Census for: XYZ CB Plan,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Year End: 2020-12-31,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
ID:d9d9b16 (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,Employment Status,Earliest Hire Date,Earliest Hire Date,Last Term Date,Not Used,Not Used,Hours,Comp (statutory - unlimited),Comp (pensionable - unlimited),Comp (testing - unlimited),Pensionable Benefit Service,415 Participation years,415 Service years,Frozen Benefit (monthly),Accrued Benefit (monthly),CB EOY Balance,Date Met DB,Entry Date DB,Not Used,Not Used,DB Service for NRD,Not Used,Vesting Service,Not Used,KEY Employee,KEY EE Determ Date,HCE,Top Paid Group,Ownership %
EE1,EE1,111-11-1000,Active,2/1/1960,Female,,2/13/2001,2/13/2001,,,,2080,200000,200000,200000,0,0,0,0,,0,2/12/2002,1/1/2010,2/12/2002,1/1/2010,0,0,0,21,,,,,0
EE2,EE2,111-11-1002,Active,2/1/1962,Male,,2/13/2001,2/13/2001,,,,2080,98000,98000,98000,0,0,0,0,,0,2/12/2002,1/1/2010,2/12/2002,1/1/2010,0,0,0,21,,,,,0
EE3,EE3,111-11-1003,Active,2/1/1972,Female,,5/19/2010,5/19/2010,,,,2080,55000,55000,55000,0,0,0,0,,0,5/18/2011,6/1/2011,5/18/2011,7/1/2011,0,0,0,12,,,,,0
EE4,EE4,111-11-1004,Active,2/1/1978,Male,,5/20/2011,5/20/2011,,,,2080,105000,105000,105000,0,0,0,0,,0,5/19/2012,6/1/2012,5/19/2012,7/1/2012,0,0,0,11,,,,,0
EE5,EE5,111-11-1005,Active,2/1/1952,Female,,2/13/2001,2/13/2018,,,,2080,250000,225000,250000,0,0,0,0,,0,2/12/2002,1/1/2010,2/12/2002,1/1/2010,0,0,0,3,,,,,100
EE6,EE6,111-11-1006,Active,2/1/1988,Male,,6/14/2005,6/14/2005,,,,100,45000,45000,45000,0,0,0,0,,0,2/1/2009,1/1/2010,2/1/2009,1/1/2010,0,0,0,15,,,,,0
EE7,EE7,111-11-1007,Active,2/1/1992,Female,,8/15/2015,8/15/2015,,,,2080,100000,100000,100000,0,0,0,0,,0,8/14/2016,9/1/2016,8/14/2016,1/1/2017,0,0,0,6,,,,,0
EE8,EE8,111-11-1008,Active,2/1/1997,Male,,6/16/2019,6/16/2019,,,,2080,25000,25000,25000,0,0,0,0,,0,6/15/2020,7/1/2020,6/15/2020,7/1/2020,0,0,0,3,,,,,0
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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)",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Employment Status,"Employment status (Active,P-Term)",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Earliest Hire Date,Earliest hire date (mm/dd/yyyy),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Earliest Hire Date,COPY PREVIOUS FIELD (mm/dd/yyyy),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Last Term Date,Last term date (mm/dd/yyyy) - DO NOT INCLUDE TERM DATE IF ACTIVE AT CONVERSION,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Not Used,LEAVE BLANK (Rehire date),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Not Used,LEAVE BLANK (Second term date),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,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",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Comp (testing - unlimited),"Unlimited testing compensation (401(a)(4) implications) - NO COMMAS OR $,UP TO 2-DECIMALS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Pensionable Benefit Service,Years of cumulative DB pension service - TRADITIONAL DB PLANS ONLY,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,415 Participation years,Years of cumulative 415 Participation - ALL PLANS,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,415 Service years,Years of cumulative 415 Service - ALL PLANS,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Frozen Benefit (monthly),Frozen monthly accrued benefit - ONLY IF FORMULA TYPE = FROZEN BENEFIT,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Accrued Benefit (monthly),Monthly accrued benefit at conversion (after 415 limits) - TRADITIONAL DB PLANS ONLY,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,CB EOY Balance,Cash Balance at conversion - CASH BALANCE PLANS ONLY,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Date Met DB,Date initial eligibility met for DB plan (mm/dd/yyyy),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Entry Date DB,Entry date for DB plan (mm/dd/yyyy),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Not Used,LEAVE BLANK (Initial eligibility date met for disagg),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Not Used,LEAVE BLANK (Entry date for disagg),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,DB Service for NRD,Years of cumulative DB elig service at BOY - POPULATE IF NRD BASED ON ELIG SERVICE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Not Used,LEAVE BLANK (Years of cumulative service (disagg part of plan)),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Vesting Service,Years of cumulative service for vesting at BOY,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Not Used,LEAVE BLANK (Vesting years of service for terminated participant),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,KEY Employee,"Key Employee in current year (Yes,No)",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,KEY EE Determ Date,"Key Employee for determination date year (Yes,No)",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,HCE,"HCE status (Yes,No)",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Top Paid Group,"Employee is in top paid group (Yes,No)",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,Ownership %,"Percentage ownership - NO % SIGN,UP TO 2-DECIMALS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,