401k Plan data: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN plan

GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 401k Plan overview

Plan Name	GRACE CHURCH COMMUNITY CENTER 403(B) PLAN
Plan identification number	002

GRACE CHURCH COMMUNITY CENTER 403(B) 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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

LIFTING UP WESTCHESTER has sponsored the creation of one or more 401k plans.

Company Name: LIFTING UP WESTCHESTER

Employer identification number (EIN): 133121606

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRACE CHURCH COMMUNITY CENTER 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 CARL WILLIAMS 2023-10-12
002 2021-01-01 CARL WILLIAMS 2022-10-11
002 2020-01-01 CARL WILLIAMS 2021-12-21
002 2019-01-01 CARL WILLIAMS 2021-12-20
002 2018-01-01
002 2014-01-01 ANAHAITA KOTVAL ANAHAITA KOTVAL 2019-04-10
002 2013-01-01 ANAHAITA KOTVAL ANAHAITA KOTVAL 2019-04-10
002 2012-01-01 ANAHAITA KOTVAL ANAHAITA KOTVAL 2019-04-10
002 2011-01-01 ANAHAITA KOTVAL ANAHAITA KOTVAL 2019-04-10
002 2010-01-01 ANAHAITA KOTVAL ANAHAITA KOTVAL 2019-04-10
002 2009-01-01 PAUL ANDERSON-WINCHELL PAUL ANDERSON-WINCHELL 2010-10-14
002 2009-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01	CARL WILLIAMS	2023-10-12
002	2021-01-01	CARL WILLIAMS	2022-10-11
002	2020-01-01	CARL WILLIAMS	2021-12-21
002	2019-01-01	CARL WILLIAMS	2021-12-20
002	2018-01-01
002	2014-01-01	ANAHAITA KOTVAL		ANAHAITA KOTVAL	2019-04-10
002	2013-01-01	ANAHAITA KOTVAL		ANAHAITA KOTVAL	2019-04-10
002	2012-01-01	ANAHAITA KOTVAL		ANAHAITA KOTVAL	2019-04-10
002	2011-01-01	ANAHAITA KOTVAL		ANAHAITA KOTVAL	2019-04-10
002	2010-01-01	ANAHAITA KOTVAL		ANAHAITA KOTVAL	2019-04-10
002	2009-01-01	PAUL ANDERSON-WINCHELL		PAUL ANDERSON-WINCHELL	2010-10-14
002	2009-01-01

