401k Plan data: COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN plan

COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN
Plan identification number	004

COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING 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

COMMUNITY BANK OF THE SOUTH has sponsored the creation of one or more 401k plans.

Company Name: COMMUNITY BANK OF THE SOUTH

Employer identification number (EIN): 582453395

NAIC Classification: 522120
NAIC Description: Savings Institutions

Additional information about COMMUNITY BANK OF THE SOUTH

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 1999-09-22

Company Identification Number: P99000084114

Legal Registered Office Address: 277 NORTH SYKES CREEK PARKWAY

MERRITT ISLAND

32953

More information about COMMUNITY BANK OF THE SOUTH

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2018-01-01 PHYLLIS BOYETT 2018-08-06 PHYLLIS BOYETT 2018-08-06
004 2017-01-01 PHYLLIS BOYETT 2018-05-10 PHYLLIS BOYETT 2018-05-10
004 2016-01-01 PHYLLIS BOYETT 2017-08-10 PHYLLIS BOYETT 2017-08-10
004 2015-01-01 PHYLLIS BOYETT 2016-10-11 PHYLLIS BOYETT 2016-10-11
004 2015-01-01
004 2015-01-01 PHYLLIS BOYETT 2016-10-11 PHYLLIS BOYETT 2016-10-11
004 2014-01-01 MARY TINSLEY
004 2013-01-01 MARY TINSLEY
004 2012-01-01 MARY TINSLEY
004 2011-01-01 MARY TINSLEY
004 2010-01-01 MARY TINSLEY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
004	2018-01-01	PHYLLIS BOYETT	2018-08-06	PHYLLIS BOYETT	2018-08-06
004	2017-01-01	PHYLLIS BOYETT	2018-05-10	PHYLLIS BOYETT	2018-05-10
004	2016-01-01	PHYLLIS BOYETT	2017-08-10	PHYLLIS BOYETT	2017-08-10
004	2015-01-01	PHYLLIS BOYETT	2016-10-11	PHYLLIS BOYETT	2016-10-11
004	2015-01-01
004	2015-01-01	PHYLLIS BOYETT	2016-10-11	PHYLLIS BOYETT	2016-10-11
004	2014-01-01	MARY TINSLEY
004	2013-01-01	MARY TINSLEY
004	2012-01-01	MARY TINSLEY
004	2011-01-01	MARY TINSLEY
004	2010-01-01	MARY TINSLEY

Plan Statistics for COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN

Measure Date Value
2014: COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 71
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 62
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 11
Total of all active and inactive participants 2014-01-01 73
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 73
Number of participants with account balances 2014-01-01 63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 74
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 64
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 7
Total of all active and inactive participants 2013-01-01 71
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 71
Number of participants with account balances 2013-01-01 62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 70
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 64
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 10
Total of all active and inactive participants 2012-01-01 74
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 74
Number of participants with account balances 2012-01-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 68
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 59
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 11
Total of all active and inactive participants 2011-01-01 70
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 70
Number of participants with account balances 2011-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2010: COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 76
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 57
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 11
Total of all active and inactive participants 2010-01-01 68
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 68
Number of participants with account balances 2010-01-01 57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0

Measure	Date	Value
2014: COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	71
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	62
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	11
Total of all active and inactive participants	2014-01-01	73
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	73
Number of participants with account balances	2014-01-01	63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	74
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	64
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	7
Total of all active and inactive participants	2013-01-01	71
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	71
Number of participants with account balances	2013-01-01	62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	70
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	64
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	10
Total of all active and inactive participants	2012-01-01	74
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	74
Number of participants with account balances	2012-01-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	68
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	59
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	11
Total of all active and inactive participants	2011-01-01	70
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	70
Number of participants with account balances	2011-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2010: COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	76
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	57
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	11
Total of all active and inactive participants	2010-01-01	68
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	68
Number of participants with account balances	2010-01-01	57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0

