Instructions for completing Form 5500-EZ

Transcription

1 Instructions for completing Form 5500-EZ PART I- ANNUAL RETURN IDENTIFICATION INFORMATION Select option A (1) if this if the first return filed for the Plan. Select option A (4) if filing for a period of less than 12 months. Show the dates at the top of the form. Note: You can select both if appropriate. PART II BASIC PLAN INFORMATION 1a.Enter thename ofyour Plan.This canbe foundonthefirst pagein the Plan sectionofyour Solo 401k Binder. 1b. Enter the three-digit Plan Number, which is c. EffectiveDate meansjanuary1ofthefirstplan Year inwhichyour planwasestablished. 2a. Enter thename andaddressof theentity whichadoptedyoursolo401k plan.this canbe found onpage I-1in the Plan sectionofyoursolo 401kBinder. 2b. Enter the Employer Identification Number of 2a above. If your plan is sponsored by a Sole Proprietorship, please obtain an EIN for the Sole Proprietorship. This can be obtained online: cation-number-(ein)-online. 2c. Enter the telephone number of 2a above. 2d. Enter the six-digit applicable code that best describes the nature of the plan sponsor's business from the list of principal business activity codes later in these instructions. 3a. Enter "Same" and continue to section "4". 4a. Previous adopting entity (if applicable). 4b. Previous EIN (if applicable). 4c. Previous Plan name (if applicable). 4d. Previous plan number (if applicable).

2 5a(1). Enter the total number of participants at the beginning of the Plan year. 5a(2). Enter the total number of active participants at the beginning of the Plan year. 5b(1). Enter the total number of participants at the end of the Plan year. 5b(2). Enter the total number of active participants at the end of the Plan year. 5c. Enter 0 PART III FINANCIAL INFORMATION 6a. Enter the Total plan Assets of your Solo 401k for the beginning and end of the year. 6b. Enter the Total plan liabilities of your Solo 401k for the beginning and end of the year. 6c. Subtract line 7b from 7a and enter the amount onto line 7c for the beginning and end of the year. 7a. Enter the contributions made by the Employer to your Solo 401k Plan. This is the profitsharing portion of your contributions. 7b. Enter the contributions made by the Participants to your Solo 401k Plan. This is the salary deferral portion of your contributions. 7c. Enter any other contributions made to your Solo 401k Plan (including rollovers) PART IV PLAN CHARACTERISTICS 8. Enter 3B and 3D as Plan Characteristics. PART V COMPLIANCE AND FUNDING QUESTIONS 9. If you took a participant loan during the plan year, enter the amount as of year-end. 10. Select No 11. Select "No" Sign the Form as Plan Administrator, and insert the date.

3 Forms 5500, 5500-SF, and 5500-EZ Codes for Principal Business Activity This list of principal business activities and their associated codes is designed to classify an enterprise by the type of activity in which it is engaged. These principal activity codes are based on the North American Industry Classification System. Agriculture, Forestry, Fishing and Hunting Crop Production Oilseed & Grain Farming Vegetable & Melon Farming (including potatoes & yams) Fruit & Tree Nut Farming Greenhouse, Nursery, & Floriculture Production Other Crop Farming (including tobacco, cotton, sugarcane, hay, peanut, sugar beet, & all other crop farming) Animal Production Beef Cattle Ranching & Farming Cattle Feedlots Dairy Cattle & Milk Production Hog & Pig Farming Poultry & Egg Production Sheep & Goat Farming Aquaculture (including shellfish & finfish farms & hatcheries) Other Animal Production Forestry and Logging Timber Tract Operations Forest Nurseries & Gathering of Forest Products Logging Fishing, Hunting and Trapping Fishing Hunting & Trapping Support for Agriculture and Forestry Support for Crop Production (including cotton ginning, soil preparation, planting, & cultivating) Support for Animal Production Support For Forestry Mining Oil & Gas Extraction Coal Mining Metal Ore Mining Stone Mining & Quarrying