401k Plan data: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN plan

ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 401k Plan overview

Plan Name	ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN
Plan identification number	001

ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ROSICKI, ROSICKI & ASSOCIATES, P.C. has sponsored the creation of one or more 401k plans.

Company Name: ROSICKI, ROSICKI & ASSOCIATES, P.C.

Employer identification number (EIN): 113217082

NAIC Classification: 541110
NAIC Description: Offices of Lawyers

Additional information about ROSICKI, ROSICKI & ASSOCIATES, P.C.

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1994-06-23

Company Identification Number: 1831620

Legal Registered Office Address: 998 OLD COUNTRY ROAD #333
Nassau
PLAINVIEW
United States of America (USA)
11803

More information about ROSICKI, ROSICKI & ASSOCIATES, P.C.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01
001 2018-01-01
001 2017-01-01 DAWN POLEWAC
001 2016-01-01 DAWN POLEWAC
001 2015-01-01 DAWN POLEWAC
001 2014-01-01 DAWN POLEWAC
001 2013-01-01 DAWN POLEWAC
001 2012-01-01 DAWN POLEWAC
001 2011-01-01 DAWN POLEWAC
001 2009-01-01 DAWN POLEWAC
001 2009-01-01 DAWN POLEWAC

Plan Statistics for ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN

401k plan membership statisitcs for ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN

Measure Date Value
2019: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 240
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 0
Number of participants with account balances 2019-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 470
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 103
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 128
Total of all active and inactive participants 2018-01-01 231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 231
Number of participants with account balances 2018-01-01 187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 36
2017: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 483
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 401
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 66
Total of all active and inactive participants 2017-01-01 467
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 467
Number of participants with account balances 2017-01-01 318
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 39
2016: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 514
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 416
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 55
Total of all active and inactive participants 2016-01-01 471
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 471
Number of participants with account balances 2016-01-01 313
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 24
2015: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 540
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 460
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 46
Total of all active and inactive participants 2015-01-01 506
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 506
Number of participants with account balances 2015-01-01 298
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 23
2014: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 419
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 469
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 166
Total of all active and inactive participants 2014-01-01 635
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 635
Number of participants with account balances 2014-01-01 296
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 79
2013: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 387
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 374
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 45
Total of all active and inactive participants 2013-01-01 419
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 419
Number of participants with account balances 2013-01-01 223
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 13
2012: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 298
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 325
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 40
Total of all active and inactive participants 2012-01-01 365
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 365
Number of participants with account balances 2012-01-01 193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 10
2011: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 281
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 237
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 59
Total of all active and inactive participants 2011-01-01 296
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 296
Number of participants with account balances 2011-01-01 202
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 15
2009: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 139
Total of all active and inactive participants 2009-01-01 139
Total participants 2009-01-01 139
Number of participants with account balances 2009-01-01 139

Measure	Date	Value
2019: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	240
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	0
Number of participants with account balances	2019-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	470
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	103
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	128
Total of all active and inactive participants	2018-01-01	231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	231
Number of participants with account balances	2018-01-01	187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	36
2017: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	483
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	401
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	66
Total of all active and inactive participants	2017-01-01	467
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	467
Number of participants with account balances	2017-01-01	318
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	39
2016: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	514
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	416
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	55
Total of all active and inactive participants	2016-01-01	471
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	471
Number of participants with account balances	2016-01-01	313
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	24
2015: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	540
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	460
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	46
Total of all active and inactive participants	2015-01-01	506
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	506
Number of participants with account balances	2015-01-01	298
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	23
2014: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	419
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	469
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	166
Total of all active and inactive participants	2014-01-01	635
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	635
Number of participants with account balances	2014-01-01	296
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	79
2013: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	387
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	374
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	45
Total of all active and inactive participants	2013-01-01	419
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	419
Number of participants with account balances	2013-01-01	223
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	13
2012: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	298
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	325
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	40
Total of all active and inactive participants	2012-01-01	365
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	365
Number of participants with account balances	2012-01-01	193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	10
2011: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	281
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	237
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	59
Total of all active and inactive participants	2011-01-01	296
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	296
Number of participants with account balances	2011-01-01	202
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	15
2009: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	139
Total of all active and inactive participants	2009-01-01	139
Total participants	2009-01-01	139
Number of participants with account balances	2009-01-01	139

