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Alternative Reporting and Disclosure Statement

Top Hat Plan Exemption
Pension and Welfare Benefits Administration
Room N-5644
U.S. Department of Labor
200 Constitution Avenue, N.W.
Washington, D.C. 20210

Corporation hereby supplies the following information pursuant to Department of Labor Regulations Section 2520.104-23:

  1. Name and Address of Employer:
    ABC Corporation
    _________________________
    _________________________

  2. Employer Identification Number:__________________

  3. ABC Corporation maintains the following plans for a select group of management or highly compensated employees:
          1. [Name of Plan]____________
            Number of Participants:________________

          2. [Name of Plan]____________
            Number of Participants_________________

          3. [Name of Plan]____________
            Number of Participants_________________

 

 

Very truly yours,
ABC Corporation

By______________________________

Title______________________________

 

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