Sand, Gravel, Clay, & Ceramic & Refractory Minerals Mining & Quarrying Other Nonmetallic Mineral Mining & Quarrying Support for Mining Utilities Electric Power Generation, Transmission & Distribution Natural Gas Distribution Water, Sewage, & Other Systems Combination Gas and Electric of Buildings Residential Building Nonresidential Building Heavy and Civil Engineering Utility System Land Subdivision Highway, Street, & Bridge Other Heavy & Civil Engineering Specialty Trade Contractors Foundation, Structure, & Building Exterior Contractors (including framing carpentry, masonry, glass, roofing, & siding) Electrical Contractors Plumbing, Heating, & Air-Conditioning Contractors Other Building Equipment Contractors Building Finishing Contractors (including drywall, insulation, painting, wallcovering, flooring, tile, & finish carpentry) Other Specialty Trade Contractors (including site preparation) Food Animal Food Grain & Oilseed Milling Sugar & Confectionery Product Fruit & Vegetable Preserving & Specialty Food Dairy Product Animal Slaughtering and Processing Seafood Product Preparation & Packaging Bakeries, Tortilla & Dry Pasta Other Food (including coffee, tea, flavorings & seasonings) Beverage and Tobacco Product Soft Drink & Ice Breweries Wineries Distilleries Tobacco Textile Mills and Textile Product Mills Textile Mills Textile Product Mills Apparel Apparel Knitting Mills Cut & Sew Apparel Contractors Men's & Boys' Cut & Sew Apparel Women's, Girls' and Infants' Cut & Sew Apparel Other Cut & Sew Apparel Apparel Accessories & Other Apparel Leather and Allied Product Leather & Hide Tanning & Finishing Footwear (including rubber & plastics) Other Leather & Allied Product Wood Product Sawmills & Wood Preservation Veneer, Plywood, & Engineered Wood Product Other Wood Product Paper Pulp, Paper, & Paperboard Mills Converted Paper Product Printing and Related Support Printing & Related Support Petroleum and Coal Products Petroleum Refineries (including integrated) Asphalt Paving, Roofing, & Saturated Materials Other Petroleum & Coal Products Chemical Basic Chemical Resin, Synthetic Rubber, & Artificial & Synthetic Fibers & Filaments Pesticide, Fertilizer, & Other Agricultural Chemical Pharmaceutical & Medicine Paint, Coating, & Adhesive Soap, Cleaning Compound, & Toilet Preparation Other Chemical Product & Preparation Plastics and Rubber Products Plastics Product Rubber Product Nonmetallic Mineral Product Clay Product & Refractory Glass & Glass Product Cement & Concrete Product Lime & Gypsum Product Other Nonmetallic Mineral Product Primary Metal Iron & Steel Mills & Ferroalloy Steel Product from Purchased Steel Alumina & Aluminum Production & Processing Nonferrous Metal (except Aluminum) Production & Processing Foundries Fabricated Metal Product Forging & Stamping Cutlery & Handtool Architectural & Structural Metals Boiler, Tank, & Shipping Container Hardware Spring & Wire Product Machine Shops; Turned Product; & Screw, Nut, & Bolt Coating, Engraving, Heat Treating, & Allied Other Fabricated Metal Product Machinery Agriculture,, & Mining Machinery Industrial Machinery Commercial & Service Industry Machinery Ventilation, Heating, Air-Conditioning, & Commercial Refrigeration Equipment Metalworking Machinery Engine, Turbine & Power Transmission Equipment Other General Purpose Machinery Computer and Electronic Product Computer & Peripheral Equipment Communications Equipment Audio & Video Equipment Semiconductor & Other Electronic Component Navigational, Measuring, Electromedical, & Control Instruments & Reproducing Magnetic & Optical Media Electrical Equipment, Appliance, and Component Electric Lighting Equipment Household Appliance Electrical Equipment Other Electrical Equipment & Component Equipment Motor Vehicle Motor Vehicle Body & Trailer Motor Vehicle Parts Aerospace Product & Parts Railroad Rolling Stock Ship & Boat Building Other Equipment Furniture and Related Product Furniture & Related Product Miscellaneous Medical Equipment & Other Miscellaneous Wholesale Trade Merchant Wholesalers, Durable Motor Vehicle & Motor Vehicle Parts & Furniture & Home Furnishings Lumber & Other Materials Professional & Commercial Equipment & Metals & Minerals (except Petroleum) Household Appliances and Electrical & Electronic Hardware, Plumbing & Heating Equipment & Machinery, Equipment, & Sporting & Recreational & Toy & Hobby & Recyclable Materials Jewelry, Watches, Precious Stones, & Precious Metals Other Miscellaneous Durable -8-

