Regulation S-X
Rule 6A-04

Statements of Income and Changes in Plan Equity 

Statements of income and changes in plan equity filed under this rule shall comply with the following provisions:

1. Net investment income.

(a) Income. State separately income from

(1) cash dividends,

(2) interest, and

(3) other sources.  

Income from investments in or indebtedness of participating employers shall be segregated under the appropriate sub-caption.

(b) Expenses. State separately any significant amounts.

(c) Net investment income.  

2. Realized gain or loss on investments.

(a) State separately the net of gains or losses arising from transactions in

(1) investments in securities of the participating employer or employers;

(2) other investments in securities; and

(3) other investments.

(b) State in a footnote or otherwise for each category of investment in paragraph (a) above the aggregate cost, the aggregate proceeds and the net gain or loss. State the principle followed in determining the cost of securities sold, e.g., "average cost" or "first-in, first-out."  

3. Unrealized appreciation or depreciation of investments.

(a) State the amount of increase or decrease in unrealized appreciation or depreciation of investments during the period.

(b) State in a footnote or otherwise the amount of unrealized appreciation or depreciation of investments at the beginning of the period of report, at the end of the period of report, and the increase or decrease during the period.  

4. Contributions and deposits.

(a) State separately

(1) total of amounts deposited by participating employees, and

(2) total of amounts contributed by the participating employer or employers.  

(b) If employees of more than one employer participate in the plan, state in tabular form in a footnote or otherwise the amount contributed by each employer and the deposits of the employees of each such employer.  

5. Withdrawals, lapses and forfeitures. State separately

(a) balances of employees' accounts withdrawn, lapsed or forfeited during the period;

(b) amounts disbursed in settlement of such accounts; and

(c) disposition of balances remaining after settlement specified in (b).  

6. Plan equity at beginning of period.

7. Plan equity at end of period.