401k Plan data: PIPER INSURANCE RETIREMENT PLAN plan

PIPER INSURANCE RETIREMENT PLAN 401k Plan overview

Plan Name	PIPER INSURANCE RETIREMENT PLAN
Plan identification number	001

PIPER INSURANCE RETIREMENT 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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

PIPER INSURANCE, INC. has sponsored the creation of one or more 401k plans.

Company Name: PIPER INSURANCE, INC.

Employer identification number (EIN): 464103624

NAIC Classification: 524210
NAIC Description: Insurance Agencies and Brokerages

Additional information about PIPER INSURANCE, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 2013-11-13

Company Identification Number: P13000092313

Legal Registered Office Address: 3529 SANDBURG RD.

JACKSONVILLE

32277

More information about PIPER INSURANCE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PIPER INSURANCE RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 DAVID R. PIPER DAVID R. PIPER 2016-09-13
001 2015-01-01 DAVID R. PIPER DAVID R. PIPER 2016-09-12
001 2014-01-01 DAVID R. PIPER DAVID R. PIPER 2015-06-09

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	DAVID R. PIPER	DAVID R. PIPER	2016-09-13
001	2015-01-01	DAVID R. PIPER	DAVID R. PIPER	2016-09-12
001	2014-01-01	DAVID R. PIPER	DAVID R. PIPER	2015-06-09

Plan Statistics for PIPER INSURANCE RETIREMENT PLAN

401k plan membership statisitcs for PIPER INSURANCE RETIREMENT PLAN

Measure Date Value
2016: PIPER INSURANCE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 0
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: PIPER INSURANCE RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 1
Number of participants with account balances 2015-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: PIPER INSURANCE RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1
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 0
Total of all active and inactive participants 2014-01-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 1
Number of participants with account balances 2014-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0

Measure	Date	Value
2016: PIPER INSURANCE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	0
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: PIPER INSURANCE RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	1
Number of participants with account balances	2015-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: PIPER INSURANCE RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1
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	0
Total of all active and inactive participants	2014-01-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	1
Number of participants with account balances	2014-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0

Financial Data on PIPER INSURANCE RETIREMENT PLAN

Measure	Date	Value
2016 : PIPER INSURANCE RETIREMENT PLAN 2016 401k financial data
Total income from all sources	2016-06-16	$-11,284
Expenses. Total of all expenses incurred	2016-06-16	$277
Benefits paid (including direct rollovers)	2016-06-16	$227
Total plan assets at end of year	2016-06-16	$0
Total plan assets at beginning of year	2016-06-16	$11,561
Expenses. Other expenses not covered elsewhere	2016-06-16	$50
Other income received	2016-06-16	$-11,284
Net income (gross income less expenses)	2016-06-16	$-11,561
Net plan assets at end of year (total assets less liabilities)	2016-06-16	$0
Net plan assets at beginning of year (total assets less liabilities)	2016-06-16	$11,561
Assets. Value of employer securities	2016-06-16	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-06-16	$0
2015 : PIPER INSURANCE RETIREMENT PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$-22,630
Expenses. Total of all expenses incurred	2015-12-31	$150
Total plan assets at end of year	2015-12-31	$11,561
Total plan assets at beginning of year	2015-12-31	$34,341
Expenses. Other expenses not covered elsewhere	2015-12-31	$150
Other income received	2015-12-31	$-22,630
Net income (gross income less expenses)	2015-12-31	$-22,780
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$11,561
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$34,341
Assets. Value of employer securities	2015-12-31	$11,284
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : PIPER INSURANCE RETIREMENT PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$34,561
Expenses. Total of all expenses incurred	2014-12-31	$220
Total plan assets at end of year	2014-12-31	$34,341
Expenses. Other expenses not covered elsewhere	2014-12-31	$220
Contributions received from other sources (not participants or employers)	2014-12-31	$99,641
Other income received	2014-12-31	$-65,080
Net income (gross income less expenses)	2014-12-31	$34,341
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$34,341
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$0
Assets. Value of employer securities	2014-12-31	$33,914

Form 5500 Responses for PIPER INSURANCE RETIREMENT PLAN

2016: PIPER INSURANCE RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	Yes
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: PIPER INSURANCE RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: PIPER INSURANCE RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	First time form 5500 has been submitted	Yes
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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes

Potentially related plans

PIPER INSURANCE AGENCY INC. 401(K) P/S PLAN [EIN = 141841573]

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Company Name:	PIPER INSURANCE, INC.
Employer identification number (EIN):	464103624
NAIC Classification:	524210
NAIC Description:	Insurance Agencies and Brokerages

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	2013-11-13
Company Identification Number:	P13000092313
Legal Registered Office Address:	3529 SANDBURG RD. JACKSONVILLE 32277