401k Plan data: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN plan

CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN
Plan identification number	001

CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Money purchase (other than target benefit)
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

CLEAR LAKE BANK AND TRUST COMPANY has sponsored the creation of one or more 401k plans.

Company Name: CLEAR LAKE BANK AND TRUST COMPANY

Employer identification number (EIN): 420185531

NAIC Classification: 522110
NAIC Description: Commercial Banking

Additional information about CLEAR LAKE BANK AND TRUST COMPANY

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities

Incorporation Date: 1939-10-19

Company Identification Number: 084751

Legal Registered Office Address: 322 MAIN AVE.

CLEAR LAKE
United States of America (USA)
50428

More information about CLEAR LAKE BANK AND TRUST COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 AIMEE KERN 2024-06-07
001 2022-01-01 AIMEE KERN 2023-09-14
001 2021-01-01 AIMEE KERN 2022-06-08 AIMEE KERN 2022-06-08
001 2020-01-01 AIMEE KERN 2021-06-07 AIMEE KERN 2021-06-07
001 2019-01-01 AIMEE KERN 2020-10-13 AIMEE KERN 2020-10-13
001 2018-01-01 AIMEE KERN 2019-07-25 AIMEE KERN 2019-07-25
001 2017-01-01 AIMEE KERN 2018-07-20
001 2016-01-01 AIMEE KERN 2017-10-12
001 2015-01-01 KATHRYN A. KADOLPH 2016-07-19 MARK HEWITT 2016-07-19
001 2014-01-01 KATHRYN A. KADOLPH
001 2013-01-01 KATHRYN A. KADOLPH
001 2012-01-01 KATHRYN KADOLPH
001 2011-01-01 KATHRYN KADOLPH KATHRYN KADOLPH 2012-07-25
001 2010-01-01 KATHRYN A KADOLPH KATHRYN A KADOLPH 2011-10-12
001 2009-01-01 KATHRYN A. KADOLPH

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2023-01-01	AIMEE KERN	2024-06-07
001	2022-01-01	AIMEE KERN	2023-09-14
001	2021-01-01	AIMEE KERN	2022-06-08	AIMEE KERN	2022-06-08
001	2020-01-01	AIMEE KERN	2021-06-07	AIMEE KERN	2021-06-07
001	2019-01-01	AIMEE KERN	2020-10-13	AIMEE KERN	2020-10-13
001	2018-01-01	AIMEE KERN	2019-07-25	AIMEE KERN	2019-07-25
001	2017-01-01	AIMEE KERN	2018-07-20
001	2016-01-01	AIMEE KERN	2017-10-12
001	2015-01-01	KATHRYN A. KADOLPH	2016-07-19	MARK HEWITT	2016-07-19
001	2014-01-01	KATHRYN A. KADOLPH
001	2013-01-01	KATHRYN A. KADOLPH
001	2012-01-01	KATHRYN KADOLPH
001	2011-01-01	KATHRYN KADOLPH		KATHRYN KADOLPH	2012-07-25
001	2010-01-01	KATHRYN A KADOLPH		KATHRYN A KADOLPH	2011-10-12
001	2009-01-01	KATHRYN A. KADOLPH

