401k Plan data: KLEBBA AGENCY ESOP plan

KLEBBA AGENCY ESOP 401k Plan overview

Plan Name	KLEBBA AGENCY ESOP
Plan identification number	002

KLEBBA AGENCY ESOP Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Stock bonus Leveraged ESOP - An ESOP that acquires employer securities with borrowed money or other debt-financing techniques. A completed Schedule E must be attached to a Form 5500 filed for an ESOP.

401k Sponsoring company profile

KLEBBA AGENCY, INC. has sponsored the creation of one or more 401k plans.

Company Name: KLEBBA AGENCY, INC.

Employer identification number (EIN): 300193447

NAIC Classification: 524210
NAIC Description: Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KLEBBA AGENCY ESOP

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2014-01-01 WILLIAM ST. CHARLES
002 2013-01-01 WILLIAM ST. CHARLES
002 2012-01-01 WILLIAM ST. CHARLES
002 2010-01-01 WILLIAM ST CHARLES

Plan id#	Filing Submission Date	Name of Administrator
002	2014-01-01	WILLIAM ST. CHARLES
002	2013-01-01	WILLIAM ST. CHARLES
002	2012-01-01	WILLIAM ST. CHARLES
002	2010-01-01	WILLIAM ST CHARLES

Plan Statistics for KLEBBA AGENCY ESOP

401k plan membership statisitcs for KLEBBA AGENCY ESOP

Measure Date Value
2014: KLEBBA AGENCY ESOP 2014 401k membership
Total participants, beginning-of-year 2014-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 4
Number of retired or separated participants receiving benefits 2014-01-01 3
Total of all active and inactive participants 2014-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 8
Number of participants with account balances 2014-01-01 7
2013: KLEBBA AGENCY ESOP 2013 401k membership
Total participants, beginning-of-year 2013-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 5
Number of retired or separated participants receiving benefits 2013-01-01 2
Total of all active and inactive participants 2013-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 1
Total participants 2013-01-01 8
2012: KLEBBA AGENCY ESOP 2012 401k membership
Total participants, beginning-of-year 2012-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 8
Number of retired or separated participants receiving benefits 2012-01-01 2
Total of all active and inactive participants 2012-01-01 10
Total participants 2012-01-01 10
2010: KLEBBA AGENCY ESOP 2010 401k membership
Total participants, beginning-of-year 2010-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 9
Number of retired or separated participants receiving benefits 2010-01-01 1
Total of all active and inactive participants 2010-01-01 10
Total participants 2010-01-01 10
Number of participants with account balances 2010-01-01 10

Measure	Date	Value
2014: KLEBBA AGENCY ESOP 2014 401k membership
Total participants, beginning-of-year	2014-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	4
Number of retired or separated participants receiving benefits	2014-01-01	3
Total of all active and inactive participants	2014-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	8
Number of participants with account balances	2014-01-01	7
2013: KLEBBA AGENCY ESOP 2013 401k membership
Total participants, beginning-of-year	2013-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	5
Number of retired or separated participants receiving benefits	2013-01-01	2
Total of all active and inactive participants	2013-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	1
Total participants	2013-01-01	8
2012: KLEBBA AGENCY ESOP 2012 401k membership
Total participants, beginning-of-year	2012-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	8
Number of retired or separated participants receiving benefits	2012-01-01	2
Total of all active and inactive participants	2012-01-01	10
Total participants	2012-01-01	10
2010: KLEBBA AGENCY ESOP 2010 401k membership
Total participants, beginning-of-year	2010-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	9
Number of retired or separated participants receiving benefits	2010-01-01	1
Total of all active and inactive participants	2010-01-01	10
Total participants	2010-01-01	10
Number of participants with account balances	2010-01-01	10

Financial Data on KLEBBA AGENCY ESOP

Measure	Date	Value
2014 : KLEBBA AGENCY ESOP 2014 401k financial data
Total income from all sources	2014-12-31	$123,267
Expenses. Total of all expenses incurred	2014-12-31	$87,363
Benefits paid (including direct rollovers)	2014-12-31	$87,102
Total plan assets at end of year	2014-12-31	$1,002,338
Total plan assets at beginning of year	2014-12-31	$966,434
Expenses. Other expenses not covered elsewhere	2014-12-31	$261
Other income received	2014-12-31	$123,267
Net income (gross income less expenses)	2014-12-31	$35,904
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,002,338
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$966,434
Assets. Value of employer securities	2014-12-31	$949,225
2013 : KLEBBA AGENCY ESOP 2013 401k financial data
Total income from all sources	2013-12-31	$62,768
Expenses. Total of all expenses incurred	2013-12-31	$173,716
Benefits paid (including direct rollovers)	2013-12-31	$173,666
Total plan assets at end of year	2013-12-31	$966,434
Total plan assets at beginning of year	2013-12-31	$1,077,382
Expenses. Other expenses not covered elsewhere	2013-12-31	$50
Other income received	2013-12-31	$62,768
Net income (gross income less expenses)	2013-12-31	$-110,948
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$966,434
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,077,382
Assets. Value of employer securities	2013-12-31	$837,049
2012 : KLEBBA AGENCY ESOP 2012 401k financial data
Total income from all sources	2012-12-31	$-34,081
Expenses. Total of all expenses incurred	2012-12-31	$50
Total plan assets at end of year	2012-12-31	$1,077,382
Total plan assets at beginning of year	2012-12-31	$1,111,513
Expenses. Other expenses not covered elsewhere	2012-12-31	$50
Other income received	2012-12-31	$-34,081
Net income (gross income less expenses)	2012-12-31	$-34,131
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,077,382
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,111,513
Assets. Value of employer securities	2012-12-31	$963,264
2010 : KLEBBA AGENCY ESOP 2010 401k financial data
Transfers to/from the plan	2010-12-31	$-48,700
Total income from all sources	2010-12-31	$45,759
Expenses. Total of all expenses incurred	2010-12-31	$100
Total plan assets at end of year	2010-12-31	$1,024,184
Total plan assets at beginning of year	2010-12-31	$1,027,225
Expenses. Other expenses not covered elsewhere	2010-12-31	$100
Other income received	2010-12-31	$45,759
Net income (gross income less expenses)	2010-12-31	$45,659
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,024,184
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,027,225
Assets. Value of employer securities	2010-12-31	$923,757

Form 5500 Responses for KLEBBA AGENCY ESOP

2014: KLEBBA AGENCY ESOP 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: KLEBBA AGENCY ESOP 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: KLEBBA AGENCY ESOP 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2010: KLEBBA AGENCY ESOP 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	KLEBBA AGENCY, INC.
Employer identification number (EIN):	300193447
NAIC Classification:	524210
NAIC Description:	Insurance Agencies and Brokerages