Financial Data on ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN

Measure	Date	Value
2019 : ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$1,555,918
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$13,480,233
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$13,400,235
Value of total corrective distributions	2019-12-31	$51,928
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$72,848
Value of total assets at end of year	2019-12-31	$0
Value of total assets at beginning of year	2019-12-31	$11,924,315
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$28,070
Total interest from all sources	2019-12-31	$4,456
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$78,724
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$78,724
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$72,627
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$173,213
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$51
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$28,070
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$-11,924,315
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$11,924,315
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$11,750,986
Interest on participant loans	2019-12-31	$4,456
Net investment gain/loss from pooled separate accounts	2019-12-31	$1,399,890
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$221
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$65
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$13,400,235
Did the plan have assets held for investment	2019-12-31	No
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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	COVATI & JANHSEN, CPA PC
Accountancy firm EIN	2019-12-31	113461263
2018 : ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) 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	$417,926
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$3,563,996
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$3,480,883
Value of total corrective distributions	2018-12-31	$35,977
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$970,714
Value of total assets at end of year	2018-12-31	$11,924,315
Value of total assets at beginning of year	2018-12-31	$15,070,385
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$47,136
Total interest from all sources	2018-12-31	$11,120
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$286,253
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	$286,253
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$695,359
Participant contributions at end of year	2018-12-31	$173,213
Participant contributions at beginning of year	2018-12-31	$286,029
Participant contributions at end of year	2018-12-31	$51
Participant contributions at beginning of year	2018-12-31	$248
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$5,824
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Other income not declared elsewhere	2018-12-31	$0
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	$-3,146,070
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$11,924,315
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$15,070,385
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
Value of interest in pooled separate accounts at end of year	2018-12-31	$11,750,986
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$14,784,011
Income. Interest from loans (other than to participants)	2018-12-31	$11,120
Net investment gain/loss from pooled separate accounts	2018-12-31	$-850,161
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	$269,531
Employer contributions (assets) at end of year	2018-12-31	$65
Employer contributions (assets) at beginning of year	2018-12-31	$97
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$3,480,883
Contract administrator fees	2018-12-31	$47,136
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	2018-12-31	Yes
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	COVATI & JANHSEN, CPA PC
Accountancy firm EIN	2018-12-31	113461263
2017 : ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$3,654,485
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$836,587
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$751,871
Value of total corrective distributions	2017-12-31	$54,828
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,432,920
Value of total assets at end of year	2017-12-31	$15,070,385
Value of total assets at beginning of year	2017-12-31	$12,252,487
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$29,888
Total interest from all sources	2017-12-31	$11,728
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$199,669
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$199,669
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$998,058
Participant contributions at end of year	2017-12-31	$286,029
Participant contributions at beginning of year	2017-12-31	$292,606
Participant contributions at end of year	2017-12-31	$248
Participant contributions at beginning of year	2017-12-31	$123
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$13,523
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$0
Other income not declared elsewhere	2017-12-31	$1,531
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$2,817,898
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$15,070,385
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$12,252,487
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in pooled separate accounts at end of year	2017-12-31	$14,784,011
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$11,959,677
Interest on participant loans	2017-12-31	$11,728
Net investment gain/loss from pooled separate accounts	2017-12-31	$2,008,637
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$421,339
Employer contributions (assets) at end of year	2017-12-31	$97
Employer contributions (assets) at beginning of year	2017-12-31	$81
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$751,871
Contract administrator fees	2017-12-31	$29,888
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	COVATI & JANHSEN, CPA PC
Accountancy firm EIN	2017-12-31	113461263
2016 : ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$2,911
Total income from all sources (including contributions)	2016-12-31	$2,453,097
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$324,032
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$230,009
Value of total corrective distributions	2016-12-31	$70,841
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,627,151
Value of total assets at end of year	2016-12-31	$12,252,487
Value of total assets at beginning of year	2016-12-31	$10,126,333
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$23,182
Total interest from all sources	2016-12-31	$12,629
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$953,114
Participant contributions at end of year	2016-12-31	$292,606
Participant contributions at beginning of year	2016-12-31	$259,952
Participant contributions at end of year	2016-12-31	$123