Financial Data on COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2014 : COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$433,258
Expenses. Total of all expenses incurred	2014-12-31	$66,995
Benefits paid (including direct rollovers)	2014-12-31	$64,865
Total plan assets at end of year	2014-12-31	$3,025,984
Total plan assets at beginning of year	2014-12-31	$2,659,721
Value of fidelity bond covering the plan	2014-12-31	$1,000,000
Total contributions received or receivable from participants	2014-12-31	$251,018
Contributions received from other sources (not participants or employers)	2014-12-31	$2,138
Other income received	2014-12-31	$91,112
Net income (gross income less expenses)	2014-12-31	$366,263
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$3,025,984
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$2,659,721
Assets. Value of participant loans	2014-12-31	$79,600
Total contributions received or receivable from employer(s)	2014-12-31	$88,990
Value of certain deemed distributions of participant loans	2014-12-31	$2,130
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$6,199
Total income from all sources	2013-12-31	$539,658
Expenses. Total of all expenses incurred	2013-12-31	$58,258
Benefits paid (including direct rollovers)	2013-12-31	$58,258
Total plan assets at end of year	2013-12-31	$2,659,721
Total plan assets at beginning of year	2013-12-31	$2,172,122
Value of fidelity bond covering the plan	2013-12-31	$2,000,000
Total contributions received or receivable from participants	2013-12-31	$206,255
Contributions received from other sources (not participants or employers)	2013-12-31	$2,685
Other income received	2013-12-31	$291,149
Net income (gross income less expenses)	2013-12-31	$481,400
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$2,659,721
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$2,172,122
Assets. Value of participant loans	2013-12-31	$78,873
Total contributions received or receivable from employer(s)	2013-12-31	$39,569
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$375,344
Expenses. Total of all expenses incurred	2012-12-31	$99,487
Benefits paid (including direct rollovers)	2012-12-31	$89,460
Total plan assets at end of year	2012-12-31	$2,172,122
Total plan assets at beginning of year	2012-12-31	$1,896,265
Value of fidelity bond covering the plan	2012-12-31	$2,000,000
Total contributions received or receivable from participants	2012-12-31	$165,690
Other income received	2012-12-31	$177,497
Net income (gross income less expenses)	2012-12-31	$275,857
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$2,172,122
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,896,265
Assets. Value of participant loans	2012-12-31	$83,505
Total contributions received or receivable from employer(s)	2012-12-31	$32,157
Value of corrective distributions	2012-12-31	$10,027
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$164,773
Expenses. Total of all expenses incurred	2011-12-31	$47,525
Benefits paid (including direct rollovers)	2011-12-31	$47,525
Total plan assets at end of year	2011-12-31	$1,896,265
Total plan assets at beginning of year	2011-12-31	$1,779,017
Value of fidelity bond covering the plan	2011-12-31	$2,000,000
Total contributions received or receivable from participants	2011-12-31	$155,986
Contributions received from other sources (not participants or employers)	2011-12-31	$817
Other income received	2011-12-31	$-22,028
Net income (gross income less expenses)	2011-12-31	$117,248
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,896,265
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,779,017
Assets. Value of participant loans	2011-12-31	$75,719
Total contributions received or receivable from employer(s)	2011-12-31	$29,998
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$375,238
Expenses. Total of all expenses incurred	2010-12-31	$313,606
Benefits paid (including direct rollovers)	2010-12-31	$313,606
Total plan assets at end of year	2010-12-31	$1,779,017
Total plan assets at beginning of year	2010-12-31	$1,717,385
Value of fidelity bond covering the plan	2010-12-31	$2,000,000
Total contributions received or receivable from participants	2010-12-31	$133,697
Contributions received from other sources (not participants or employers)	2010-12-31	$19,376
Other income received	2010-12-31	$222,165
Net income (gross income less expenses)	2010-12-31	$61,632
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,779,017
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,717,385
Assets. Value of participant loans	2010-12-31	$85,159
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for COMMUNITY BANK OF THE SOUTH 401(K) PROFIT SHARING PLAN

2014: COMMUNITY BANK OF THE SOUTH 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
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: COMMUNITY BANK OF THE SOUTH 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
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: COMMUNITY BANK OF THE SOUTH 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
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: COMMUNITY BANK OF THE SOUTH 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	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
2010: COMMUNITY BANK OF THE SOUTH 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 – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-B2-DG3X

Policy instance

Insurance contract or identification number	GAP-B2-DG3X
Number of Individuals Covered	63
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $397
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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 $397
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INVESTMENT
Insurance broker organization code?	3
Insurance broker name	INVEST FINANCIAL CORPORATION

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-B2-DG3X

Policy instance

Insurance contract or identification number	GAP-B2-DG3X
Number of Individuals Covered	62
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $817
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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 $817
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INVESTMENT
Insurance broker organization code?	3
Insurance broker name	INVEST FINANCIAL CORPORATION

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-B2-DG3X

Policy instance

Insurance contract or identification number	GAP-B2-DG3X
Number of Individuals Covered	65
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $701
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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 $533
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INVESTMENT
Insurance broker organization code?	3
Insurance broker name	INVEST FINANCIAL CORPORATION

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-B2-DG3X

Policy instance

Insurance contract or identification number	GAP-B2-DG3X
Number of Individuals Covered	59
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $179
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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

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Company Name:	COMMUNITY BANK OF THE SOUTH
Employer identification number (EIN):	582453395
NAIC Classification:	522120
NAIC Description:	Savings Institutions

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	1999-09-22
Company Identification Number:	P99000084114
Legal Registered Office Address:	277 NORTH SYKES CREEK PARKWAY MERRITT ISLAND 32953