Attention

:
• Telephone requests for the 2005 Form 5500-series forms, schedules and instructions will not be filled until December 1, 2005. • Requests for the 2005 Form 5500-series products can be made on the Internet (see below) beginning December 1, 2005. Requests made prior to that date will be filled with the 2004 version of the products. The product you are about to view is provided for information purposes and should not be reproduced on personal computer printers by individual taxpayers for filing. The Forms 5500 and 5500-EZ (and related schedules) are printed on special paper with dropout ink so they can be processed by the computerized processing system “EFAST.” These forms and schedules may be obtained by calling 1800-TAX-FORM (1-800-829-3676). Be sure to order using the IRS form number. Note: You can also use the Internet link http://www.irs.gov/formspubs/index.html to request a limited number of these forms and schedules. If you use this link, select “Order:” and “Forms and publications by U.S. mail.” Check the Department of Labor’s website at www.efast.dol.gov for additional information concerning the processing system, electronic filing, software, and “nonstandard” filings. ________________________________________________

SCHEDULE D (Form 5500)
Department of the Treasury Internal Revenue Service Department of Labor Employee Benefits Security Administration

DFE/Participating Plan Information
This schedule is required to be filed under section 104 of the Employee Retirement Income Security Act of 1974 (ERISA).

Official Use Only

OMB No. 1210-0110

2005

and ending
B

A

Name of plan or DFE

R

Three-digit plan number

C

Plan or DFE sponsor's name as shown on line 2a of Form 5500

D

(a)

Name of MTIA, CCT, PSA, or 103-12IE

LY

,D

(b) Name of sponsor of entity listed in (a)

(c)

EIN

PN

ON

(d) Entity code

O

NO

(e) Dollar value of interest in MTIA, CCT, PSA, or 103-12IE at end of year (see instructions)

T

Part I

Information on interests in MTIAs, CCTs, PSAs, and 103-12 IEs (to be completed by plans and DFEs)

US E

FO

Employer Identification Number

FI

LI

For calendar plan year 2005 or fiscal plan year beginning

MM / D D / Y Y Y Y

MM / D D / Y Y Y Y

NG

File as an attachment to Form 5500.

This Form is Open to Public Inspection.

(a)

Name of MTIA, CCT, PSA, or 103-12IE

AT IO N

PU

(b) Name of sponsor of entity listed in (a)

RP

OS

ES

.00

(c)

EIN

PN

(d) Entity code

(e) Dollar value of interest in MTIA, CCT, PSA, or 103-12IE at end of year (see instructions)

.00

For Paperwork Reduction Act Notice and OMB Control Numbers, see the instructions for Form 5500. Cat. No. 22774J Schedule D (Form 5500) 2005

FO R

IN

FO RM

1

1

0

5

A

A

0

1

0

S
v8.2

Schedule D (Form 5500) 2005

Page

2
Official Use Only

(a)

Name of MTIA, CCT, PSA, or 103-12IE

(c)

EIN

PN

FI

(d) Entity code

(e) Dollar value of interest in MTIA, CCT, PSA, or 103-12IE at end of year (see instructions)

LI

NG
PN

(b) Name of sponsor of entity listed in (a)

(c)

EIN

,D

O

(d) Entity code

NO

(e) Dollar value of interest in MTIA, CCT, PSA, or 103-12IE at end of year (see instructions)

T

(b) Name of sponsor of entity listed in (a)

US E

(a)

Name of MTIA, CCT, PSA, or 103-12IE

FO

.00

R

.00

(a)

Name of MTIA, CCT, PSA, or 103-12IE

(b) Name of sponsor of entity listed in (a)

OS

ES
(d) Entity code

ON
PN

LY
(c) EIN

PU

RP

(e) Dollar value of interest in MTIA, CCT, PSA, or 103-12IE at end of year (see instructions)

.00

(a)

Name of MTIA, CCT, PSA, or 103-12IE

FO RM

(b) Name of sponsor of entity listed in (a)

AT IO N

IN

(c)

EIN

PN

(d) Entity code

(e) Dollar value of interest in MTIA, CCT, PSA, or 103-12IE at end of year (see instructions)

FO R

.00

1

1

0

5

A

A

0

2

0

T

Schedule D (Form 5500) 2005

Page

3
Official Use Only

Part II
(a)

Information on Participating Plans (to be completed by DFEs)

Plan name

(b) Name of plan sponsor

(c) (a)

EIN Plan name

PN

(b) Name of plan sponsor

(c) (a)

EIN Plan name

PN

(b) Name of plan sponsor

(c) (a)

EIN Plan name

PN

(c) (a)

EIN Plan name

AT IO N

PU

(b) Name of plan sponsor

RP

(b) Name of plan sponsor

FO R

(c)

EIN

IN

FO RM

1

1

0

OS

PN

PN

5

ES

A

ON

A

LY

,D

0

O

3

NO

0

T

U

US E

FO

R

FI

LI

NG

Schedule D (Form 5500) 2005

Page

4
Official Use Only

(a)

Plan name

(a)

Plan name

(a)

Plan name

(b) Name of plan sponsor

(c) (a)

EIN Plan name

PN

(c) (a)

EIN Plan name

PU

RP

(b) Name of plan sponsor

(c)

EIN

FO RM

(b) Name of plan sponsor

AT IO N

FO R

IN

1

1

0

OS

PN

PN

5

ES

A

ON

A

LY

,D

0

O

4

NO

(c)

EIN

PN

0

T

V

US E

(b) Name of plan sponsor

FO

R

FI

(c)

EIN

PN

LI

NG

(b) Name of plan sponsor