Census of Trusteed Pension Funds 2010

Confidential when completed; The data reported on this questionnaire are protected under the Statistics Act and will be treated in strict confidence, used for statistical purposes and published in aggregate form only.

Collected under the authority of the Statistics Act. Revised Statutes of Canada, 1985, Chapter S19 (22).

This is a mandatory survey.

To return completed questionnaire either:

• Use enclosed postage paid envelope;
• Address your own envelope to:
  Pensions and Wealth Surveys Section
  Income Statistics Division
  Statistics Canada
  170 Tunney's Pasture Driveway
  Ottawa, Ontario K1A 0T6
• Fax to: (613) 951-4296
  (Note : Data sent by facsimile may be at risk of disclosure during the transmission process.)

If you have questions:

• Call (613) 951-4092
• E-mail: tpfc@statcan.gc.ca

Si vous préférez ce questionnaire en français, veuillez cocher

(Please make any necessary changes in above name or mailing address; add the name of the fund if missing.)

Please complete and return the questionnaire by May 31, 2011.

1. Does this organization operate, either by sponsoring or managing, the trusteed pension fund named at the top of this page? For a definition of a trusteed pension fund, please refer to "Definitions" on the "Notes/Instructions".

• Yes – Please complete the remainder of the questionnaire and return it to Statistics Canada.
• No – Please elaborate
  • Fund closed (MM-YYYY)
  • Fund is deposited in total with an insurance company under an insurance company contract
  • Other, please specify
    
    Please provide your name (bottom of this page), complete question 8 and return the questionnaire to Statistics Canada.

2. If this pension fund participates in a master trust fund, indicate the name of this master trust:

Please complete Section A (Administrative Data) and Section B (Receipts and Disbursements) and return this document to Statistics Canada.
The information for Section C (Assets) will be provided by the master trust.

3. If it is necessary to obtain the financial data on this pension fund from a trustee outside your company, please complete the following authorization notice, as well as Section A (Administrative Data) and the employee and employer contribution information requested in Section B, and forward this document to the trustee or return it to Statistics Canada for forwarding.

• Authorization Notice (to be completed only if item 3 above applies)
  
  
• This is to authorize (contact name), (telephone number) to supply Statistics Canada with the information requested in Sections B and C of the questionnaire "Census of Trusteed Pension Funds 2010". We understand that the information will be treated as strictly confidential and used only in compiling aggregates.
  
  
• (Name of company)
• (Date)
• (Signature)
• (Title)

Name of person completing questionnaire (please print)

Telephone ()

Fax ()

E-mail address

Thank you for your cooperation

Section A: Administrative Data

1. Year of Inauguration of This Fund

2. Fund Fiscal Year End (MM-DD)

3. Investment Decision made by (check one or more)

Note: If a committee is actively involved in directing the investments, indicate which of the following are represented on the committee.

• (a) Trustee(s)
• (b) Employer (includes investment staff of the employer and public sector funds whose investment is governed by legislation)
• (c) Outside investment counsel
• (d) Employee (plan members)
• (e) Other (specify)

4. Insurance Company Holdings

Is any of the money in this pension fund invested with or managed by an insurance company?
(If part of a master trust, consider only money associated with this participant.)

• Yes
• No

If yes, what is the amount involved?

• Market value $ (omit cents)

5. Members Covered

Note: Should be as of same time period as assets, preferably December 31.

• (a) Number of employed plan members (including employees on temporary lay-off)
  Indicate year end used:
  • December 31, 2010
  • Other year end between April 1, 2010 and March 31, 2011
• (b) Number of additional persons having equity in the fund (e.g. retired persons receiving pension, persons who will receive deferred pension, etc.)
  Indicate year end used:
  • December 31, 2010
  • Other year end between April 1, 2010 and March 31, 2011

6. Contributory Status(for the majority of members)

Are the majority of members required to contribute to the pension fund?

• Yes
• No

7. Type of Plan (for the majority of employed members participating in the fund – check one only)

• (a) Defined benefit / flat benefit
• (b) Defined contribution (money purchase/profit sharing)
• (c) Combination of above or as selected by employee
• (d) Other (specify)

8. Plan Registration Number(s)* (of all plans included in this fund)
(If space insufficient, attach another page.)

* Number used by Canada Revenue Agency (CRA). Also provide the number used by the provincial pension regulatory authority or the Office of the Superintendent of Financial Institutions (OSFI), if different from the Plan registration number.

