401k Plan data: COGENTIX MEDICAL, INC. 401(K) PLAN plan

COGENTIX MEDICAL, INC. 401(K) PLAN 401k Plan overview

Plan Name	COGENTIX MEDICAL, INC. 401(K) PLAN
Plan identification number	001

COGENTIX MEDICAL, INC. 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

COGENTIX MEDICAL, INC. has sponsored the creation of one or more 401k plans.

Company Name: COGENTIX MEDICAL, INC.

Employer identification number (EIN): 133430173

NAIC Classification: 339110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COGENTIX MEDICAL, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2018-01-01
001 2018-01-01
001 2017-01-01 AIMEE MOORE
001 2016-01-01 BRETT REYNOLDS
001 2015-01-01 BRETT REYNOLDS BRETT REYNOLDS 2016-10-06
001 2012-04-01 HOWARD ZAUBERMAN 2013-06-17
001 2011-04-01 HOWARD ZAUBERMAN
001 2010-04-01 KATHERINE WOLF
001 2009-04-01 KATHERINE WOLF

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2018-01-01
001	2018-01-01
001	2017-01-01	AIMEE MOORE
001	2016-01-01	BRETT REYNOLDS
001	2015-01-01	BRETT REYNOLDS		BRETT REYNOLDS	2016-10-06
001	2012-04-01	HOWARD ZAUBERMAN	2013-06-17
001	2011-04-01	HOWARD ZAUBERMAN
001	2010-04-01	KATHERINE WOLF
001	2009-04-01	KATHERINE WOLF

Plan Statistics for COGENTIX MEDICAL, INC. 401(K) PLAN

401k plan membership statisitcs for COGENTIX MEDICAL, INC. 401(K) PLAN

Measure Date Value
2018: COGENTIX MEDICAL, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 257
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 141
Number of retired or separated participants receiving benefits 2018-01-01 1
Number of other retired or separated participants entitled to future benefits 2018-01-01 102
Total of all active and inactive participants 2018-01-01 244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 244
Number of participants with account balances 2018-01-01 226
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 14
2017: COGENTIX MEDICAL, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 243
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 179
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 75
Total of all active and inactive participants 2017-01-01 254
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 254
Number of participants with account balances 2017-01-01 239
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 3
2016: COGENTIX MEDICAL, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 245
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 158
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 82
Total of all active and inactive participants 2016-01-01 240
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 240
Number of participants with account balances 2016-01-01 225
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: COGENTIX MEDICAL, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 163
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 80
Total of all active and inactive participants 2015-01-01 243
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 243
Number of participants with account balances 2015-01-01 225
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2011: COGENTIX MEDICAL, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-04-01 136
Total number of active participants reported on line 7a of the Form 5500 2011-04-01 62
Number of retired or separated participants receiving benefits 2011-04-01 0
Number of other retired or separated participants entitled to future benefits 2011-04-01 22
Total of all active and inactive participants 2011-04-01 84
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-04-01 0
Total participants 2011-04-01 84
Number of participants with account balances 2011-04-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-04-01 3
2010: COGENTIX MEDICAL, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-04-01 116
Total number of active participants reported on line 7a of the Form 5500 2010-04-01 93
Number of retired or separated participants receiving benefits 2010-04-01 0
Number of other retired or separated participants entitled to future benefits 2010-04-01 15
Total of all active and inactive participants 2010-04-01 108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-04-01 0
Total participants 2010-04-01 108
Number of participants with account balances 2010-04-01 87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-04-01 1
2009: COGENTIX MEDICAL, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-04-01 149
Total number of active participants reported on line 7a of the Form 5500 2009-04-01 93
Number of retired or separated participants receiving benefits 2009-04-01 0
Number of other retired or separated participants entitled to future benefits 2009-04-01 23
Total of all active and inactive participants 2009-04-01 116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-04-01 0
Total participants 2009-04-01 116
Number of participants with account balances 2009-04-01 92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-04-01 4

