29 CFR 4041A.12 - Contents of notice.
(a) Information to be contained in notice. Except to the extent provided in paragraph (d), each Notice shall contain:
(1) The name of the plan;
(2) The name, address and telephone number of the plan sponsor and of the plan sponsor's duly authorized representative, if any;
(3) The name, address, and telephone number of the person that will administer the plan after the date of termination, if other than the plan sponsor;
(4) A copy of the plan's most recent Form 5500 (Annual Report Form), including schedules; and
(5) The date of termination of the plan.
(b) Information to be contained in a notice involving a mass withdrawal. In addition to the information contained in paragraph (a) and except as provided in paragraph (d), the following information shall be contained in a Notice filed by a plan that has terminated by mass withdrawal:
(1) A copy of the plan document in effect 5 years prior to the date of termination and copies of any amendments adopted after that date.
(2) A copy (or copies) of the trust agreement (or agreements), if any, authorizing the plan sponsor to control and manage the operation and administration of the plan.
(3) A copy of the most recent actuarial statement and opinion (if any) relating to the plan.
(4) A statement of any material change in the assets or liabilities of the plan occurring after either the date of the actuarial statement referred to in item (5) or the date of the plan's Form 5500 submitted as part of the Notice.
(5) Complete copies of any letters of determination issued by the IRS relating to the establishment of the plan, any letters of determination relating to the disqualification of the plan and any subsequent requalification, and any letters of determination relating to the termination of the plan.
(6) A statement whether the plan assets will be sufficient to pay all benefits in pay status during the 12-month period following the date of termination.
(7) If plan assets on hand are sufficient to satisfy all nonforfeitable benefits under the plan, and if the plan sponsor intends to distribute such assets, a brief description of the proposed method of distributing the plan assets.
(8) If plan assets on hand are not sufficient to satisfy all nonforfeitable benefits under the plan, the name and address of any employer who contributed to the plan within 3 plan years prior to the date of termination.
(c) Certification. As part of the Notice, the plan sponsor or duly authorized representatives shall certify that all information and documents submitted pursuant to this section are true and correct to the best of the plan sponsor's or representative's knowledge and belief.
(d) Avoiding duplication. Information described in paragraphs (a) and (b) of this section need not be supplied if it duplicates information contained in Form 5500, or a schedule thereof, that a plan submits as part of the Notice.
(e) Additional information. In addition to the information described in paragraphs (a) and (b) of this section, the PBGC may require the submission of any other information which the PBGC determines is necessary for review of a Notice of Termination.