Form 5310 - Application For Determination For Terminating Plan Page 12
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1312
Form 5310 (Rev. 12-2013)
Page
(Line 21 continued)
Assets (continued)
c
General Investments:
(1) Interest-bearing cash (including money market funds)
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21c(1)
(2) Certificate of deposit
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21c(2)
(3) U.S. Government securities .
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21c(3)
(4) Corporate debt instruments .
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21c(4)
(5) Corporate stocks
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21c(5)
(6) Partnership/joint venture interests .
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21c(6)
(7) Real estate:
(A) Income-producing .
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21c(7)(A)
(B) Nonincome-producing
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21c(7)(B)
(8) Loans (other than to participants) secured by mortgages
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21c(8)
(9) Loans to participants
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21c(9)
(10) Other Loans
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21c(10)
(11) Value of interest in registered investment companies
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21c(11)
(12) Value of funds held in insurance company general account
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21c(12)
(13) Other .
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21c(13)
(14) Total. Add lines 21c(1) through 21c(13) .
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21c(14)
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d
Employer-related investments:
(1) Employer Securities .
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21d(1)
(2) Employer real property .
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21d(2)
e
Building equipment and other property used in plan operation .
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21e
f
21f
Total assets. Add lines 21a, 21b(6), 21c(14), 21d(2), and 21e
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▶
Liabilities
g
Benefit claims payable .
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21g
h
Operating payables .
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21h
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Acquisition indebtedness .
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21i
j
Other liabilities
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21j
k
Total liabilities. Add lines 21g through 21j .
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21k
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Net Assets
l
Net Assets. Subtract line 21k from line 21f
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21l
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5310
Form
(Rev. 12-2013)
11840Y12201312
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