401k Plan data: OC AUTO TEAM 401K PLAN plan

OC AUTO TEAM 401K PLAN 401k Plan overview

Plan Name	OC AUTO TEAM 401K PLAN
Plan identification number	002

OC AUTO TEAM 401K PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

401k Sponsoring company profile

PB&J AUTOMOTIVE, INC. DBA TUSTIN MAZDA/TUSTIN HYUNDAI has sponsored the creation of one or more 401k plans.

Company Name: PB&J AUTOMOTIVE, INC. DBA TUSTIN MAZDA/TUSTIN HYUNDAI

Employer identification number (EIN): 161690678

NAIC Classification: 441110
NAIC Description: New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OC AUTO TEAM 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 CHARLES KEITH 2023-07-14
002 2021-01-01 CHARLES KEITH 2022-07-19
002 2020-01-01 CHARLES KEITH 2021-08-18
002 2019-01-01 CHARLES KEITH 2020-08-25
002 2018-01-01 CHARLES KEITH 2019-07-30
002 2017-01-01
002 2016-04-01 CHARLES KEITH 2017-03-28
002 2016-04-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2022-01-01	CHARLES KEITH	2023-07-14
002	2021-01-01	CHARLES KEITH	2022-07-19
002	2020-01-01	CHARLES KEITH	2021-08-18
002	2019-01-01	CHARLES KEITH	2020-08-25
002	2018-01-01	CHARLES KEITH	2019-07-30
002	2017-01-01
002	2016-04-01	CHARLES KEITH	2017-03-28
002	2016-04-01

Plan Statistics for OC AUTO TEAM 401K PLAN

401k plan membership statisitcs for OC AUTO TEAM 401K PLAN

Measure Date Value
2022: OC AUTO TEAM 401K PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 248
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 190
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 78
Total of all active and inactive participants 2022-01-01 268
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 268
Number of participants with account balances 2022-01-01 246
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 14
2021: OC AUTO TEAM 401K PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 258
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 178
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 66
Total of all active and inactive participants 2021-01-01 244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 244
Number of participants with account balances 2021-01-01 217
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 29
2020: OC AUTO TEAM 401K PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 221
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 186
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 61
Total of all active and inactive participants 2020-01-01 247
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 247
Number of participants with account balances 2020-01-01 210
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 21
2019: OC AUTO TEAM 401K PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 225
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 179
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 42
Total of all active and inactive participants 2019-01-01 221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 221
Number of participants with account balances 2019-01-01 202
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 24
2018: OC AUTO TEAM 401K PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 161
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 156
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 19
Total of all active and inactive participants 2018-01-01 175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 175
Number of participants with account balances 2018-01-01 153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 13
2017: OC AUTO TEAM 401K PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 146
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 149
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 12
Total of all active and inactive participants 2017-01-01 161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 161
Number of participants with account balances 2017-01-01 132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 9
2016: OC AUTO TEAM 401K PLAN 2016 401k membership
Total participants, beginning-of-year 2016-04-01 143
Total number of active participants reported on line 7a of the Form 5500 2016-04-01 143
Number of retired or separated participants receiving benefits 2016-04-01 0
Number of other retired or separated participants entitled to future benefits 2016-04-01 3
Total of all active and inactive participants 2016-04-01 146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-04-01 0
Total participants 2016-04-01 146
Number of participants with account balances 2016-04-01 89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-04-01 3

Measure	Date	Value
2022: OC AUTO TEAM 401K PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	248
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	190
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	78
Total of all active and inactive participants	2022-01-01	268
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	268
Number of participants with account balances	2022-01-01	246
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	14
2021: OC AUTO TEAM 401K PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	258
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	178
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	66
Total of all active and inactive participants	2021-01-01	244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	244
Number of participants with account balances	2021-01-01	217
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	29
2020: OC AUTO TEAM 401K PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	221
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	186
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	61
Total of all active and inactive participants	2020-01-01	247
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	247
Number of participants with account balances	2020-01-01	210
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	21
2019: OC AUTO TEAM 401K PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	225
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	179
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	42
Total of all active and inactive participants	2019-01-01	221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	221
Number of participants with account balances	2019-01-01	202
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	24
2018: OC AUTO TEAM 401K PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	161
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	156
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	19
Total of all active and inactive participants	2018-01-01	175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	175
Number of participants with account balances	2018-01-01	153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	13
2017: OC AUTO TEAM 401K PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	146
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	149
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	12
Total of all active and inactive participants	2017-01-01	161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	161
Number of participants with account balances	2017-01-01	132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	9
2016: OC AUTO TEAM 401K PLAN 2016 401k membership
Total participants, beginning-of-year	2016-04-01	143
Total number of active participants reported on line 7a of the Form 5500	2016-04-01	143
Number of retired or separated participants receiving benefits	2016-04-01	0
Number of other retired or separated participants entitled to future benefits	2016-04-01	3
Total of all active and inactive participants	2016-04-01	146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-04-01	0
Total participants	2016-04-01	146
Number of participants with account balances	2016-04-01	89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-04-01	3