4 Forms 5500, 5500-SF, and 5500-EZ Codes for Principal Business Activity (Continued) Merchant Wholesalers, Nondurable Paper & Paper Products Drugs & Druggists' Sundries Apparel, Piece, & Notions Grocery & Related Products Farm Product Raw Materials Chemical & Allied Products Petroleum & Petroleum Products Beer, Wine, & Distilled Alcoholic Beverages Farm Books, Periodicals, & Newspapers Flower, Nursery Stock, & Florists' Tobacco & Tobacco Products Paint, Varnish, & Other Miscellaneous Nondurable Wholesale Electronic Markets and Agents and Brokers Business to Business Electronic Markets Wholesale Trade Agents & Brokers Retail Trade Motor Vehicle and Parts Dealers New Car Dealers Used Car Dealers Recreational Vehicle Dealers Motorcycle, ATV, and All Other Motor Vehicle Dealers Boat Dealers Automotive Parts, Accessories, & Tire Furniture and Home Furnishings Furniture Floor Covering Window Treatment All Other Home Furnishings Electronics and Appliance Household Appliance Electronics (including Audio, Video, Computer, and Camera ) Building Material and Garden Equipment and Dealers Home Centers Paint & Wallpaper Hardware Other Building Material Dealers Lawn & Garden Equipment & Food and Beverage Supermarkets and Other Grocery (except Convenience) Convenience Meat Markets Fish & Seafood Markets Fruit & Vegetable Markets Baked Confectionery & Nut All Other Specialty Food Beer, Wine, & Liquor Health and Personal Care Pharmacies & Drug Cosmetics, Beauty, & Perfume Optical Other Health & Personal Care Gasoline Stations Gasoline Stations (including convenience stores with gas) Clothing and Clothing Accessories Men's Clothing Women's Clothing Children's & Infants' Clothing Family Clothing Clothing Accessories Other Clothing Shoe Jewelry Luggage & Leather Sporting, Hobby, Book, and Music Sporting Hobby, Toy, & Game Sewing, Needlework, & Piece Musical Instrument & Book News Dealers & Newsstands General Merchandise Department Other General Merchandise Miscellaneous Store Retailers Florists Office & Stationery Gift, Novelty, & Souvenir Used Merchandise Pet & Pet Art Dealers Manufactured (Mobile) Home Dealers All Other Miscellaneous Store Retailers (including tobacco, candle, & trophy shops) Nonstore Retailers Electronic Shopping & Mail-Order Houses Vending Machine Operators Fuel dealers (including Heating Oil and Liquefied Petroleum) Other Direct Selling Establishments (including door-to-door retailing, frozen food plan providers, party plan merchandisers, & coffee-break service providers) and Warehousing Air, Rail, and Water Air Rail Water Truck General Freight Trucking, Local General Freight Trucking, Long-distance Specialized Freight Trucking Transit and Ground Passenger Urban Transit Systems Interurban & Rural Bus Taxi Service Limousine Service School & Employee Bus Charter Bus Industry Other Transit & Ground Passenger Pipeline Pipeline Scenic & Sightseeing Scenic & Sightseeing Support for Support for Air Support for Rail Support for Water Motor Vehicle Towing Other Support for Road Freight Arrangement Other Support for Couriers and Messengers Couriers Local Messengers & Local Delivery Warehousing and Storage Warehousing & Storage (except lessors of miniwarehouses & self-storage units) Information Publishing Industries (except Internet) Newspaper Publishers Periodical Publishers Book Publishers Directory & Mailing List Publishers Other Publishers Software Publishers Motion Picture and Sound Recording Industries Motion Picture & Video Industries (except video rental) Sound Recording Industries Broadcasting (except