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$244,027
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$2,911
Other income not declared elsewhere	2016-12-31	$171
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$2,129,065
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$12,252,487
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$10,123,422
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$11,959,677
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$9,866,381
Interest on participant loans	2016-12-31	$12,629
Net investment gain/loss from pooled separate accounts	2016-12-31	$813,146
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$430,010
Employer contributions (assets) at end of year	2016-12-31	$81
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$230,009
Contract administrator fees	2016-12-31	$23,182
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	COVATI & JANHSEN, CPA PC
Accountancy firm EIN	2016-12-31	113461263
2015 : ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$2,911
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	$1,312,526
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$731,252
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$631,639
Value of total corrective distributions	2015-12-31	$80,748
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,348,687
Value of total assets at end of year	2015-12-31	$10,126,333
Value of total assets at beginning of year	2015-12-31	$9,542,148
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$18,865
Total interest from all sources	2015-12-31	$8,017
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
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	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$891,993
Participant contributions at end of year	2015-12-31	$259,952
Participant contributions at beginning of year	2015-12-31	$117,472
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$49,480
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$2,911
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$0
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	$581,274
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$10,123,422
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$9,542,148
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
Value of interest in pooled separate accounts at end of year	2015-12-31	$9,866,381
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$9,424,676
Interest on participant loans	2015-12-31	$8,017
Net investment gain/loss from pooled separate accounts	2015-12-31	$-44,178
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	$407,214
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$631,639
Contract administrator fees	2015-12-31	$18,865
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	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	COVATI & JANHSEN, CPA PC
Accountancy firm EIN	2015-12-31	113461263
2014 : ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$1,733,856
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	$1,438,877
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$210,607
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$205,598
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,061,236
Value of total assets at end of year	2014-12-31	$9,542,148
Value of total assets at beginning of year	2014-12-31	$6,580,022
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$5,009
Total interest from all sources	2014-12-31	$3,330
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$673,227
Participant contributions at end of year	2014-12-31	$117,472
Participant contributions at beginning of year	2014-12-31	$57,940
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$55,391
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$50,102
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	$1,228,270
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$9,542,148
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$6,580,022
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
Value of interest in pooled separate accounts at end of year	2014-12-31	$9,424,676
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$6,471,980
Interest on participant loans	2014-12-31	$3,330
Net investment gain/loss from pooled separate accounts	2014-12-31	$374,311
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	$332,618
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$205,598
Contract administrator fees	2014-12-31	$5,009
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	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	COVATI & JANHSEN, CPA PC
Accountancy firm EIN	2014-12-31	113461263
2013 : ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
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	$1,815,663
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$345,092
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$324,838
Value of total corrective distributions	2013-12-31	$18,918
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$899,075
Value of total assets at end of year	2013-12-31	$6,529,920
Value of total assets at beginning of year	2013-12-31	$5,059,349
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,336
Total interest from all sources	2013-12-31	$3,035
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$598,313
Participant contributions at end of year	2013-12-31	$57,940
Participant contributions at beginning of year	2013-12-31	$50,509
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$17,544
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$5,042
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$2,254
Other income not declared elsewhere	2013-12-31	$50,102
Total non interest bearing cash at end of year	2013-12-31	$0
Total non interest bearing cash at beginning of year	2013-12-31	$6,915
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	$1,470,571
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$6,529,920
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$5,059,349
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
Value of interest in pooled separate accounts at end of year	2013-12-31	$6,471,980
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$4,972,678
Interest on participant loans	2013-12-31	$3,035
Net investment gain/loss from pooled separate accounts	2013-12-31	$913,553
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
Assets. Invements in employer securities at end of year	2013-12-31	$0
Assets. Invements in employer securities at beginning of year	2013-12-31	$0
Contributions received in cash from employer	2013-12-31	$295,720
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$9,449
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$324,838
Contract administrator fees	2013-12-31	$1,336
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	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	COVATI & JANHSEN, CPA PC
Accountancy firm EIN	2013-12-31	113461263
2012 : ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets to this plan	2012-12-31	$5,479