Plan Statistics for CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN

Measure Date Value
2014: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 81
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 79
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 10
Total of all active and inactive participants 2014-01-01 89
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 89
Number of participants with account balances 2014-01-01 85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 4
2013: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 76
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 75
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 9
Total of all active and inactive participants 2013-01-01 84
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 84
Number of participants with account balances 2013-01-01 77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 6
2012: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 69
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 70
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 9
Total of all active and inactive participants 2012-01-01 79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 79
Number of participants with account balances 2012-01-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 67
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 63
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 3
Total of all active and inactive participants 2011-01-01 66
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 66
Number of participants with account balances 2011-01-01 66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 69
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 61
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 61
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 61
Number of participants with account balances 2010-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 68
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 59
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 6
Total of all active and inactive participants 2009-01-01 65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 65
Number of participants with account balances 2009-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2014: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	81
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	79
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	10
Total of all active and inactive participants	2014-01-01	89
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	89
Number of participants with account balances	2014-01-01	85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	4
2013: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	76
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	75
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	9
Total of all active and inactive participants	2013-01-01	84
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	84
Number of participants with account balances	2013-01-01	77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	6
2012: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	69
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	70
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	9
Total of all active and inactive participants	2012-01-01	79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	79
Number of participants with account balances	2012-01-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	67
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	63
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	3
Total of all active and inactive participants	2011-01-01	66
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	66
Number of participants with account balances	2011-01-01	66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	69
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	61
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	61
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	61
Number of participants with account balances	2010-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	68
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	59
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	6
Total of all active and inactive participants	2009-01-01	65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	65
Number of participants with account balances	2009-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2014 : CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$1,139,520
Expenses. Total of all expenses incurred	2014-12-31	$132,716
Benefits paid (including direct rollovers)	2014-12-31	$132,591
Total plan assets at end of year	2014-12-31	$9,940,061
Total plan assets at beginning of year	2014-12-31	$8,933,257
Value of fidelity bond covering the plan	2014-12-31	$3,500,000
Total contributions received or receivable from participants	2014-12-31	$329,049
Contributions received from other sources (not participants or employers)	2014-12-31	$38,785
Other income received	2014-12-31	$552,486
Net income (gross income less expenses)	2014-12-31	$1,006,804
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$9,940,061
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$8,933,257
Total contributions received or receivable from employer(s)	2014-12-31	$219,200
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$125
Funding deficiency by the employer to the plan for this plan year	2014-12-31	$0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	2014-12-31	$0
2013 : CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$2,072,835
Expenses. Total of all expenses incurred	2013-12-31	$323,968
Benefits paid (including direct rollovers)	2013-12-31	$323,743
Total plan assets at end of year	2013-12-31	$8,933,257
Total plan assets at beginning of year	2013-12-31	$7,184,390
Value of fidelity bond covering the plan	2013-12-31	$3,500,000
Total contributions received or receivable from participants	2013-12-31	$321,348
Contributions received from other sources (not participants or employers)	2013-12-31	$78,877
Other income received	2013-12-31	$1,479,378
Net income (gross income less expenses)	2013-12-31	$1,748,867
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$8,933,257
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$7,184,390
Assets. Value of participant loans	2013-12-31	$0
Total contributions received or receivable from employer(s)	2013-12-31	$193,232
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$225
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$1,275,818
Expenses. Total of all expenses incurred	2012-12-31	$270,187
Benefits paid (including direct rollovers)	2012-12-31	$270,112
Total plan assets at end of year	2012-12-31	$7,184,390
Total plan assets at beginning of year	2012-12-31	$6,178,759
Value of fidelity bond covering the plan	2012-12-31	$3,500,000
Total contributions received or receivable from participants	2012-12-31	$295,600
Contributions received from other sources (not participants or employers)	2012-12-31	$2,871
Other income received	2012-12-31	$778,589
Net income (gross income less expenses)	2012-12-31	$1,005,631
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$7,184,390
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$6,178,759
Assets. Value of participant loans	2012-12-31	$0
Total contributions received or receivable from employer(s)	2012-12-31	$198,758
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$75
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
2011 : CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$236,146
Expenses. Total of all expenses incurred	2011-12-31	$1,730
Benefits paid (including direct rollovers)	2011-12-31	$1,705
Total plan assets at end of year	2011-12-31	$6,178,759
Total plan assets at beginning of year	2011-12-31	$5,944,343
Value of fidelity bond covering the plan	2011-12-31	$3,500,000
Total contributions received or receivable from participants	2011-12-31	$264,437
Expenses. Other expenses not covered elsewhere	2011-12-31	$25
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-207,377
Net income (gross income less expenses)	2011-12-31	$234,416
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$6,178,759
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$5,944,343
Assets. Value of participant loans	2011-12-31	$0
Total contributions received or receivable from employer(s)	2011-12-31	$179,086
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0
2010 : CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total income from all sources	2010-12-31	$1,027,914
Expenses. Total of all expenses incurred	2010-12-31	$494,008
Benefits paid (including direct rollovers)	2010-12-31	$493,908
Total plan assets at end of year	2010-12-31	$5,944,343
Total plan assets at beginning of year	2010-12-31	$5,410,437
Value of fidelity bond covering the plan	2010-12-31	$3,500,000
Total contributions received or receivable from participants	2010-12-31	$242,476
Expenses. Other expenses not covered elsewhere	2010-12-31	$100
Contributions received from other sources (not participants or employers)	2010-12-31	$11,188
Other income received	2010-12-31	$600,822
Net income (gross income less expenses)	2010-12-31	$533,906
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$5,944,343
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$5,410,437
Assets. Value of participant loans	2010-12-31	$0
Total contributions received or receivable from employer(s)	2010-12-31	$173,428
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$0
Amount contributed by the employer to the plan for this plan year	2010-12-31	$0
2009 : CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year	2009-12-31	$0
Minimum employer required contribution for this plan year	2009-12-31	$0
Amount contributed by the employer to the plan for this plan year	2009-12-31	$0

Form 5500 Responses for CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN

2014: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: CLEAR LAKE BANK AND TRUST CO. 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-710442

Policy instance

Insurance contract or identification number	GA-710442
Number of Individuals Covered	85
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $36,467
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $36,467
Insurance broker organization code?	3
Insurance broker name	SECURITIES AMERICA INC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-710442

Policy instance

Insurance contract or identification number	GA-710442
Number of Individuals Covered	77
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $30,468
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23,510
Insurance broker organization code?	3
Insurance broker name	EAGLE ONE INVESTMENTS LLC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-710442

Policy instance

Insurance contract or identification number	GA-710442
Number of Individuals Covered	70
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $25,978
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,978
Insurance broker organization code?	3
Insurance broker name	EAGLE ONE INVESTMENTS LLC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-710442

Policy instance

Insurance contract or identification number	GA-710442
Number of Individuals Covered	66
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $24,304
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-710442

Policy instance

Insurance contract or identification number	GA-710442
Number of Individuals Covered	59
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $21,700
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,700
Insurance broker organization code?	3
Insurance broker name	EAGLE ONE INVESTMENTS LLC

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Company Name:	CLEAR LAKE BANK AND TRUST COMPANY
Employer identification number (EIN):	420185531
NAIC Classification:	522110
NAIC Description:	Commercial Banking

Jurisdiction of Incorporation:	Iowa Secretary of State Business Entities
Incorporation Date:	1939-10-19
Company Identification Number:	084751
Legal Registered Office Address:	322 MAIN AVE. CLEAR LAKE United States of America (USA) 50428