Census for: XYZ CB Plan,,,,,,,,,,,,,,,,,,,,,
Year End: 2021-12-31,,,,,,,,,,,,,,,,,,,,,
ID:ce207db (This ID must remain in the first column of third row),,,,,,,,,,,,,,,,,,,,,
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Last Name,First Name,SSN,DB Status,Birth Date,Gender,Date of Hire (1),Date of Term (1),Term Reason (1),Date of Hire (2) ,Date of Term (2),Term Reason (2),Hours,Comp (statutory - unlimited),Comp (pensionable - unlimited),Officer,Owner,Family Group,Family Group Relation,Employee Class,Employee Type (HCE),DB Group Code
EE1,EE1,111-11-1000,Active,2/1/1960,Female,2/13/2001,,,,,,2080,200000,200000,Yes,0,None,N/A,Normal,Full time,Group 2
EE2,EE2,111-11-1002,Active,2/1/1962,Male,2/13/2001,,,,,,2080,98000,98000,No,0,None,N/A,Normal,Full time,Group 3
EE3,EE3,111-11-1003,Active,2/1/1972,Female,5/19/2010,,,,,,2080,55000,55000,No,0,None,N/A,Normal,Full time,Group 5
EE4,EE4,111-11-1004,Active,2/1/1978,Male,5/20/2011,,,,,,2080,105000,105000,No,0,None,N/A,Normal,Full time,Group 4
EE5,EE5,111-11-1005,Active,2/1/1952,Female,2/13/2018,,,,,,2080,250000,225000,Yes,100,None,N/A,Normal,Full time,Group 1
EE6,EE6,111-11-1006,Active,2/1/1988,Male,6/14/2005,,,,,,100,45000,45000,No,0,None,N/A,Normal,Full time,Group 5
EE7,EE7,111-11-1007,Active,2/1/1992,Female,8/15/2015,,,,,,2080,100000,100000,No,0,None,N/A,Normal,Full time,Group 4
EE8,EE8,111-11-1008,Active,2/1/1997,Male,6/16/2019,,,,,,2080,25000,25000,No,0,None,N/A,Normal,Full time,Group 5
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Instructions:,,,,,,,,,,,,,,,,,,,,,
,Last Name,Last name,,,,,,,,,,,,,,,,,,,
,First Name,First name,,,,,,,,,,,,,,,,,,,
,SSN,Social security number (999-99-9999) - WITH DASHES,,,,,,,,,,,,,,,,,,,
,DB Status,"Active,Deferred Vested,Deferred Beneficiary,In-Pay Retiree,In-Pay Beneficiary,Term Non-Vested,Deceased,Paid Out",,,,,,,,,,,,,,,,,,,
,Birth Date,Date of birth (mm/dd/yyyy),,,,,,,,,,,,,,,,,,,
,Gender,"Gender (M,Male,F,Female)",,,,,,,,,,,,,,,,,,,
,Date of Hire (1),First date of hire (mm/dd/yyyy) - LEAVE BLANK UNLESS IN CURRENT YEAR,,,,,,,,,,,,,,,,,,,
,Date of Term (1),First termination date (mm/dd/yyyy) - LEAVE BLANK UNLESS IN CURRENT YEAR,,,,,,,,,,,,,,,,,,,
,Term Reason (1),First termination reason (mm/dd/yyyy) - LEAVE BLANK UNLESS IN CURRENT YEAR,,,,,,,,,,,,,,,,,,,
,Date of Hire (2) ,Second date of hire (mm/dd/yyyy) - LEAVE BLANK UNLESS IN CURRENT YEAR,,,,,,,,,,,,,,,,,,,
,Date of Term (2),Second termination date (mm/dd/yyyy) - LEAVE BLANK UNLESS IN CURRENT YEAR,,,,,,,,,,,,,,,,,,,
,Term Reason (2),Second termination reason (mm/dd/yyyy) - LEAVE BLANK UNLESS IN CURRENT YEAR,,,,,,,,,,,,,,,,,,,
,Hours,"Hours worked in current plan year for eligibility purposes (9999) - NO COMMAS,INTEGERS ONLY",,,,,,,,,,,,,,,,,,,
,Comp (statutory - unlimited),"Unlimited statutory compensation (415 implications) - NO COMMAS OR $,UP TO 2-DECIMALS",,,,,,,,,,,,,,,,,,,
,Comp (pensionable - unlimited),"Unlimited plan formula compensation - NO COMMAS OR $,UP TO 2-DECIMALS",,,,,,,,,,,,,,,,,,,
,Officer,"Officer status (Yes,No)",,,,,,,,,,,,,,,,,,,
,Owner,"Percentage ownership - NO % SIGN,UP TO 2-DECIMALS",,,,,,,,,,,,,,,,,,,
,Family Group,"Family group for owners (None,A,B . . . N)",,,,,,,,,,,,,,,,,,,
,Family Group Relation,"Relationship if member of family group (N/A,Principal,Spouse,Child,Parent,Grandparent)",,,,,,,,,,,,,,,,,,,
,Employee Class,"Employee class (Normal,Union,Hourly,Salary,Self Employed,Leased,Non Res Alien,Opt-out,Other)",,,,,,,,,,,,,,,,,,,
,Employee Type (HCE),Employee type (used for top paid group determinations),,,,,,,,,,,,,,,,,,,
,DB Group Code,"Used for all Group formulas (CB,DB,PS) (Group 1,Group 2 . . . Group 10)",,,,,,,,,,,,,,,,,,,