Book (cost) value of previous year’s assets

Report the net book (cost) value of assets for the year end occurring between April 1, 2009 and March 31, 2010.

• $ (omit cents)

Section B: Receipts and Disbursements

* Note: If total assets at book value are less than $10,000,000 please see Instructions Sheet before completing Sections B and C.

Report for one year period ending December 31, 2010 if possible.

Indicate year end used:

• December 31, 2010
• Other year end between April 1, 2010 and March 31, 2011

Receipts and Net Realized Gains

Note: Do not include any unrealized gains.

• Contributions:
  • employee $ (omit cents)
  • employer $ (omit cents)
• Investment income (interest, dividends, etc.) $ (omit cents)
• Net realized profit on sale of securities $ (omit cents)
• Transfers from other pension plans (specify) $ (omit cents)
• Other receipts and gains (specify) $ (omit cents)
• Total receipts and gains (total of lines 100 to 105) $ (omit cents)

Disbursements and Net Realized Losses

Note: Do not include any unrealized losses.

• Pension payments out of fund to retirees and beneficiaries $ (omit cents)
• Cost of pensions purchased $ (omit cents)
• Cash withdrawals (including transfers to other plans) $ (omit cents)
• Administration costs (if charged against fund) $ (omit cents)
• Net realized loss on sale of securities $ (omit cents)
• Refund of surplus in the fund $ (omit cents)
• Other disbursements and losses (specify) $ (omit cents)
• Total disbursements and losses (total of lines 200 to 206) $ (omit cents)

Section C: Assets

* Note: Detailed asset portfolio is essential for master trust funds (see instructions). Asset detail is not necessary for the participant accounts.

Report as of December 31, 2010 if possible.

Indicate year end used:

• December 31, 2010
• Other year end between April 1, 2010 and March 31, 2011

Pooled, mutual and investment funds:

• Book (cost) value $ (omit cents)
  • Canadian equity fund
  • Canadian bond fund (fixed income)
  • Canadian mortgage fund
  • Canadian real estate fund
  • Canadian money market fund
  • foreign fund
  • other Canadian fund (specify)
  
  
• Market value $ (omit cents)
  • Canadian equity fund
  • Canadian bond fund (fixed income)
  • Canadian mortgage fund
  • Canadian real estate fund
  • Canadian money market fund
  • foreign fund
  • other Canadian fund (specify)

Equities:

• Book (cost) value $ (omit cents)
  • Canadian common and preferred stocks
  • foreign common and preferred stocks:
    • United States
    • other
  
  
• Market value $ (omit cents)
  • Canadian common and preferred stocks
  • foreign common and preferred stocks:
    • United States
    • other

Bonds/Debentures:

• Book (cost) value $ (omit cents)
  • federal
  • provincial
  • municipal
  • other Canadian (corporate)
  • foreign
  
  
• Market value $ (omit cents)
  • federal
  • provincial
  • municipal
  • other Canadian (corporate)
  • foreign

Mortgages:

• Book (cost) value $ (omit cents)
  • residential
  • non-residential
  
  
• Market value $ (omit cents)
  • residential
  • non-residential

Real estate (including petroleum and natural gas properties)

• Book (cost) value $ (omit cents)
• Market value $ (omit cents)

Cash, deposits, short-term:

• Book (cost) value $ (omit cents)
  • cash, deposits, GICs
  • Government of Canada t-bills
  • foreign short-term investments
  • other Canadian short-term paper
  
  
• Market value $ (omit cents)
  • cash, deposits, GICs
  • Government of Canada t-bills
  • foreign short-term investments
  • other Canadian short-term paper

Miscellaneous:

• Book (cost) value $ (omit cents)
  • accrued interest and dividends receivable
  • accounts receivable
  • other assets (specify)
  
  
• Market value $ (omit cents)
  • accrued interest and dividends receivable
  • accounts receivable
  • other assets (specify)

Total assets (total of lines 300 to 372)

• Book (cost) value $ (omit cents)
• Market value $ (omit cents)

Deduct: Debts and payables

• Book (cost) value $ (omit cents)
• Market value $ (omit cents)

• Book (cost) value $ (omit cents)
• Market value $ (omit cents)

Thank you for your cooperation