Plan Statistics for GRACE CHURCH COMMUNITY CENTER 403(B) PLAN

401k plan membership statisitcs for GRACE CHURCH COMMUNITY CENTER 403(B) PLAN

Measure Date Value
2022: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 93
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 72
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 21
Total of all active and inactive participants 2022-01-01 93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 93
Number of participants with account balances 2022-01-01 46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 227
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 74
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 20
Total of all active and inactive participants 2021-01-01 94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 94
Number of participants with account balances 2021-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 1
2020: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 243
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 217
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 11
Total of all active and inactive participants 2020-01-01 228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 228
Number of participants with account balances 2020-01-01 42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1
2019: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 244
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 234
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 8
Total of all active and inactive participants 2019-01-01 242
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 242
Number of participants with account balances 2019-01-01 36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 1
2018: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 327
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 310
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 16
Total of all active and inactive participants 2018-01-01 326
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 1
Total participants 2018-01-01 327
Number of participants with account balances 2018-01-01 40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2014: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 37
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 34
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 5
Total of all active and inactive participants 2014-01-01 39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 39
Number of participants with account balances 2014-01-01 38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 35
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 30
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 7
Total of all active and inactive participants 2013-01-01 37
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 37
Number of participants with account balances 2013-01-01 37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 194
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 194
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 0
Total of all active and inactive participants 2012-01-01 194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 194
Number of participants with account balances 2012-01-01 32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 194
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 28
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 4
Total of all active and inactive participants 2011-01-01 32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 32
Number of participants with account balances 2011-01-01 32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2010: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 170
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 191
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 3
Total of all active and inactive participants 2010-01-01 194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 194
Number of participants with account balances 2010-01-01 27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 176
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 151
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 3
Total of all active and inactive participants 2009-01-01 154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 154
Number of participants with account balances 2009-01-01 30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2022: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	93
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	72
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	21
Total of all active and inactive participants	2022-01-01	93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	93
Number of participants with account balances	2022-01-01	46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	227
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	74
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	20
Total of all active and inactive participants	2021-01-01	94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	94
Number of participants with account balances	2021-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	1
2020: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	243
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	217
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	11
Total of all active and inactive participants	2020-01-01	228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	228
Number of participants with account balances	2020-01-01	42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1
2019: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	244
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	234
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	8
Total of all active and inactive participants	2019-01-01	242
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	242
Number of participants with account balances	2019-01-01	36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	1
2018: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	327
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	310
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	16
Total of all active and inactive participants	2018-01-01	326
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	1
Total participants	2018-01-01	327
Number of participants with account balances	2018-01-01	40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2014: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	37
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	34
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	5
Total of all active and inactive participants	2014-01-01	39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	39
Number of participants with account balances	2014-01-01	38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	35
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	30
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	7
Total of all active and inactive participants	2013-01-01	37
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	37
Number of participants with account balances	2013-01-01	37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	194
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	194
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	0
Total of all active and inactive participants	2012-01-01	194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	194
Number of participants with account balances	2012-01-01	32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	194
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	28
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	4
Total of all active and inactive participants	2011-01-01	32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	32
Number of participants with account balances	2011-01-01	32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2010: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	170
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	191
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	3
Total of all active and inactive participants	2010-01-01	194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	194
Number of participants with account balances	2010-01-01	27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	176
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	151
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	3
Total of all active and inactive participants	2009-01-01	154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	154
Number of participants with account balances	2009-01-01	30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on GRACE CHURCH COMMUNITY CENTER 403(B) PLAN