Measure	Date	Value
2018: COGENTIX MEDICAL, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	257
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	141
Number of retired or separated participants receiving benefits	2018-01-01	1
Number of other retired or separated participants entitled to future benefits	2018-01-01	102
Total of all active and inactive participants	2018-01-01	244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	244
Number of participants with account balances	2018-01-01	226
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	14
2017: COGENTIX MEDICAL, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	243
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	179
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	75
Total of all active and inactive participants	2017-01-01	254
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	254
Number of participants with account balances	2017-01-01	239
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	3
2016: COGENTIX MEDICAL, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	245
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	158
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	82
Total of all active and inactive participants	2016-01-01	240
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	240
Number of participants with account balances	2016-01-01	225
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: COGENTIX MEDICAL, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	163
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	80
Total of all active and inactive participants	2015-01-01	243
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	243
Number of participants with account balances	2015-01-01	225
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2011: COGENTIX MEDICAL, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-04-01	136
Total number of active participants reported on line 7a of the Form 5500	2011-04-01	62
Number of retired or separated participants receiving benefits	2011-04-01	0
Number of other retired or separated participants entitled to future benefits	2011-04-01	22
Total of all active and inactive participants	2011-04-01	84
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-04-01	0
Total participants	2011-04-01	84
Number of participants with account balances	2011-04-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-04-01	3
2010: COGENTIX MEDICAL, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-04-01	116
Total number of active participants reported on line 7a of the Form 5500	2010-04-01	93
Number of retired or separated participants receiving benefits	2010-04-01	0
Number of other retired or separated participants entitled to future benefits	2010-04-01	15
Total of all active and inactive participants	2010-04-01	108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-04-01	0
Total participants	2010-04-01	108
Number of participants with account balances	2010-04-01	87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-04-01	1
2009: COGENTIX MEDICAL, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-04-01	149
Total number of active participants reported on line 7a of the Form 5500	2009-04-01	93
Number of retired or separated participants receiving benefits	2009-04-01	0
Number of other retired or separated participants entitled to future benefits	2009-04-01	23
Total of all active and inactive participants	2009-04-01	116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-04-01	0
Total participants	2009-04-01	116
Number of participants with account balances	2009-04-01	92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-04-01	4

