401k Plan data: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN plan

PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN
Plan identification number	001

PAYROLL SOLUTIONS RETIREMENT SAVINGS 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Unknown benefit code

401k Sponsoring company profile

PAYROLL SOLUTIONS III, INC. has sponsored the creation of one or more 401k plans.

Company Name: PAYROLL SOLUTIONS III, INC.

Employer identification number (EIN): 880484098

NAIC Classification: 541214
NAIC Description: Payroll Services

Additional information about PAYROLL SOLUTIONS III, INC.

Jurisdiction of Incorporation: Nevada Department of State

Incorporation Date: 2001-01-12

Company Identification Number: 20011186111

Legal Registered Office Address: 7730 W CHEYENNE AVE #112

LAS VEGAS
United States of America (USA)
89129

More information about PAYROLL SOLUTIONS III, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 MICHAEL R. MORRISON 2024-07-01 MICHAEL R. MORRISON 2024-07-01
001 2022-01-01 MICHAEL R. MORRISON 2023-06-29 MICHAEL R. MORRISON 2023-06-29
001 2021-01-01
001 2020-01-01 MICHAEL R. MORRISON 2021-10-12 MICHAEL R. MORRISON 2021-10-12
001 2019-01-01 MICHAEL R. MORRISON 2020-10-08 MICHAEL R. MORRISON 2020-10-08
001 2018-01-01 MICHAEL R. MORRISON 2019-10-14
001 2018-01-01 MICHAEL R. MORRISON 2019-10-14
001 2017-01-01 MICHAEL R. MORRISON 2018-10-14 MICHAEL R. MORRISON 2018-10-14
001 2016-01-01 MICHAEL R. MORRISON 2017-05-02 MICHAEL R. MORRISON 2017-05-02
001 2015-01-01 MICHAEL R. MORRISON MICHAEL R. MORRISON 2016-09-16
001 2014-01-01 MICHAEL R. MORRISON MICHAEL R. MORRISON 2015-09-12
001 2013-01-01 MICHAEL R. MORRISON
001 2012-01-01 MICHAEL R. MORRISON
001 2011-01-01 MICHAEL R. MORRISON MICHAEL R. MORRISON 2012-09-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2023-01-01	MICHAEL R. MORRISON	2024-07-01	MICHAEL R. MORRISON	2024-07-01
001	2022-01-01	MICHAEL R. MORRISON	2023-06-29	MICHAEL R. MORRISON	2023-06-29
001	2021-01-01
001	2020-01-01	MICHAEL R. MORRISON	2021-10-12	MICHAEL R. MORRISON	2021-10-12
001	2019-01-01	MICHAEL R. MORRISON	2020-10-08	MICHAEL R. MORRISON	2020-10-08
001	2018-01-01	MICHAEL R. MORRISON	2019-10-14
001	2018-01-01	MICHAEL R. MORRISON	2019-10-14
001	2017-01-01	MICHAEL R. MORRISON	2018-10-14	MICHAEL R. MORRISON	2018-10-14
001	2016-01-01	MICHAEL R. MORRISON	2017-05-02	MICHAEL R. MORRISON	2017-05-02
001	2015-01-01	MICHAEL R. MORRISON		MICHAEL R. MORRISON	2016-09-16
001	2014-01-01	MICHAEL R. MORRISON		MICHAEL R. MORRISON	2015-09-12
001	2013-01-01	MICHAEL R. MORRISON
001	2012-01-01	MICHAEL R. MORRISON
001	2011-01-01	MICHAEL R. MORRISON		MICHAEL R. MORRISON	2012-09-13

Plan Statistics for PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN

Measure Date Value
2018: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 92
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 30
Total of all active and inactive participants 2018-01-01 122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 122
Number of participants with account balances 2018-01-01 86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2015: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 39
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 34
Total of all active and inactive participants 2015-01-01 73
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 73
Number of participants with account balances 2015-01-01 50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 114
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 73
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 39
Total of all active and inactive participants 2014-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 112
Number of participants with account balances 2014-01-01 67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 122
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 76
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 37
Total of all active and inactive participants 2013-01-01 113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 113
Number of participants with account balances 2013-01-01 63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 91
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 51
Total of all active and inactive participants 2012-01-01 142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 142
Number of participants with account balances 2012-01-01 80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,255
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 72
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 82
Total of all active and inactive participants 2011-01-01 154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 154
Number of participants with account balances 2011-01-01 120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 7

Measure	Date	Value
2018: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	92
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	30
Total of all active and inactive participants	2018-01-01	122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	122
Number of participants with account balances	2018-01-01	86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2015: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	39
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	34
Total of all active and inactive participants	2015-01-01	73
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	73
Number of participants with account balances	2015-01-01	50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	114
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	73
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	39
Total of all active and inactive participants	2014-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	112
Number of participants with account balances	2014-01-01	67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	122
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	76
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	37
Total of all active and inactive participants	2013-01-01	113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	113
Number of participants with account balances	2013-01-01	63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	91
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	51
Total of all active and inactive participants	2012-01-01	142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	142
Number of participants with account balances	2012-01-01	80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,255
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	72
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	82
Total of all active and inactive participants	2011-01-01	154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	154
Number of participants with account balances	2011-01-01	120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	7