Measure	Date	Value
2022 : GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2022 401k financial data
Total plan liabilities at end of year	2022-12-31	$2,140
Total plan liabilities at beginning of year	2022-12-31	$1,990
Total income from all sources	2022-12-31	$-126,316
Expenses. Total of all expenses incurred	2022-12-31	$41,524
Total plan assets at end of year	2022-12-31	$1,578,787
Total plan assets at beginning of year	2022-12-31	$1,746,477
Value of fidelity bond covering the plan	2022-12-31	$200,000
Total contributions received or receivable from participants	2022-12-31	$114,589
Expenses. Other expenses not covered elsewhere	2022-12-31	$41,524
Other income received	2022-12-31	$-273,645
Net income (gross income less expenses)	2022-12-31	$-167,840
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$1,576,647
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$1,744,487
Assets. Value of participant loans	2022-12-31	$15,353
Total contributions received or receivable from employer(s)	2022-12-31	$32,740
2021 : GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$1,990
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$3,490
Total income from all sources (including contributions)	2021-12-31	$329,513
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$68,751
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$68,751
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$178,019
Value of total assets at end of year	2021-12-31	$1,746,477
Value of total assets at beginning of year	2021-12-31	$1,487,215
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$0
Total interest from all sources	2021-12-31	$1,272
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$200,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$135,658
Participant contributions at end of year	2021-12-31	$25,810
Participant contributions at beginning of year	2021-12-31	$18,943
Participant contributions at end of year	2021-12-31	$9,236
Participant contributions at beginning of year	2021-12-31	$4,551
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$1,990
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$3,490
Administrative expenses (other) incurred	2021-12-31	$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	2021-12-31	No
Value of net income/loss	2021-12-31	$260,762
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$1,744,487
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$1,483,725
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$1,709,277
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$1,458,407
Income. Interest from loans (other than to participants)	2021-12-31	$1,272
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$150,222
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$42,361
Employer contributions (assets) at end of year	2021-12-31	$2,154
Employer contributions (assets) at beginning of year	2021-12-31	$5,314
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$68,751
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Qualified
Accountancy firm name	2021-12-31	BERARD & ASSOCIATES, CPA'S PC
Accountancy firm EIN	2021-12-31	133774222
2020 : GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$3,490
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$3,490
Total income from all sources (including contributions)	2020-12-31	$371,841
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$84,570
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$81,280
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$204,052
Value of total assets at end of year	2020-12-31	$1,487,215
Value of total assets at beginning of year	2020-12-31	$1,199,944
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$3,290
Total interest from all sources	2020-12-31	$1,729
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$200,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$160,980
Participant contributions at end of year	2020-12-31	$18,943
Participant contributions at beginning of year	2020-12-31	$33,575
Participant contributions at end of year	2020-12-31	$4,551
Participant contributions at beginning of year	2020-12-31	$11,081
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$3,490
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$3,490
Administrative expenses (other) incurred	2020-12-31	$3,290
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$287,271
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,483,725
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,196,454
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$1,458,407
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$1,152,674
Income. Interest from loans (other than to participants)	2020-12-31	$1,729
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$166,060
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$43,072
Employer contributions (assets) at end of year	2020-12-31	$5,314
Employer contributions (assets) at beginning of year	2020-12-31	$2,614
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$81,280
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	BERARD & ASSOCIATES, CPA'S, PC
Accountancy firm EIN	2020-12-31	133774222
2019 : GRACE CHURCH COMMUNITY CENTER 403(B) 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	$3,490
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	$361,165
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$585,949
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$584,971
Expenses. Certain deemed distributions of participant loans	2019-12-31	$249
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$171,285
Value of total assets at end of year	2019-12-31	$1,199,944
Value of total assets at beginning of year	2019-12-31	$1,421,238
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$729
Total interest from all sources	2019-12-31	$307
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$200,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$137,714
Participant contributions at end of year	2019-12-31	$33,575
Participant contributions at beginning of year	2019-12-31	$37,896
Participant contributions at end of year	2019-12-31	$11,081
Participant contributions 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	$3,490
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	$729
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	$-224,784
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,196,454
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,421,238
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 registered invesment companies (eg mutual funds) at end of year	2019-12-31	$786,498
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,017,166
Interest on participant loans	2019-12-31	$307
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$366,176
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$366,176
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$189,573
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	$33,571
Employer contributions (assets) at end of year	2019-12-31	$2,614
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$584,971
Did the plan have assets held for investment	2019-12-31	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	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	No
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	BERARD & ASSOCIATES, CPA'S, PC
Accountancy firm EIN	2019-12-31	133774222
2018 : GRACE CHURCH COMMUNITY CENTER 403(B) 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	$68,278
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$59,971
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$59,076
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$125,817
Value of total assets at end of year	2018-12-31	$1,421,238
Value of total assets at beginning of year	2018-12-31	$1,412,931
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$895
Total interest from all sources	2018-12-31	$13,277
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$200,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
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	$98,330
Participant contributions at end of year	2018-12-31	$37,896
Participant contributions at beginning of year	2018-12-31	$35,199
Administrative expenses (other) incurred	2018-12-31	$895
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	$8,307
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,421,238
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,412,931
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 registered invesment companies (eg mutual funds) at end of year	2018-12-31	$1,017,166
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$1,020,204
Interest on participant loans	2018-12-31	$2,263
Interest earned on other investments	2018-12-31	$11,014
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$366,176
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$357,528
Net investment gain/loss from pooled separate accounts	2018-12-31	$-70,816
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	$27,487
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$59,076
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	BERARD & ASSOCIATES, CPA'S PC
Accountancy firm EIN	2018-12-31	133774222
2014 : GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$210,461
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$41,618
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$40,102
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$157,210
Value of total assets at end of year	2014-12-31	$1,222,267
Value of total assets at beginning of year	2014-12-31	$1,053,424