Internet) Radio & Television Broadcasting Cable & Other Subscription Programming Telecommunications Telecommunications (including paging, cellular, satellite, cable & other program distribution, resellers, other telecommunications, & internet service providers) Data Processing Data Processing, Hosting, & Related Other Information Other Information (including news syndicates, libraries, internet publishing & broadcasting) Finance and Insurance Depository Credit Commercial Banking Savings Institutions Credit Unions Other Depository Credit Nondepository Credit Credit Card Issuing Sales Financing Consumer Lending Real Estate Credit (including mortgage bankers & originators) International Trade Financing Secondary Market Financing All Other Nondepository Credit Related to Credit Related to Credit (including loan brokers, check clearing, & money transmitting) Securities, Commodity Contracts, and Other Financial Investments and Related Investment Banking & Securities Dealing Securities Brokerage Commodity Contracts Dealing Commodity Contracts Brokerage Securities & Commodity Exchanges Other Financial Investment (including portfolio management & investment advice) Insurance Carriers and Related Reinsurance Carriers Direct Life, Health, & Medical Insurance Carriers Direct Insurance (except Life, Health & Medical) Carriers Insurance Agencies & Brokerages Other Insurance Related (including third-party administration of insurance and pension funds) Funds, Trusts, and Other Financial Vehicles Insurance & Employee Benefit Funds Open-End Investment Funds (Form 1120-RIC) Trusts, Estates, & Agency Accounts Other Financial Vehicles (including mortgage REITs & closed-end investment funds) Offices of Bank Holding Companies and Offices of Other Holding Companies are located under Management of Companies (Holding Companies). Real Estate and Rental and Leasing Real Estate Lessors of Residential Buildings & Dwellings (including equity REITs) Lessors of Nonresidential Buildings (except Miniwarehouses) (including equity REITs) Lessors of Miniwarehouses & Self-Storage Units (including equity REITs) Lessors of Other Real Estate Property (including equity REITs) Offices of Real Estate Agents & Brokers Real Estate Property Managers Offices of Real Estate Appraisers Other Related to Real Estate Rental and Leasing Automotive Equipment Rental & Leasing Consumer Electronics & Appliances Rental Formal Wear & Costume Rental Video Tape & Disc Rental Other Consumer Rental General Rental Centers Commercial & Industrial Machinery & Equipment Rental & Leasing Lessors of Nonfinancial Intangible Assets (except copyrighted works) Lessors of Nonfinancial Intangible Assets (except copyrighted works) -9-

5 Forms 5500, 5500-SF, and 5500-EZ Codes for Principal Business Activity (Continued) Professional, Scientific, and Technical Legal Offices of Lawyers Other Legal Accounting, Tax Preparation, Bookkeeping, and Payroll Offices of Certified Public Accountants Tax Preparation Payroll Other Accounting Architectural, Engineering, and Related Architectural Landscape Architecture Engineering Drafting Building Inspection Geophysical Surveying & Mapping Surveying & Mapping (except Geophysical) Testing Laboratories Specialized Design Specialized Design (including interior, industrial, graphic, & fashion design) Computer Systems Design and Related Custom Computer Programming Computer Systems Design Computer Facilities Management Other Computer Related Other Professional, Scientific, and Technical Management, Scientific, & Technical Consulting Scientific Research & Development Advertising & Related Marketing Research & Public Opinion Polling Photographic Translation & Interpretation Veterinary All Other Professional, Scientific, & Technical Management of Companies (Holding Companies) Offices of Bank Holding Companies Offices of Other Holding Companies Administrative and Support and Waste Management and Remediation Administrative and Support Office Administrative Facilities Support Employment Document Preparation