Financial Data on OC AUTO TEAM 401K PLAN

Measure	Date	Value
2022 : OC AUTO TEAM 401K PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$209,480
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$256,509
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$250,570
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$901,698
Value of total assets at end of year	2022-12-31	$4,108,822
Value of total assets at beginning of year	2022-12-31	$4,155,851
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$5,939
Total interest from all sources	2022-12-31	$4,027
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$420,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$769,859
Participant contributions at end of year	2022-12-31	$138,859
Participant contributions at beginning of year	2022-12-31	$77,871
Other income not declared elsewhere	2022-12-31	$15,656
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-47,029
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$4,108,822
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$4,155,851
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$3,839,963
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$3,947,980
Interest on participant loans	2022-12-31	$4,027
Net investment gain/loss from pooled separate accounts	2022-12-31	$-711,901
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$131,839
Employer contributions (assets) at end of year	2022-12-31	$130,000
Employer contributions (assets) at beginning of year	2022-12-31	$130,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$250,570
Contract administrator fees	2022-12-31	$5,939
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	KOBAYASHI & COMPANY
Accountancy firm EIN	2022-12-31	954297925
2021 : OC AUTO TEAM 401K 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,258,848
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$138,531
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$129,773
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$837,304
Value of total assets at end of year	2021-12-31	$4,155,851
Value of total assets at beginning of year	2021-12-31	$3,035,534
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$8,758
Total interest from all sources	2021-12-31	$3,027
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	$310,000
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	$707,304
Participant contributions at end of year	2021-12-31	$77,871
Participant contributions at beginning of year	2021-12-31	$68,350
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$87
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	$1,120,317
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$4,155,851
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$3,035,534
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	$3,947,980
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$2,897,097
Interest on participant loans	2021-12-31	$3,027
Net investment gain/loss from pooled separate accounts	2021-12-31	$418,517
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	$130,000
Employer contributions (assets) at end of year	2021-12-31	$130,000
Employer contributions (assets) at beginning of year	2021-12-31	$70,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$129,773
Contract administrator fees	2021-12-31	$8,758
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	Unqualified
Accountancy firm name	2021-12-31	KOBAYASHI & COMPANY
Accountancy firm EIN	2021-12-31	954297925
2020 : OC AUTO TEAM 401K 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,098,955
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$167,430
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$159,101
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$656,692
Value of total assets at end of year	2020-12-31	$3,035,534
Value of total assets at beginning of year	2020-12-31	$2,104,009
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$8,329
Total interest from all sources	2020-12-31	$2,754
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	$220,000
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	$581,440
Participant contributions at end of year	2020-12-31	$68,350
Participant contributions at beginning of year	2020-12-31	$27,474
Participant contributions at end of year	2020-12-31	$87
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$2,339
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	$931,525
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$3,035,534
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,104,009
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	$2,897,097
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$2,006,535
Interest on participant loans	2020-12-31	$2,754
Net investment gain/loss from pooled separate accounts	2020-12-31	$439,509
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	$72,913
Employer contributions (assets) at end of year	2020-12-31	$70,000
Employer contributions (assets) at beginning of year	2020-12-31	$70,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$159,101
Contract administrator fees	2020-12-31	$8,329
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	KOBAYASHI & COMPANY
Accountancy firm EIN	2020-12-31	954297925
2019 : OC AUTO TEAM 401K PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$924,771
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$27,009
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$19,530
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$629,387
Value of total assets at end of year	2019-12-31	$2,104,009
Value of total assets at beginning of year	2019-12-31	$1,206,247
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$7,479
Total interest from all sources	2019-12-31	$1,148
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	$130,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$559,387
Participant contributions at end of year	2019-12-31	$27,474
Participant contributions at beginning of year	2019-12-31	$27,117
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	$897,762
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,104,009
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,206,247
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	$2,006,535
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,129,130
Interest on participant loans	2019-12-31	$1,148
Net investment gain/loss from pooled separate accounts	2019-12-31	$294,236
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	$70,000
Employer contributions (assets) at end of year	2019-12-31	$70,000
Employer contributions (assets) at beginning of year	2019-12-31	$50,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$19,530
Contract administrator fees	2019-12-31	$7,479
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	KOBAYASHI & COMPANY
Accountancy firm EIN	2019-12-31	954297925
2018 : OC AUTO TEAM 401K 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	$420,710
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$21,701
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$13,499
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$505,655
Value of total assets at end of year	2018-12-31	$1,206,247
Value of total assets at beginning of year	2018-12-31	$807,238
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$8,202
Total interest from all sources	2018-12-31	$514
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	$90,000
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	$454,550
Participant contributions at end of year	2018-12-31	$27,117
Participant contributions at beginning of year	2018-12-31	$6,779
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$598
Other income not declared elsewhere	2018-12-31	$84
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	$399,009
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,206,247
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$807,238
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	$1,129,130
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$750,459
Interest on participant loans	2018-12-31	$514
Net investment gain/loss from pooled separate accounts	2018-12-31	$-85,543
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	$50,507
Employer contributions (assets) at end of year	2018-12-31	$50,000
Employer contributions (assets) at beginning of year	2018-12-31	$50,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$13,499
Contract administrator fees	2018-12-31	$8,202
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	KOBAYASHI & COMPANY
Accountancy firm EIN	2018-12-31	954297925
2017 : OC AUTO TEAM 401K PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$527,827
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$18,368
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$11,997
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$449,511
Value of total assets at end of year	2017-12-31	$807,238
Value of total assets at beginning of year	2017-12-31	$297,779
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$6,371
Total interest from all sources	2017-12-31	$153
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	$80,000
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	$380,638
Participant contributions at end of year	2017-12-31	$6,779
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$18,873
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	$509,459
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$807,238
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$297,779
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 registered invesment companies (eg mutual funds) at end of year	2017-12-31	$750,459
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$247,713
Interest on participant loans	2017-12-31	$153
Net investment gain/loss from pooled separate accounts	2017-12-31	$78,163
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$50,000
Employer contributions (assets) at end of year	2017-12-31	$50,000
Employer contributions (assets) at beginning of year	2017-12-31	$50,066
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$11,997
Contract administrator fees	2017-12-31	$6,371
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	KOBAYASHI & COMPANY
Accountancy firm EIN	2017-12-31	954297925
2016 : OC AUTO TEAM 401K PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$299,275
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$1,496
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$212
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$292,969
Value of total assets at end of year	2016-12-31	$297,779
Value of total assets at beginning of year	2016-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,284
Total interest from all sources	2016-12-31	$0
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	$30,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$242,903
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	$297,779
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$297,779
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$0
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 registered invesment companies (eg mutual funds) at end of year	2016-12-31	$247,713
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$0
Net investment gain/loss from pooled separate accounts	2016-12-31	$6,306
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$50,066
Employer contributions (assets) at end of year	2016-12-31	$50,066
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$212
Contract administrator fees	2016-12-31	$1,284
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	KOBAYASHI & COMPANY
Accountancy firm EIN	2016-12-31	954297925