Total transfer of assets from this plan	2012-12-31	$17,838
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	$1,297,968
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$209,032
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$198,518
Value of total corrective distributions	2012-12-31	$9,703
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$777,938
Value of total assets at end of year	2012-12-31	$5,059,349
Value of total assets at beginning of year	2012-12-31	$3,982,772
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$811
Total interest from all sources	2012-12-31	$2,615
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
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	$501,022
Participant contributions at end of year	2012-12-31	$50,509
Participant contributions at beginning of year	2012-12-31	$57,194
Participant contributions at end of year	2012-12-31	$17,544
Participant contributions at beginning of year	2012-12-31	$18,690
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$23,226
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$2,254
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$2,254
Total non interest bearing cash at end of year	2012-12-31	$6,915
Total non interest bearing cash at beginning of year	2012-12-31	$0
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	$1,088,936
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$5,059,349
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$3,982,772
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	$811
Value of interest in pooled separate accounts at end of year	2012-12-31	$4,972,678
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$3,895,482
Interest on participant loans	2012-12-31	$2,615
Net investment gain/loss from pooled separate accounts	2012-12-31	$517,415
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
Assets. Invements in employer securities at end of year	2012-12-31	$0
Assets. Invements in employer securities at beginning of year	2012-12-31	$0
Contributions received in cash from employer	2012-12-31	$253,690
Employer contributions (assets) at end of year	2012-12-31	$9,449
Employer contributions (assets) at beginning of year	2012-12-31	$9,152
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$198,518
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	Disclaimer
Accountancy firm name	2012-12-31	COVATI & JANHSEN, CPA PC
Accountancy firm EIN	2012-12-31	113461263
2011 : ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets to this plan	2011-12-31	$46,734
Total transfer of assets from this plan	2011-12-31	$223,985
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	$585,093
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$319,421
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$313,354
Value of total corrective distributions	2011-12-31	$5,464
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$700,137
Value of total assets at end of year	2011-12-31	$3,982,772
Value of total assets at beginning of year	2011-12-31	$3,894,351
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$603
Total interest from all sources	2011-12-31	$3,170
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$87,143
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	$87,143
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,000,000
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	$464,787
Participant contributions at end of year	2011-12-31	$57,194
Participant contributions at beginning of year	2011-12-31	$59,570
Participant contributions at end of year	2011-12-31	$18,690
Participant contributions at beginning of year	2011-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$6,558
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$2,254
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$2,254
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	$265,672
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$3,982,772
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$3,894,351
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
Value of interest in pooled separate accounts at end of year	2011-12-31	$3,895,482
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$3,832,527
Interest on participant loans	2011-12-31	$3,170
Net investment gain/loss from pooled separate accounts	2011-12-31	$-205,357
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
Assets. Invements in employer securities at end of year	2011-12-31	$0
Assets. Invements in employer securities at beginning of year	2011-12-31	$0
Contributions received in cash from employer	2011-12-31	$228,792
Employer contributions (assets) at end of year	2011-12-31	$9,152
Employer contributions (assets) at beginning of year	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$313,354
Contract administrator fees	2011-12-31	$603
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	Disclaimer
Accountancy firm name	2011-12-31	COVATI & JANHSEN, CPA PC
Accountancy firm EIN	2011-12-31	113461263
2010 : ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$1,426,777
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$320,693
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$302,830
Value of total corrective distributions	2010-12-31	$4,228
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$690,901
Value of total assets at end of year	2010-12-31	$3,894,351
Value of total assets at beginning of year	2010-12-31	$2,788,267
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$13,635
Total interest from all sources	2010-12-31	$10,046
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$200,000
If this is an individual account plan, was there a blackout period	2010-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$444,899
Participant contributions at end of year	2010-12-31	$59,570
Participant contributions at beginning of year	2010-12-31	$23,832
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$18,510
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$2,254
Administrative expenses (other) incurred	2010-12-31	$13,373
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$1,106,084
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$3,894,351
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$2,788,267
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$2,764,435
Value of interest in pooled separate accounts at end of year	2010-12-31	$3,832,527
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$0
Interest on participant loans	2010-12-31	$2,051
Interest earned on other investments	2010-12-31	$7,995
Net investment gain/loss from pooled separate accounts	2010-12-31	$725,830
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$227,492
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$302,830
Contract administrator fees	2010-12-31	$262
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	2010-12-31	Yes
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	COVATI & JANHSEN, CPA PC
Accountancy firm EIN	2010-12-31	113461263