Financial Data on COGENTIX MEDICAL, INC. 401(K) PLAN

Measure	Date	Value
2018 : COGENTIX MEDICAL, INC. 401(K) PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2018-12-31	$8,779
Total unrealized appreciation/depreciation of assets	2018-12-31	$8,779
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	$929,002
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$2,363,085
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$2,358,755
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,940,652
Value of total assets at end of year	2018-12-31	$15,804,422
Value of total assets at beginning of year	2018-12-31	$17,234,339
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$4,330
Total interest from all sources	2018-12-31	$13,235
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	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$1,000,000
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	$1,355,362
Participant contributions at end of year	2018-12-31	$123,120
Participant contributions at beginning of year	2018-12-31	$115,853
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$7,178
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	$-1,434,083
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$15,804,422
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$17,234,339
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	$15,123,763
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$16,589,528
Interest on participant loans	2018-12-31	$5,974
Interest earned on other investments	2018-12-31	$7,261
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$476,989
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$414,052
Net investment gain or loss from common/collective trusts	2018-12-31	$-1,033,664
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
Assets. Invements in employer securities at end of year	2018-12-31	$0
Assets. Invements in employer securities at beginning of year	2018-12-31	$38,524
Contributions received in cash from employer	2018-12-31	$578,112
Employer contributions (assets) at end of year	2018-12-31	$80,550
Employer contributions (assets) at beginning of year	2018-12-31	$76,382
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$2,358,755
Contract administrator fees	2018-12-31	$4,330
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	GRANT THORNTON LLP
Accountancy firm EIN	2018-12-31	363055558
2017 : COGENTIX MEDICAL, INC. 401(K) PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$13,839
Total unrealized appreciation/depreciation of assets	2017-12-31	$13,839
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	$5,057,022
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$1,861,728
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,858,083
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$2,619,932
Value of total assets at end of year	2017-12-31	$17,234,339
Value of total assets at beginning of year	2017-12-31	$14,039,045
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$3,645
Total interest from all sources	2017-12-31	$14,803
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,000,000
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	$1,357,443
Participant contributions at end of year	2017-12-31	$115,853
Participant contributions at beginning of year	2017-12-31	$143,010
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$677,220
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	$3,195,294
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$17,234,339
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$14,039,045
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	$16,589,528
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$13,110,214
Interest on participant loans	2017-12-31	$6,455
Interest earned on other investments	2017-12-31	$8,348
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$414,052
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$706,460
Net investment gain/loss from pooled separate accounts	2017-12-31	$2,408,448
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
Assets. Invements in employer securities at end of year	2017-12-31	$38,524
Assets. Invements in employer securities at beginning of year	2017-12-31	$24,685
Contributions received in cash from employer	2017-12-31	$585,269
Employer contributions (assets) at end of year	2017-12-31	$76,382
Employer contributions (assets) at beginning of year	2017-12-31	$54,676
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,858,083
Contract administrator fees	2017-12-31	$3,645
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	GRANT THORNTON LLP
Accountancy firm EIN	2017-12-31	363055558
2016 : COGENTIX MEDICAL, INC. 401(K) PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2016-12-31	$8,741
Total unrealized appreciation/depreciation of assets	2016-12-31	$8,741
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	$0
Total income from all sources (including contributions)	2016-12-31	$3,486,172
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$953,995
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$949,026
Value of total corrective distributions	2016-12-31	$791
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$2,515,128
Value of total assets at end of year	2016-12-31	$14,039,045
Value of total assets at beginning of year	2016-12-31	$11,506,868
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$4,178
Total interest from all sources	2016-12-31	$11,864
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	$1,000,000
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	$1,316,515
Participant contributions at end of year	2016-12-31	$143,010
Participant contributions at beginning of year	2016-12-31	$143,561
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$763,137
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	$2,532,177
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$14,039,045
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$11,506,868
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	$13,110,214
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$10,963,473
Interest on participant loans	2016-12-31	$6,058
Interest earned on other investments	2016-12-31	$5,806
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$706,460
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$289,650
Net investment gain/loss from pooled separate accounts	2016-12-31	$950,439
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
Assets. Invements in employer securities at end of year	2016-12-31	$24,685
Assets. Invements in employer securities at beginning of year	2016-12-31	$15,944
Contributions received in cash from employer	2016-12-31	$435,476
Employer contributions (assets) at end of year	2016-12-31	$54,676
Employer contributions (assets) at beginning of year	2016-12-31	$94,240
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$949,026
Contract administrator fees	2016-12-31	$4,178
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	GRANT THORNTON LLP
Accountancy firm EIN	2016-12-31	363055558
2015 : COGENTIX MEDICAL, INC. 401(K) PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$-18,769
Total unrealized appreciation/depreciation of assets	2015-12-31	$-18,769
Total transfer of assets to this plan	2015-12-31	$5,297,603
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$1,897,453
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$2,778,104
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$2,773,248
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,968,732
Value of total assets at end of year	2015-12-31	$11,506,868
Value of total assets at beginning of year	2015-12-31	$7,089,916
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$4,856
Total interest from all sources	2015-12-31	$106,491
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	$1,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	Yes
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	$1,129,844
Participant contributions at end of year	2015-12-31	$143,561
Participant contributions at beginning of year	2015-12-31	$85,483
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$392,391
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	$-880,651
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$11,506,868
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$7,089,916
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 registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$6,861,256
Value of interest in pooled separate accounts at end of year	2015-12-31	$10,963,473
Interest on participant loans	2015-12-31	$5,115
