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MP-200 Template
ICR 202606-1212-004 · OMB 1212-0069 · Object 170035201.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
|---|---|
| File Title | MP-200 Template |
| Author | Michael Rae |
| Last Modified By | Calc |
| File Modified | 2023-10-16 |
| File Created | 2026-06-19 |
| Conversion State | complete |
Extracted Text
1) 2) 3) 4) 5) 6) 7) a) b) c) d) e) f) Instructions for Completing Excel Template Review the Form MP-200 Instructions before entering data.https://www.pbgc.go Enter the PBGC case number assigned to your plan and case name in the heading of the applicable tab. Use the appropriate schedule as a guide while filling out this spreadsheet. Overwrite the sample data in each tab and populate the applicable tab for: - Notifying PBGC of transfer to Financial Institution: Schedule A; or - Transferring Funds to PBGC: Schedule B - Missing Distributees Removed via Amendment The item number on the schedule corresponds to the applicable section or question on MP-200 Save your spreadsheet as "Form 200 Excel Attachment_12345600" where "12345600" applicable case number of your plan. Feel free to add a row at the bottom totaling amounts, counting participants, etc., but p insert a blank row between the individual data and any "total" row you want to add. Tips for Schedule B See Color Coding tips to help understand when additional data or an attachment is re See Definitions of Qualified and Non-Qualified Roth Transfers to determine if Post-Ta transfers are Qualified. Uncashed checks should be transferred to PBGC without any reduction for tax withho If the administrative fee gets paid out of participant funds, record the amount net of If the plan has Other non-taxable benefits, include a description/plan provisions If the Missing Distributee is a Beneficiary, list the beneficiary's information and includ attachment, or use the Beneficiary tab, to include the originating Participant and why beneficiary is due money Schedule B Individual data for Transferring Plans - Attachment to F COLOR CODE KEY Additional information or attachment Required to describe this situation Roth benefit does not appear to be Qualified Additional Information is Required in this cell TAB Removed via Amendment When Data is entered and the Cell is highlighted with a blue b white font, additional information is needed to describe the s You can use fields to the right if it's related to a missing distrib beneficiary or a portion of the benefit attributable to non-US will need to include an attachment if it's related to Other post Beneficiary election form. When Data is entered in the Qualified Roth Transfers and the than age 59.5, the cell is highlighted with an orange backgrou data is correct, add a note about why the Missing Distributee When Data is entered and the Cell is highlighted with a yellow bright blue font, Additional Information is Required in this cel dividual data for Transferring Plans - Attachment to Form MP-200 Use these color indicators when reviewing your filing spreadsheet to insure you have included all the necessary data and descriptions. When Data is entered and the Cell is highlighted with a blue background and a white font, additional information is needed to describe the situation. You can use fields to the right if it's related to a missing distributee being a beneficiary or a portion of the benefit attributable to non-US source income. You will need to include an attachment if it's related to Other post-tax contributions or a Beneficiary election form. When Data is entered in the Qualified Roth Transfers and the Missing Distributee is less than age 59.5, the cell is highlighted with an orange background and a black font. If this data is correct, add a note about why the Missing Distributee's Roth benefit is Qualified. When Data is entered and the Cell is highlighted with a yellow background and a bright blue font, Additional Information is Required in this cell. Use this Tab for participants that were removed from the Plan Via Amendment, why they were removed and any benefit amount in 8a if a copy of the form is not available. is less If this alified. Schedule A h items may be left blank Part II - Individual Information Missing distributee's name Last First Middle 3a(1) 3a(1) 3a(1) White Betty E Yellow Joseph F Black Polly G Last-known address Date of birth Social securit Street City 3a(2) 3b(1) 3b(2) 20214 111111111 123 Robin HwyCity1 23899 222222222 123 Blackbird City2 25756 333333333 123 Eagle St City3 Page 6 Schedule A State 3b(3) DE WV DE Zip 3b(4) Account information Amended Filing Code Account numbAccount balancUse "Removed via Amendment" tab below if needed 3c(1) 3c(2) $4.00 42345 1111111111 25000 52345 2222222222 10000 62345 3333333333 2500 Page 7 Schedule B Schedule B Individual data for Transferring Plans - Attachment to Form MP-200 See instructions for detailed information about data to be entered, including information about which item Case Number 33333300 Case Name Bus. Corp. Part II - Individual Information Page 8 Schedule B hment to Form MP-200 ding information about which items may be left blank COLOR CODE KEY Part III - Transfer Amount Page 9 Schedule B OLOR CODE KEY Page 10 Schedule B Part IV - Miscellaneous Information Information if Missing Distributee is a Beneficiary (if answer Page 11 Schedule B ributee is a Beneficiary (if answer in 2f is B= Beneficiary) Page 12 Removed via Amendment Removed via Amendment data - Attachment to Form MP-200 See instructions for detailed information about data to be entered, including information about which items m Case Number 33333300 Case Name Bus. Corp. Removed via Amendment Last-known address Distributee SSDistributee N Street Page 13 Removed via Amendment ng information about which items may be left blank Page 14