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$1,516
Total interest from all sources	2014-12-31	$6,815
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	$200,000
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	$120,592
Participant contributions at end of year	2014-12-31	$32,045
Participant contributions at beginning of year	2014-12-31	$15,331
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$3,135
Administrative expenses (other) incurred	2014-12-31	$1,516
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	$168,843
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,222,267
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,053,424
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 registered invesment companies (eg mutual funds) at end of year	2014-12-31	$963,641
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$867,237
Interest on participant loans	2014-12-31	$1,326
Interest earned on other investments	2014-12-31	$5,489
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$226,581
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$170,856
Net investment gain/loss from pooled separate accounts	2014-12-31	$46,436
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	$33,483
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$40,102
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	BERARD & ASSOCIATES CPA'S PC
Accountancy firm EIN	2014-12-31	133774222
2013 : GRACE CHURCH COMMUNITY CENTER 403(B) 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	$293,993
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$67,211
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$65,981
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$156,658
Value of total assets at end of year	2013-12-31	$1,053,424
Value of total assets at beginning of year	2013-12-31	$826,659
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,230
Total interest from all sources	2013-12-31	$5,945
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	$200,000
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	$118,209
Participant contributions at end of year	2013-12-31	$15,331
Participant contributions at beginning of year	2013-12-31	$26,028
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$6,300
Administrative expenses (other) incurred	2013-12-31	$1,230
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	$226,782
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,053,424
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$826,659
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 registered invesment companies (eg mutual funds) at end of year	2013-12-31	$867,237
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$649,745
Interest on participant loans	2013-12-31	$1,043
Interest earned on other investments	2013-12-31	$4,902
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$170,856
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$150,886
Net investment gain/loss from pooled separate accounts	2013-12-31	$131,390
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$32,149
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$65,981
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	BERARD & ASSOCIATES CPA'S PC
Accountancy firm EIN	2013-12-31	133774222
2012 : GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
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	$295,311
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$69,492
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$68,035
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$219,191
Value of total assets at end of year	2012-12-31	$826,659
Value of total assets at beginning of year	2012-12-31	$600,840
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$1,457
Total interest from all sources	2012-12-31	$5,719
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	$200,000
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	$189,578
Participant contributions at end of year	2012-12-31	$26,028
Participant contributions at beginning of year	2012-12-31	$38,496
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$6
Other income not declared elsewhere	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$1,457
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	$225,819
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$826,659
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$600,840
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$649,745
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$465,351
Interest on participant loans	2012-12-31	$1,796
Interest earned on other investments	2012-12-31	$3,923
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$150,886
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$96,993
Net investment gain/loss from pooled separate accounts	2012-12-31	$70,401
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$29,607
Employer contributions (assets) at end of year	2012-12-31	$0
Employer contributions (assets) at beginning of year	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$68,035
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	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	BERARD & DONAHUE CPA'S PC
Accountancy firm EIN	2012-12-31	133774222
2011 : GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
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	$184,248
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$22,120
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$20,623
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$196,269
Value of total assets at end of year	2011-12-31	$600,840
Value of total assets at beginning of year	2011-12-31	$438,712
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$1,497
Total interest from all sources	2011-12-31	$3,182
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$200,000
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	$118,848
Participant contributions at end of year	2011-12-31	$38,496
Participant contributions at beginning of year	2011-12-31	$5,882
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$1,587
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$42,314
Other income not declared elsewhere	2011-12-31	$0
Administrative expenses (other) incurred	2011-12-31	$1,497
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	$162,128
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$600,840
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$438,712
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 registered invesment companies (eg mutual funds) at end of year	2011-12-31	$465,351
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$355,004
Interest on participant loans	2011-12-31	$804
Interest earned on other investments	2011-12-31	$2,378
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$96,993
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$68,598
Net investment gain/loss from pooled separate accounts	2011-12-31	$-15,203
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$35,107
Employer contributions (assets) at end of year	2011-12-31	$0
Employer contributions (assets) at beginning of year	2011-12-31	$7,641
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$20,623
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	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	BERARD & DONAHUE, CPA'S, PC
Accountancy firm EIN	2011-12-31	133774222
2010 : GRACE CHURCH COMMUNITY CENTER 403(B) 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	$178,241
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$22,144
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$13,818
Expenses. Certain deemed distributions of participant loans	2010-12-31	$3,909
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$137,960
Value of total assets at end of year	2010-12-31	$438,712
Value of total assets at beginning of year	2010-12-31	$282,615
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$4,417
Total interest from all sources	2010-12-31	$254
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	No
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	$99,723
Participant contributions at end of year	2010-12-31	$5,882
Participant contributions at end of year	2010-12-31	$1,587
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$7,758
Other income not declared elsewhere	2010-12-31	$40,027
Administrative expenses (other) incurred	2010-12-31	$3,354
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	$156,097
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$438,712
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$282,615
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	$355,004
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$216,434
Interest on participant loans	2010-12-31	$254
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$68,598
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$31,851
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	$30,479
Employer contributions (assets) at end of year	2010-12-31	$7,641
Employer contributions (assets) at beginning of year	2010-12-31	$34,330
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$13,818
Contract administrator fees	2010-12-31	$1,063
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	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	BERARD & DONAHUE, CPA'S, PC
Accountancy firm EIN	2010-12-31	133774222
2009 : GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year	2009-12-31	$0
Minimum employer required contribution for this plan year	2009-12-31	$0
Amount contributed by the employer to the plan for this plan year	2009-12-31	$0