Interest earned on other investments	2015-12-31	$101,376
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$80,193
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$80,193
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$289,650
Net investment gain/loss from pooled separate accounts	2015-12-31	$-159,001
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
Assets. Invements in employer securities at end of year	2015-12-31	$15,944
Assets. Invements in employer securities at beginning of year	2015-12-31	$62,984
Contributions received in cash from employer	2015-12-31	$446,497
Employer contributions (assets) at end of year	2015-12-31	$94,240
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$2,773,248
Contract administrator fees	2015-12-31	$4,856
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	Yes
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	GRANT THORNTON LLP
Accountancy firm EIN	2015-12-31	363055558
2012 : COGENTIX MEDICAL, INC. 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-03-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-03-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-03-31	$11,840
Total income from all sources (including contributions)	2012-03-31	$539,825
Total loss/gain on sale of assets	2012-03-31	$0
Total of all expenses incurred	2012-03-31	$322,670
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-03-31	$292,767
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-03-31	$367,671
Value of total assets at end of year	2012-03-31	$4,335,500
Value of total assets at beginning of year	2012-03-31	$4,130,185
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-03-31	$29,903
Total interest from all sources	2012-03-31	$3,432
Total dividends received (eg from common stock, registered investment company shares)	2012-03-31	$114,001
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-03-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-03-31	$114,001
Administrative expenses professional fees incurred	2012-03-31	$2,094
Was this plan covered by a fidelity bond	2012-03-31	Yes
Value of fidelity bond cover	2012-03-31	$500,000
If this is an individual account plan, was there a blackout period	2012-03-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-03-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-03-31	No
Contributions received from participants	2012-03-31	$360,590
Participant contributions at end of year	2012-03-31	$68,151
Participant contributions at beginning of year	2012-03-31	$95,800
Participant contributions at end of year	2012-03-31	$13,052
Participant contributions at beginning of year	2012-03-31	$297
Income. Received or receivable in cash from other sources (including rollovers)	2012-03-31	$7,081
Total non interest bearing cash at end of year	2012-03-31	$3,805
Total non interest bearing cash at beginning of year	2012-03-31	$12,607
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-03-31	No
Value of net income/loss	2012-03-31	$217,155
Value of net assets at end of year (total assets less liabilities)	2012-03-31	$4,335,500
Value of net assets at beginning of year (total assets less liabilities)	2012-03-31	$4,118,345
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-03-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-03-31	No
Were any leases to which the plan was party in default or uncollectible	2012-03-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-03-31	$3,889,684
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-03-31	$3,690,631
Interest on participant loans	2012-03-31	$3,432
Value of interest in common/collective trusts at end of year	2012-03-31	$0
Value of interest in common/collective trusts at beginning of year	2012-03-31	$330,850
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-03-31	$360,808
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-03-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-03-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-03-31	$42,266
Net investment gain or loss from common/collective trusts	2012-03-31	$12,455
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-03-31	No
Was there a failure to transmit to the plan any participant contributions	2012-03-31	No
Has the plan failed to provide any benefit when due under the plan	2012-03-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-03-31	$292,767
Contract administrator fees	2012-03-31	$27,809
Liabilities. Value of benefit claims payable at end of year	2012-03-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2012-03-31	$11,840
Did the plan have assets held for investment	2012-03-31	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	2012-03-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-03-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-03-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-03-31	Disclaimer
Accountancy firm name	2012-03-31	EISNERAMPER LLP
Accountancy firm EIN	2012-03-31	131639826
2011 : COGENTIX MEDICAL, INC. 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-03-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-03-31	$11,840
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-03-31	$0
Total income from all sources (including contributions)	2011-03-31	$906,986
Total loss/gain on sale of assets	2011-03-31	$0
Total of all expenses incurred	2011-03-31	$174,054
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-03-31	$128,013
Expenses. Certain deemed distributions of participant loans	2011-03-31	$8,680
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-03-31	$443,839
Value of total assets at end of year	2011-03-31	$4,130,185
Value of total assets at beginning of year	2011-03-31	$3,385,413
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-03-31	$37,361
Total interest from all sources	2011-03-31	$2,680
Total dividends received (eg from common stock, registered investment company shares)	2011-03-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-03-31	No
Was this plan covered by a fidelity bond	2011-03-31	Yes
Value of fidelity bond cover	2011-03-31	$500,000
If this is an individual account plan, was there a blackout period	2011-03-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-03-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-03-31	No
Contributions received from participants	2011-03-31	$368,586
Participant contributions at end of year	2011-03-31	$95,800
Participant contributions at beginning of year	2011-03-31	$66,061
Participant contributions at end of year	2011-03-31	$297
Income. Received or receivable in cash from other sources (including rollovers)	2011-03-31	$75,253
Total non interest bearing cash at end of year	2011-03-31	$12,607
Total non interest bearing cash at beginning of year	2011-03-31	$425
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-03-31	No
Value of net income/loss	2011-03-31	$732,932
Value of net assets at end of year (total assets less liabilities)	2011-03-31	$4,118,345
Value of net assets at beginning of year (total assets less liabilities)	2011-03-31	$3,385,413
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-03-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-03-31	No
Were any leases to which the plan was party in default or uncollectible	2011-03-31	No
Investment advisory and management fees	2011-03-31	$37,361
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-03-31	$3,690,631
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-03-31	$3,013,110
Interest on participant loans	2011-03-31	$2,680
Value of interest in common/collective trusts at end of year	2011-03-31	$330,850
Value of interest in common/collective trusts at beginning of year	2011-03-31	$305,817
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-03-31	$453,990
Net investment gain or loss from common/collective trusts	2011-03-31	$6,477
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-03-31	No
Was there a failure to transmit to the plan any participant contributions	2011-03-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-03-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-03-31	$128,013
Liabilities. Value of benefit claims payable at end of year	2011-03-31	$11,840
Did the plan have assets held for investment	2011-03-31	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	2011-03-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-03-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-03-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-03-31	Disclaimer
Accountancy firm name	2011-03-31	EISNERAMPER LLP
Accountancy firm EIN	2011-03-31	131639826
2010 : COGENTIX MEDICAL, INC. 401(K) PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-03-31	$0

