are reportable.

    Schedule of Purchases This schedule lists all purchases by fund and date.

    Schedule of Sales This schedule lists all sales by fund and date.

    Schedule of Program Fee Sales This schedule details all asset fee sales on an aggregate basis.

    Schedule of Asset Based Plan Administration Fee Sales This schedule details all asset-based plan administration fee sales on an aggregate basis.

    Post Period Reconciliation Report This report is not a part of the trust report. It is an addendum to assist in reconciling the trust reports to participant statements. This report may not provide all necessary items for reconciliation if a correction occurs after the trust reports are processed.

    Disclosures Nationwide may enter into agreements with its affiliates to perform certain responsibilities. Investments made in accordance with direction from the Sponsor or Participants may include mutual funds or other investments advised or managed by affiliates of Nationwide. These affiliates may derive investment management and/or other fees for the services provided.

    Fund Window and Designated Funds This Schedule lists all plan funds by name and fund symbol categorized by Plan Designation funds and Fund Window funds.

  • ANNUAL REPORT January 01, 2019 through December 31, 2019

    Case Number abc-12345

    Sample Annual Trust Report Sample Annual Trust Report 401k Attn: Plan Sponsor 123 MAIN STREET NORTHEAST SUITE ABC ANYWHERE, USA 12345-6789

    Pursuant to the Employee Retirement Income Security Act of 1974 as applicable and amended, Nationwide Trust Company, FSB ("Nationwide") hereby certifies that this annual statement, furnished pursuant to DOL rule 29 CFR 2520.103 - 5 (c) for the period designated, is a complete and accurate written account of all investments, receipts, disbursements, earnings and other transactions related to the assets held by Nationwide. Nationwide does not certify loans or information regarding assets held outside of Nationwide. Any cost information provided is an estimate calculated as accurately as possible using information available only for the period that the assets have been held by Nationwide.

    by ________________________________________

    Chief Trust Officer, Nationwide Trust Company, FSB

    *This statement may not include accrued transactions.

  • Table of Contents

    Market Value Reconciliation Schedule of Assets Held for Investment Statement of Changes in Net Assets Available for Benefits Transaction Summaries

    1 1 3

    75 Series of Transactions that Amount to More than 5% of Plan Assets 130 Single Transactions in Excess of 5% of Plan Assets

    Schedule of Sales Program Fee Sales Asset-Based Plan Administration Fee Sales Fund Options

    180 193 194 195

    131 Schedule of Purchases 131

  • Sample Annual Trust Report 401k January 01, 2019 through December 31, 2019 Case Number abc-12345

    Market Value Reconciliation

    Beginning Market Value

    Receipts Cash Contributions Non-Cash Contributions Other Cash Receipts Non-Cash Receipts Total Receipts

    Disbursements Benefit Payments Non-Cash Benefit Disbursements Other Cash Disbursements Non-Cash Disbursements Total Disbursements

    Investment Activity Net Investment Income Total Investment Activity

    Ending Market Value

    4,419,727.16 0.00

    75,759.69 0.00

    632,131.49 - 0.00

    201,869.96 - 138,164.99 -

    7,464,112.49

    31,557,945.22

    4,495,486.85

    972,166.44 -

    7,464,112.49

    42,545,378.12

    Schedule of Assets Held for Investment as of 12/31/2019

    Product Summary Investment Program Accounts 38,986,599.68 Retirement Advisor Accounts 3,553,912.73 Self-Directed Brokerage Accounts 4,865.71 Total for all Investments 42,545,378.12

    Investment Program Accounts Underlying Assets

    Description of Assets Market Value Shares/Units Held Cost Ab Hi Inc I 114,214.23 13,711.1917 s 104,758.32 Abrden Emrg Mkt Inst 14,622.67 912.2064 s 12,790.91 Allnzgi Tech Inst 897,059.87 13,722.8072 s 811,054.83 Amfds Gr Fd Am R6 844,749.86 16,521.6089 s 743,874.79 Amfds New Prspct R6 19,909.66 421.3685 s 17,284.34 Dws Scnc Tech S 9,01