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PEQUOT LAKES / Page 1
<br /> Schedule Form for Lump Sum Pension Plans
<br /> Reporting Year 2004
<br /> Determination of Plan Liabilities and Required Municipal Contribution for 2005
<br /> Relief Association jPequot Lakes Fire Relief Association County Crow Wing
<br /> Annual benefit level in effect for 2004
<br /> (If you change your benefit level before 12/31/04,the SC must be recalculated at the new level.)
<br /> Active Member Information
<br /> Fire Dept. Leaves To end of 2004 To end of 2005
<br /> Date of Age Entry of Years Years
<br /> Birth on Date Absence of Accrued of Accrued
<br /> Name mm-dd-yy 12/31/04 mm-dd-yy (months) Service Liability Service Liability
<br /> 1 Peterson,Robert J. 4/17/1951 53 1/2/1975 30 1 75,000 31 77,500
<br /> 2 Casanova,Neil T. 1/9/1946 58 2/5/1976 29 72,500 30 75,000
<br /> 3 Schmidt,Lance 7/18/1963 41 4/18/1989 16 35,700 17 39,000
<br /> 4
<br /> 5 Greer,Chris 6/25/1963 41 2/23/1992 13 26,750 14 29,60F0
<br /> Oaks,Larry 11/15/1964 40 3/27/1992 13 26,750 14 29,600
<br /> i Loven,Dan 10/21/1962 42 8/20/1992 12 24,050 13 26,750
<br /> 7 Szymanski,Dave 8/11/1952 52 11/4/1993 11 21,450 12 24,050
<br /> 8 Peterson,Robert J. 12/19/1963 41 9/15/1994 10 19,000 11 21,450
<br /> 9 Crist,Timothy D. 9/21/1964 40 12/15/1994 10 19,000 11 21,450
<br /> 10 Nelson,Thomas 8/20/1968 36 6/6/1996 9 16,650 10 19,000
<br /> 11 Nordb ,Daren 2/3/1973 31 11/6/1997 7 12,300 8 14,400
<br /> 12 Bridge,Jeromie A. 10/29/1973 31 8/11/1998 6 10,250 7 12,300
<br /> 13 Sta ner,J.Bruce 1/25/1960 44 8/11/1998 6 6 10,250 7 12,300
<br /> 14 Rickard,William 9/20/1971 33 3/7/2001 4 6,500 5 8,350
<br /> 15 Gemer,Brad 8/3/1969 35 3/7/2001 4 6,500 5 8,350
<br /> 16 Knutson,David 3/2/1969 35 11/21/2001 3 4,750 4 6,500
<br /> 17 Varilek,Roger 8/7/1957 47 12/5/2001 3 4,750 4 6,500
<br /> 18 Carlson,Chris 8/8/1974 30 12/5/2001 3 4,750 4 6,500
<br /> 19 Larson,Kelly L. 6/21/1969 35 12/19/2001 3 4,750 4 6,500
<br /> 20 Peterson,Michael 4/7/1976 28 7/21/2002 2 3,100 3 4,750
<br /> 21 Evenson,Brian 11/8/1967 37 10/2/2002 2 3,100 3 4,750
<br /> 22
<br /> 23 Larson,Kirk 5/12/1978 26 10/16/2002 2 3,100 3 4,750
<br /> t25 Harrin ton,Tina 3/19/1979 25 12/4/2002 2 3,100 3 4,750
<br /> Stoehr,Sean 3/4/1973 31 12/4/2002 2 3,100 3 4,750
<br /> Subtotal of Page 1 Liability-Active Members 417,150 1 468,850
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