Form 5500 Responses for COGENTIX MEDICAL, INC. 401(K) PLAN

2018: COGENTIX MEDICAL, INC. 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	Yes
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: COGENTIX MEDICAL, INC. 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: COGENTIX MEDICAL, INC. 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: COGENTIX MEDICAL, INC. 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
2011: COGENTIX MEDICAL, INC. 401(K) PLAN 2011 form 5500 responses
2011-04-01	Type of plan entity	Single employer plan
2011-04-01	Submission has been amended	Yes
2011-04-01	This submission is the final filing	No
2011-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-04-01	Plan is a collectively bargained plan	No
2011-04-01	Plan funding arrangement – Trust	Yes
2011-04-01	Plan benefit arrangement - Trust	Yes
2010: COGENTIX MEDICAL, INC. 401(K) PLAN 2010 form 5500 responses
2010-04-01	Type of plan entity	Single employer plan
2010-04-01	Submission has been amended	No
2010-04-01	This submission is the final filing	No
2010-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-04-01	Plan is a collectively bargained plan	No
2010-04-01	Plan funding arrangement – Trust	Yes
2010-04-01	Plan benefit arrangement - Trust	Yes
2009: COGENTIX MEDICAL, INC. 401(K) PLAN 2009 form 5500 responses
2009-04-01	Type of plan entity	Single employer plan
2009-04-01	Submission has been amended	No
2009-04-01	This submission is the final filing	No
2009-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-04-01	Plan is a collectively bargained plan	No
2009-04-01	Plan funding arrangement – Insurance	Yes
2009-04-01	Plan funding arrangement – Trust	Yes
2009-04-01	Plan benefit arrangement – Insurance	Yes
2009-04-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

068710

Policy instance

Insurance contract or identification number	068710
Number of Individuals Covered	244
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $31,631
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 $31,631
Insurance broker organization code?	3

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

068710

Policy instance

Insurance contract or identification number	068710
Number of Individuals Covered	254
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $30,329
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 $30,329
Insurance broker organization code?	3
Insurance broker name	ROYAL ALLIANCE

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

068710

Policy instance

Insurance contract or identification number	068710
Number of Individuals Covered	243
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $13,760
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $13,760
Insurance broker organization code?	3
Insurance broker name	ROYAL ALLIANCE

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Company Name:	COGENTIX MEDICAL, INC.
Employer identification number (EIN):	133430173
NAIC Classification:	339110