401k Plan data: DAVID CLARKSON, SR. AGE-WEIGHTED PROFIT SHARING PLAN plan

DAVID CLARKSON, SR. AGE-WEIGHTED PROFIT SHARING PLAN 401k Plan overview

Plan Name	DAVID CLARKSON, SR. AGE-WEIGHTED PROFIT SHARING PLAN
Plan identification number	002

DAVID CLARKSON, SR. AGE-WEIGHTED PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
Plan covering Self-Employed individuals.
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

DAVID CLARKSON, SR. has sponsored the creation of one or more 401k plans.

Company Name: DAVID CLARKSON, SR.

Employer identification number (EIN): 860037382

NAIC Classification: 524210
NAIC Description: Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DAVID CLARKSON, SR. AGE-WEIGHTED PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2010-01-01 DAVID CLARKSON DAVID CLARKSON 2011-07-21

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2010-01-01	DAVID CLARKSON		DAVID CLARKSON	2011-07-21

Plan Statistics for DAVID CLARKSON, SR. AGE-WEIGHTED PROFIT SHARING PLAN

401k plan membership statisitcs for DAVID CLARKSON, SR. AGE-WEIGHTED PROFIT SHARING PLAN

Measure Date Value
2010: DAVID CLARKSON, SR. AGE-WEIGHTED PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1
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 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 1
Number of participants with account balances 2010-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0

Measure	Date	Value
2010: DAVID CLARKSON, SR. AGE-WEIGHTED PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1
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	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	1
Number of participants with account balances	2010-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0

Financial Data on DAVID CLARKSON, SR. AGE-WEIGHTED PROFIT SHARING PLAN

Measure	Date	Value
2010 : DAVID CLARKSON, SR. AGE-WEIGHTED PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$-99,242
Expenses. Total of all expenses incurred	2010-12-31	$25,310
Benefits paid (including direct rollovers)	2010-12-31	$25,310
Total plan assets at end of year	2010-12-31	$432,267
Total plan assets at beginning of year	2010-12-31	$556,819
Total contributions received or receivable from participants	2010-12-31	$0
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$-137,154
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$-124,552
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$432,267
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$556,819
Assets. Value of real-estate (other than employer real property)	2010-12-31	$285,000
Total contributions received or receivable from employer(s)	2010-12-31	$37,912
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$0
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 DAVID CLARKSON, SR. AGE-WEIGHTED PROFIT SHARING PLAN

2010: DAVID CLARKSON, SR. AGE-WEIGHTED PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
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
2010-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	DAVID CLARKSON, SR.
Employer identification number (EIN):	860037382
NAIC Classification:	524210
NAIC Description:	Insurance Agencies and Brokerages