Telephone Call Centers Business Service Centers (including private mail centers & copy shops) Collection Agencies Credit Bureaus Other Business Support (including repossession services, court reporting, & stenotype services) Travel Arrangement & Reservation Investigation & Security Exterminating & Pest Control Janitorial Landscaping Carpet & Upholstery Cleaning Other to Buildings & Dwellings Other Support (including packaging & labeling services, & convention & trade show organizers) Waste Management and Remediation Waste Management & Remediation Educational Educational (including schools, colleges, & universities) Health Care and Social Assistance Offices of Physicians and Dentists Offices of Physicians (except mental health specialists) Offices of Physicians, Mental Health Specialists Offices of Dentists Offices of Other Health Practitioners Offices of Chiropractors Offices of Optometrists Offices of Mental Health Practitioners (except Physicians) Offices of Physical, Occupational & Speech Therapists, & Audiologists Offices of Podiatrists Offices of All Other Miscellaneous Health Practitioners Outpatient Care Centers Family Planning Centers Outpatient Mental Health & Substance Abuse Centers HMO Medical Centers Kidney Dialysis Centers Freestanding Ambulatory Surgical & Emergency Centers All Other Outpatient Care Centers Medical and Diagnostic Laboratories Medical & Diagnostic Laboratories Home Health Care Home Health Care Other Ambulatory Health Care Other Ambulatory Health Care (including ambulance services & blood & organ banks) Hospitals Hospitals Nursing and Residential Care Facilities Nursing & Residential Care Facilities Social Assistance Individual & Family Community Food & Housing, & Emergency & Other Relief Vocational Rehabilitation Child Day Care Arts, Entertainment, and Recreation Performing Arts, Spectator Sports, and Related Industries Performing Arts Companies Spectator Sports (including sports clubs & racetracks) Promoters of Performing Arts, Sports, & Similar Events Agents & Managers for Artists, Athletes, Entertainers, & Other Public Figures Independent Artists, Writers, & Performers Museums, Historical Sites, and Similar Institutions Museums, Historical Sites, & Similar Institutions Amusement, Gambling, and Recreation Industries Amusement Parks & Arcades Gambling Industries Other Amusement & Recreation Industries (including golf courses, skiing facilities, marinas, fitness centers, & bowling centers) Accommodation and Food Accommodation Hotels (except Casino Hotels) & Motels Casino Hotels Bed & Breakfast Inns All Other Traveler Accommodation RV (Recreational Vehicle) Parks & Recreational Camps Rooming & Boarding Houses Food and Drinking Places Special Food (including food service contractors & caterers) Drinking Places (Alcoholic Beverages) Full-Service Restaurants Limited-Service Restaurants Cafeterias and Buffets Snack and Non-alcoholic Beverage Bars Other Repair and Automotive Mechanical & Electrical Repair & Automotive Body, Paint, Interior, & Glass Repair Other Automotive Repair & (including oil change & lubrication shops & car washes) Electronic & Precision Equipment Repair & Commercial & Industrial Machinery & Equipment (except Automotive & Electronic) Repair & Home & Garden Equipment & Appliance Repair & Reupholstery & Furniture Repair Footwear & Leather Repair Other Personal & Household Repair & Personal and Laundry Barber Shops Beauty Salons Nail Salons Other Personal Care (including diet & weight reducing centers) Funeral Homes & Funeral Cemeteries & Crematories Coin-Operated Laundries & Drycleaners Drycleaning & Laundry (except Coin-Operated) Linen & Uniform Supply Pet Care (except Veterinary) Photofinishing Parking Lots & Garages All Other Personal Religious, Grantmaking, Civic, Professional, and Similar Organizations Religious, Grantmaking, Civic, Professional, & Similiar Organizations (including condominium and homeowners associations) Labor Unions and Similar Labor Organizations Governmental Instrumentality or Agency -10-