Form 5500 Annual Return Report — Schedule D Supplement
Form 5500 Series Schedule D is an attachment to Form 5500 that is required if a plan participated in a Pooled Separate Account (PSA).
To complete Part I of Schedule D for RecordkeeperDirect-Multifund® plans, you will need this information:
- Part 1a, Name of MTIA, CCT, PSA, or 103-12 IE: Variable Annuity Account 5
- Part 1b, Name of sponsor entity listed in (a): Great-West Life & Annuity Insurance Company
- Part 1c, EIN-PN: GWLA 27-2892241-004
- Part 1d, Entity Code: “P” for “Pooled Separate Account”
- Part 1e, Dollar value of interest in MTIA, CCT, PSA or 103-12 IE at end of year: enter the value from Part II, line 5 found on the “Form 5500 Annual Return Report — Schedule A” in the “Reports and Analysis” section of the Plan Sponsor Website.