Form 5500 Responses for OC AUTO TEAM 401K PLAN

2022: OC AUTO TEAM 401K 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: OC AUTO TEAM 401K 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: OC AUTO TEAM 401K 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
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: OC AUTO TEAM 401K PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	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
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: OC AUTO TEAM 401K PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: OC AUTO TEAM 401K 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: OC AUTO TEAM 401K PLAN 2016 form 5500 responses
2016-04-01	Type of plan entity	Single employer plan
2016-04-01	First time form 5500 has been submitted	Yes
2016-04-01	Submission has been amended	Yes
2016-04-01	This submission is the final filing	No
2016-04-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2016-04-01	Plan is a collectively bargained plan	No
2016-04-01	Plan funding arrangement – Insurance	Yes
2016-04-01	Plan funding arrangement – Trust	Yes
2016-04-01	Plan benefit arrangement – Insurance	Yes
2016-04-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

807175-000

Policy instance

Insurance contract or identification number	807175-000
Number of Individuals Covered	268
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $14,803
Total amount of fees paid to insurance company	USD $1,850
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,803
Insurance broker organization code?	3
Amount paid for insurance broker fees	1850
Additional information about fees paid to insurance broker	TPA FEES

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

807175-000

Policy instance

Insurance contract or identification number	807175-000
Number of Individuals Covered	244
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $13,999
Total amount of fees paid to insurance company	USD $1,776
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,999
Insurance broker organization code?	3
Amount paid for insurance broker fees	1776
Additional information about fees paid to insurance broker	TPA FEES

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

807175-000

Policy instance

Insurance contract or identification number	807175-000
Number of Individuals Covered	247
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $9,056
Total amount of fees paid to insurance company	USD $1,143
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,056
Insurance broker organization code?	3
Amount paid for insurance broker fees	1143
Additional information about fees paid to insurance broker	TPA FEES

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

807175-000

Policy instance

Insurance contract or identification number	807175-000
Number of Individuals Covered	221
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $6,319
Total amount of fees paid to insurance company	USD $805
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,319
Insurance broker organization code?	3
Amount paid for insurance broker fees	805
Additional information about fees paid to insurance broker	TPA FEES

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

807175-000

Policy instance

Insurance contract or identification number	807175-000
Number of Individuals Covered	175
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $3,986
Total amount of fees paid to insurance company	USD $508
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,986
Insurance broker organization code?	3
Amount paid for insurance broker fees	363
Additional information about fees paid to insurance broker	TPA FEES

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

807175-000

Policy instance

Insurance contract or identification number	807175-000
Number of Individuals Covered	161
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,975
Total amount of fees paid to insurance company	USD $256
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,975
Insurance broker organization code?	3
Amount paid for insurance broker fees	256
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	T. CHARLES CORPORATION

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Company Name:	PB&J AUTOMOTIVE, INC. DBA TUSTIN MAZDA/TUSTIN HYUNDAI
Employer identification number (EIN):	161690678
NAIC Classification:	441110
NAIC Description:	New Car Dealers