Financial Data on PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN

Measure	Date	Value
2018 : PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$381,964
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$114,233
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$77,916
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$477,449
Value of total assets at end of year	2018-12-31	$2,574,735
Value of total assets at beginning of year	2018-12-31	$2,307,004
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$36,317
Total interest from all sources	2018-12-31	$2,973
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$51,729
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$51,729
Was this plan covered by a fidelity bond	2018-12-31	No
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$258,148
Participant contributions at end of year	2018-12-31	$66,207
Participant contributions at beginning of year	2018-12-31	$45,924
Participant contributions at end of year	2018-12-31	$15,515
Participant contributions at beginning of year	2018-12-31	$52,568
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$814
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$436
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$267,731
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,574,735
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,307,004
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Investment advisory and management fees	2018-12-31	$4,802
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$2,483,431
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$2,189,821
Value of interest in pooled separate accounts at end of year	2018-12-31	$3,406
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$3,715
Interest on participant loans	2018-12-31	$2,973
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-149,934
Net investment gain/loss from pooled separate accounts	2018-12-31	$-253
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$219,301
Employer contributions (assets) at end of year	2018-12-31	$5,362
Employer contributions (assets) at beginning of year	2018-12-31	$14,540
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$77,916
Contract administrator fees	2018-12-31	$31,515
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	SCOTT SKIBBIE INCORPORATED
Accountancy firm EIN	2018-12-31	270851321
2015 : PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets from this plan	2015-12-31	$454,990
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$164,008
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$100,917
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$73,643
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$164,894
Value of total assets at end of year	2015-12-31	$1,164,080
Value of total assets at beginning of year	2015-12-31	$1,555,979
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$27,274
Total interest from all sources	2015-12-31	$3,796
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$25,525
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$25,525
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$110,862
Participant contributions at end of year	2015-12-31	$59,165
Participant contributions at beginning of year	2015-12-31	$98,537
Participant contributions at end of year	2015-12-31	$4,334
Participant contributions at beginning of year	2015-12-31	$4,084
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$936
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$1,041
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$63,091
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,164,080
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,555,979
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$3,401
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$1,094,764
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,446,895
Value of interest in pooled separate accounts at end of year	2015-12-31	$2,954
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$3,038
Interest on participant loans	2015-12-31	$3,796
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-30,189
Net investment gain/loss from pooled separate accounts	2015-12-31	$-18
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$54,032
Employer contributions (assets) at end of year	2015-12-31	$1,927
Employer contributions (assets) at beginning of year	2015-12-31	$2,384
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$73,643
Contract administrator fees	2015-12-31	$23,873
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	Yes
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	SCOTT SKIBBIE, INC.
Accountancy firm EIN	2015-12-31	270851321
2014 : PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$273,278
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$76,598
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$51,605
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$153,260
Value of total assets at end of year	2014-12-31	$1,555,979
Value of total assets at beginning of year	2014-12-31	$1,359,299
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$24,993
Total interest from all sources	2014-12-31	$3,861
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$21,849
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$21,849
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$99,719
Participant contributions at end of year	2014-12-31	$98,537
Participant contributions at beginning of year	2014-12-31	$117,736
Participant contributions at end of year	2014-12-31	$4,084
Participant contributions at beginning of year	2014-12-31	$3,294
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$1,041
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$2,368
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$196,680
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,555,979
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,359,299
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$3,066
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$1,446,895
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,214,404
Value of interest in pooled separate accounts at end of year	2014-12-31	$3,038
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$19,494
Interest on participant loans	2014-12-31	$3,861
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$94,017
Net investment gain/loss from pooled separate accounts	2014-12-31	$291
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$53,541
Employer contributions (assets) at end of year	2014-12-31	$2,384
Employer contributions (assets) at beginning of year	2014-12-31	$2,002
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$51,605
Contract administrator fees	2014-12-31	$21,927
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Unqualified
Accountancy firm name	2014-12-31	SCOTT SKIBBIE, INC.
Accountancy firm EIN	2014-12-31	270851321
2013 : PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets from this plan	2013-12-31	$78,301
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$348,306
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$355,110
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$328,629
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$130,132
Value of total assets at end of year	2013-12-31	$1,359,299
Value of total assets at beginning of year	2013-12-31	$1,444,404
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$26,481
Total interest from all sources	2013-12-31	$4,534
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$36,529
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$36,529
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$46,346
Participant contributions at end of year	2013-12-31	$117,736
Participant contributions at beginning of year	2013-12-31	$124,387
Participant contributions at end of year	2013-12-31	$3,294
Participant contributions at beginning of year	2013-12-31	$8,848
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$2,368
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$1,377
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$-6,804
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,359,299
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,444,404
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$2,922
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$1,214,404
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,292,813
Value of interest in pooled separate accounts at end of year	2013-12-31	$19,494
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$14,887
Interest on participant loans	2013-12-31	$4,534
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$1
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$172,304
Net investment gain/loss from pooled separate accounts	2013-12-31	$4,807
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$83,786
Employer contributions (assets) at end of year	2013-12-31	$2,002
Employer contributions (assets) at beginning of year	2013-12-31	$2,091
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$328,629
Contract administrator fees	2013-12-31	$23,559
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	No
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	SKIBBIE & COMPANY, INC.
Accountancy firm EIN	2013-12-31	205413691
2012 : PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets from this plan	2012-12-31	$469,170
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$351,505
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$102,931
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$76,406
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$179,444
Value of total assets at end of year	2012-12-31	$1,444,404
Value of total assets at beginning of year	2012-12-31	$1,665,000
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$26,525
Total interest from all sources	2012-12-31	$3,269
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$29,064
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$29,064
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$121,065
Participant contributions at end of year	2012-12-31	$124,387
Participant contributions at beginning of year	2012-12-31	$86,110
Participant contributions at end of year	2012-12-31	$8,848
Participant contributions at beginning of year	2012-12-31	$5,028
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$1,377
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$904
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$248,574
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,444,404
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,665,000
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$1,552
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$1,292,813
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$1,546,528
Value of interest in pooled separate accounts at end of year	2012-12-31	$14,887
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$23,285
Interest on participant loans	2012-12-31	$3,269
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$1
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$1
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$137,337
Net investment gain/loss from pooled separate accounts	2012-12-31	$2,391
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$58,379
Employer contributions (assets) at end of year	2012-12-31	$2,091
Employer contributions (assets) at beginning of year	2012-12-31	$3,144
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$76,406
Contract administrator fees	2012-12-31	$24,973
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	SKIBBIE & COMPANY, INC.
Accountancy firm EIN	2012-12-31	205413691
2011 : PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets from this plan	2011-12-31	$3,414,996
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$336,157
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$912,405
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$838,746
Value of total corrective distributions	2011-12-31	$16,982
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$267,465
Value of total assets at end of year	2011-12-31	$1,665,000
Value of total assets at beginning of year	2011-12-31	$5,656,244
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$56,677
Total interest from all sources	2011-12-31	$3,209
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$63,766
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$63,766
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$202,886
Participant contributions at end of year	2011-12-31	$86,110
Participant contributions at beginning of year	2011-12-31	$244,542
Participant contributions at end of year	2011-12-31	$5,028
Participant contributions at beginning of year	2011-12-31	$42,392
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$904
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$3,517
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-576,248
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,665,000
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$5,656,244
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Investment advisory and management fees	2011-12-31	$5,377
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$1,546,528
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$5,284,440
Value of interest in pooled separate accounts at end of year	2011-12-31	$23,285
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$23,018
Interest on participant loans	2011-12-31	$3,209
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$1
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$1,449
Net investment gain/loss from pooled separate accounts	2011-12-31	$268
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$64,579
Employer contributions (assets) at end of year	2011-12-31	$3,144
Employer contributions (assets) at beginning of year	2011-12-31	$58,334
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$838,746
Contract administrator fees	2011-12-31	$51,300
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	SKIBBIE & COMPANY, INC.
Accountancy firm EIN	2011-12-31	205413691