Form 5500 Responses for GRACE CHURCH COMMUNITY CENTER 403(B) PLAN

2022: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	Yes
2019-01-01	This submission is the final filing	No
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
2018: GRACE CHURCH COMMUNITY CENTER 403(B) 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
2014: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	Yes
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
2013: GRACE CHURCH COMMUNITY CENTER 403(B) 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
2012: GRACE CHURCH COMMUNITY CENTER 403(B) 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
2011: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
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
2010: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: GRACE CHURCH COMMUNITY CENTER 403(B) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

GAP-D2-LT2J

Policy instance

Insurance contract or identification number	GAP-D2-LT2J
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3

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

Policy contract number

GAP-D2-LT2J

Policy instance

Insurance contract or identification number	GAP-D2-LT2J
Number of Individuals Covered	243
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Insurance broker organization code?	3

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

Policy contract number

GAP-D2-LT2J

Policy instance

Insurance contract or identification number	GAP-D2-LT2J
Number of Individuals Covered	243
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Insurance broker organization code?	3

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

Policy contract number

GA-751136

Policy instance

Insurance contract or identification number	GA-751136
Number of Individuals Covered	40
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $3,350
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $1,912
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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

Policy contract number

GA-751136

Policy instance

Insurance contract or identification number	GA-751136
Number of Individuals Covered	38
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $3,832
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $3,832
Insurance broker organization code?	3

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

Policy contract number

GA-751136

Policy instance

Insurance contract or identification number	GA-751136
Number of Individuals Covered	37
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,761
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $3,761
Insurance broker organization code?	3

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

Policy contract number

GA-751136

Policy instance

Insurance contract or identification number	GA-751136
Number of Individuals Covered	32
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $4,649
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $4,649
Insurance broker organization code?	3

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

Policy contract number

GA-751136

Policy instance

Insurance contract or identification number	GA-751136
Number of Individuals Covered	32
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $4,256
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $4,256
Insurance broker organization code?	3

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

Policy contract number

GA-751136

Policy instance

Insurance contract or identification number	GA-751136
Number of Individuals Covered	194
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,354
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $3,354
Insurance broker organization code?	3

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Company Name:	LIFTING UP WESTCHESTER
Employer identification number (EIN):	133121606
NAIC Classification:	621610
NAIC Description:	Home Health Care Services