Form 5500 Responses for ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN

2019: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	Yes
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single 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 – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – 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: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) 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: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	Yes
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: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
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: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: ROSICKI, ROSICKI & ASSOCIATES, P.C. 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

517359

Policy instance

Insurance contract or identification number	517359
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,561
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?	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	2561
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	5

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

517359

Policy instance

Insurance contract or identification number	517359
Number of Individuals Covered	187
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 $6,547
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?	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	6547
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	5

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

517042

Policy instance

Insurance contract or identification number	517042
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 $-87
Total amount of fees paid to insurance company	USD $637
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?	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	637
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	5

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

517042

Policy instance

Insurance contract or identification number	517042
Number of Individuals Covered	318
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $611
Total amount of fees paid to insurance company	USD $6,779
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?	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	6779
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	5
Insurance broker name	MERRILL LYNCH PIERCE FENNER & SMITH

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

517042

Policy instance

Insurance contract or identification number	517042
Number of Individuals Covered	298
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $9,129
Total amount of fees paid to insurance company	USD $31,017
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	31017
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	5
Insurance broker name	MORGAN STANLEY SMITH BARNEY HOLDING

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

517042

Policy instance

Insurance contract or identification number	517042
Number of Individuals Covered	635
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $70,508
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,844
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY SMITH BARNEY HOLDING

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

821468

Policy instance

Insurance contract or identification number	821468
Number of Individuals Covered	203
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $15,571
Total amount of fees paid to insurance company	USD $2,595
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $15,571
Insurance broker organization code?	3
Amount paid for insurance broker fees	2595
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE FEES
Insurance broker name	ASSOCIATED PENSION CONSULTANTS, INC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

821468

Policy instance

Insurance contract or identification number	821468
Number of Individuals Covered	189
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $12,900
Total amount of fees paid to insurance company	USD $2,135
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,834
Insurance broker organization code?	3
Amount paid for insurance broker fees	2135
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE FEES
Insurance broker name	MORGAN STANLEY SMITH BARNEY LLC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

821468

Policy instance

Insurance contract or identification number	821468
Number of Individuals Covered	201
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $8,343
Total amount of fees paid to insurance company	USD $1,971
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

821468

Policy instance

Insurance contract or identification number	821468
Number of Individuals Covered	209
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $34,480
Total amount of fees paid to insurance company	USD $5,728
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ROSICKI, ROSICKI & ASSOCIATES, P.C.
Employer identification number (EIN):	113217082
NAIC Classification:	541110
NAIC Description:	Offices of Lawyers

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1994-06-23
Company Identification Number:	1831620
Legal Registered Office Address:	998 OLD COUNTRY ROAD #333 Nassau PLAINVIEW United States of America (USA) 11803