Form 5500 Responses for PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN

2018: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Mulitple employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2015: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Mulitple 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 – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Mulitple 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: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Mulitple 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: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Mulitple 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: PAYROLL SOLUTIONS RETIREMENT SAVINGS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Mulitple 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

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

GP 86420

Policy instance

Insurance contract or identification number	GP 86420
Number of Individuals Covered	0
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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?	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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

MULTIPLE

Policy instance

Insurance contract or identification number	MULTIPLE
Number of Individuals Covered	3
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $7
Total amount of fees paid to insurance company	USD $64
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
Commission paid to Insurance Broker	USD $7
Amount paid for insurance broker fees	0
Insurance broker organization code?	4
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION TO SALES REP
Insurance broker name	SLAVIC INTERGRATED

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

MULTIPLE

Policy instance

Insurance contract or identification number	MULTIPLE
Number of Individuals Covered	3
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
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?	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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

350472300

Policy instance

Insurance contract or identification number	350472300
Number of Individuals Covered	3
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
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?	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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

350472300

Policy instance

Insurance contract or identification number	350472300
Number of Individuals Covered	2
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
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?	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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

350472300

Policy instance

Insurance contract or identification number	350472300
Number of Individuals Covered	3
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
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?	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

Potentially related plans

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Company Name:	PAYROLL SOLUTIONS III, INC.
Employer identification number (EIN):	880484098
NAIC Classification:	541214
NAIC Description:	Payroll Services

Jurisdiction of Incorporation:	Nevada Department of State
Incorporation Date:	2001-01-12
Company Identification Number:	20011186111
Legal Registered Office Address:	7730 W CHEYENNE AVE #112 LAS VEGAS United States of America (USA) 89129