401k Plan data: THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN plan

THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 401k Plan overview

Plan Name	THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN
Plan identification number	001

THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
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.

401k Sponsoring company profile

THE COUNTRY CLUB OF ST. ALBANS, INC. has sponsored the creation of one or more 401k plans.

Company Name: THE COUNTRY CLUB OF ST. ALBANS, INC.

Employer identification number (EIN): 430889658

NAIC Classification: 713900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01
001 2016-01-01
001 2015-01-01 BEVERLY SPATH 2016-10-14
001 2014-01-01 DAVID DERFEL 2015-10-09
001 2013-01-01 DAVID DERFEL
001 2012-01-01 DAVID DERFEL
001 2011-01-01 DAVID DERFEL
001 2009-01-01 LAWRENCE AVERY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2017-01-01
001	2016-01-01
001	2015-01-01	BEVERLY SPATH	2016-10-14
001	2014-01-01	DAVID DERFEL	2015-10-09
001	2013-01-01	DAVID DERFEL
001	2012-01-01	DAVID DERFEL
001	2011-01-01	DAVID DERFEL
001	2009-01-01	LAWRENCE AVERY

Plan Statistics for THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN

401k plan membership statisitcs for THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN

Measure Date Value
2013: THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 67
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 67
Number of other retired or separated participants entitled to future benefits 2013-01-01 6
Total of all active and inactive participants 2013-01-01 73
Total participants 2013-01-01 73
Number of participants with account balances 2013-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 71
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 60
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 7
Total of all active and inactive participants 2012-01-01 67
Total participants 2012-01-01 67
Number of participants with account balances 2012-01-01 27
2011: THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 98
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 60
Number of other retired or separated participants entitled to future benefits 2011-01-01 11
Total of all active and inactive participants 2011-01-01 71
Total participants 2011-01-01 71
Number of participants with account balances 2011-01-01 34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2009: THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 89
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 95
Total participants 2009-01-01 95
Number of participants with account balances 2009-01-01 51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2013: THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	67
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	67
Number of other retired or separated participants entitled to future benefits	2013-01-01	6
Total of all active and inactive participants	2013-01-01	73
Total participants	2013-01-01	73
Number of participants with account balances	2013-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	71
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	60
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	7
Total of all active and inactive participants	2012-01-01	67
Total participants	2012-01-01	67
Number of participants with account balances	2012-01-01	27
2011: THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	98
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	60
Number of other retired or separated participants entitled to future benefits	2011-01-01	11
Total of all active and inactive participants	2011-01-01	71
Total participants	2011-01-01	71
Number of participants with account balances	2011-01-01	34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2009: THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	89
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	95
Total participants	2009-01-01	95
Number of participants with account balances	2009-01-01	51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN

Measure	Date	Value
2013 : THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 2013 401k financial data
Total plan liabilities at end of year	2013-12-31	$494
Total income from all sources	2013-12-31	$196,103
Expenses. Total of all expenses incurred	2013-12-31	$210,592
Benefits paid (including direct rollovers)	2013-12-31	$200,861
Total plan assets at end of year	2013-12-31	$577,958
Total plan assets at beginning of year	2013-12-31	$591,953
Value of fidelity bond covering the plan	2013-12-31	$500,000
Total contributions received or receivable from participants	2013-12-31	$38,350
Contributions received from other sources (not participants or employers)	2013-12-31	$97,813
Other income received	2013-12-31	$59,940
Net income (gross income less expenses)	2013-12-31	$-14,489
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$577,464
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$591,953
Assets. Value of participant loans	2013-12-31	$51,298
Value of certain deemed distributions of participant loans	2013-12-31	$4,666
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$5,065
2012 : THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$102,268
Expenses. Total of all expenses incurred	2012-12-31	$161,438
Benefits paid (including direct rollovers)	2012-12-31	$149,541
Total plan assets at end of year	2012-12-31	$591,953
Total plan assets at beginning of year	2012-12-31	$651,123
Value of fidelity bond covering the plan	2012-12-31	$500,000
Total contributions received or receivable from participants	2012-12-31	$48,945
Other income received	2012-12-31	$53,323
Net income (gross income less expenses)	2012-12-31	$-59,170
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$591,953
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$651,123
Assets. Value of participant loans	2012-12-31	$41,685
Total contributions received or receivable from employer(s)	2012-12-31	$0
Value of certain deemed distributions of participant loans	2012-12-31	$5,833
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$6,064
2011 : THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$31,237
Expenses. Total of all expenses incurred	2011-12-31	$304,505
Benefits paid (including direct rollovers)	2011-12-31	$284,805
Total plan assets at end of year	2011-12-31	$651,123
Total plan assets at beginning of year	2011-12-31	$924,391
Value of fidelity bond covering the plan	2011-12-31	$3,000,000
Total contributions received or receivable from participants	2011-12-31	$58,803
Other income received	2011-12-31	$-27,566
Net income (gross income less expenses)	2011-12-31	$-273,268
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$651,123
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$924,391
Assets. Value of participant loans	2011-12-31	$58,137
Total contributions received or receivable from employer(s)	2011-12-31	$0
Value of certain deemed distributions of participant loans	2011-12-31	$10,627
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$9,073
2010 : THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$198,710
Expenses. Total of all expenses incurred	2010-12-31	$149,578
Benefits paid (including direct rollovers)	2010-12-31	$138,302
Total plan assets at end of year	2010-12-31	$924,391
Total plan assets at beginning of year	2010-12-31	$875,259
Value of fidelity bond covering the plan	2010-12-31	$3,000,000
Total contributions received or receivable from participants	2010-12-31	$89,956
Other income received	2010-12-31	$108,754
Net income (gross income less expenses)	2010-12-31	$49,132
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$924,391
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$875,259
Assets. Value of participant loans	2010-12-31	$35,816
Value of certain deemed distributions of participant loans	2010-12-31	$1,778
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$9,498

Form 5500 Responses for THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN

2013: THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) 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
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) 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
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
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
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: THE COUNTRY CLUB OF ST. ALBANS, INC. 401(K) 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
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

GP38887

Policy instance

Insurance contract or identification number	GP38887
Number of Individuals Covered	33
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,952
Total amount of fees paid to insurance company	USD $44
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

GP38887

Policy instance

Insurance contract or identification number	GP38887
Number of Individuals Covered	43
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,138
Total amount of fees paid to insurance company	USD $20
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $2,138
Amount paid for insurance broker fees	20
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION TO SALES REP
Insurance broker organization code?	4
Insurance broker name	CUTTER AND COMPANY BROKERAGE, INC

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Company Name:	THE COUNTRY CLUB OF ST. ALBANS, INC.
Employer identification number (EIN):	430889658
NAIC Classification:	713900