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LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 401k Plan overview

Plan NameLAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN
Plan identification number 001

LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN Benefits

401k Plan TypeDefined 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.
  • 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.

401k Sponsoring company profile

LAFATA MANAGEMENT, INC. has sponsored the creation of one or more 401k plans.

Company Name:LAFATA MANAGEMENT, INC.
Employer identification number (EIN):201965835
NAIC Classification:339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01DIANE CONNELLY2024-09-24
0012022-01-01
0012021-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01DIANE CONNELLY
0012017-01-01
0012016-01-01DIANE CONNELLY
0012016-01-01
0012015-01-01DIANE CONNELLY2016-07-21
0012014-01-01DIANE CONNELLY2015-07-21
0012013-01-01LAFATA MANAGEMENT EMPLOYEES2014-07-15
0012012-01-01DIANE CONNELLY2013-07-19 DIANE CONNELLY2013-07-19
0012011-01-01DIANE CONNELLY2012-07-23 DIANE CONNELLY2012-07-23
0012010-01-01DIANE CONNELLY
0012009-01-01DIANE CONNELLY
0012009-01-01DIANE CONNELLY
0012007-01-01DIANE CONNELLY

Plan Statistics for LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN

401k plan membership statisitcs for LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN

Measure Date Value
2022: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01140
Total number of active participants reported on line 7a of the Form 55002022-01-01114
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0122
Total of all active and inactive participants2022-01-01136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01136
Number of participants with account balances2022-01-0184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-011
2021: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01141
Total number of active participants reported on line 7a of the Form 55002021-01-01115
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0123
Total of all active and inactive participants2021-01-01138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01138
Number of participants with account balances2021-01-0189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-012
2020: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01140
Total number of active participants reported on line 7a of the Form 55002020-01-01118
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0118
Total of all active and inactive participants2020-01-01136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-011
Total participants2020-01-01137
Number of participants with account balances2020-01-0185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01144
Total number of active participants reported on line 7a of the Form 55002019-01-01120
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0119
Total of all active and inactive participants2019-01-01139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01139
Number of participants with account balances2019-01-0183
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-012
2018: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01151
Total number of active participants reported on line 7a of the Form 55002018-01-01124
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0115
Total of all active and inactive participants2018-01-01139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01139
Number of participants with account balances2018-01-0171
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-012
2017: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01139
Total number of active participants reported on line 7a of the Form 55002017-01-01134
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0113
Total of all active and inactive participants2017-01-01147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01147
Number of participants with account balances2017-01-0170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-012
2016: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01133
Total number of active participants reported on line 7a of the Form 55002016-01-01122
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-0111
Total of all active and inactive participants2016-01-01134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01134
Number of participants with account balances2016-01-0164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012
2010: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01108
Total number of active participants reported on line 7a of the Form 55002010-01-0177
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0116
Total of all active and inactive participants2010-01-0193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0193
Number of participants with account balances2010-01-0162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-011
2009: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01107
Total number of active participants reported on line 7a of the Form 55002009-01-0158
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0122
Total of all active and inactive participants2009-01-0180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0180
Number of participants with account balances2009-01-0166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010
2007: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01125
Total number of active participants reported on line 7a of the Form 55002007-01-01101
Number of retired or separated participants receiving benefits2007-01-010
Number of other retired or separated participants entitled to future benefits2007-01-0115
Total of all active and inactive participants2007-01-01116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2007-01-010
Total participants2007-01-01116
Number of participants with account balances2007-01-0178
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2007-01-011

Financial Data on LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN

Measure Date Value
2022 : LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2022 401k financial data
Total income from all sources (including contributions)2022-12-31$-484,658
Total of all expenses incurred2022-12-31$248,857
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$216,069
Value of total corrective distributions2022-12-31$9,944
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$330,546
Value of total assets at end of year2022-12-31$4,250,817
Value of total assets at beginning of year2022-12-31$4,984,332
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$22,844
Total interest from all sources2022-12-31$1,222
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$80,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$203,160
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$16,346
Administrative expenses (other) incurred2022-12-31$22,844
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-733,515
Value of net assets at end of year (total assets less liabilities)2022-12-31$4,250,817
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$4,984,332
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in pooled separate accounts at end of year2022-12-31$4,152,911
Value of interest in pooled separate accounts at beginning of year2022-12-31$4,900,235
Interest earned on other investments2022-12-31$1,222
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$97,906
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$56,909
Net investment gain/loss from pooled separate accounts2022-12-31$-816,426
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$127,386
Employer contributions (assets) at end of year2022-12-31$0
Employer contributions (assets) at beginning of year2022-12-31$10,842
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$216,069
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-12-31No
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Disclaimer
Accountancy firm name2022-12-31COHEN & TRENKAMP CPA'S PLLC
Accountancy firm EIN2022-12-31274296060
2021 : LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2021 401k financial data
Total income from all sources (including contributions)2021-12-31$978,012
Total of all expenses incurred2021-12-31$56,249
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$19,838
Value of total corrective distributions2021-12-31$13,118
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$324,583
Value of total assets at end of year2021-12-31$4,984,332
Value of total assets at beginning of year2021-12-31$4,062,569
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$23,293
Total interest from all sources2021-12-31$723
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$80,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$199,644
Participant contributions at end of year2021-12-31$16,346
Participant contributions at beginning of year2021-12-31$11,984
Administrative expenses (other) incurred2021-12-31$23,293
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$921,763
Value of net assets at end of year (total assets less liabilities)2021-12-31$4,984,332
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$4,062,569
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in pooled separate accounts at end of year2021-12-31$4,900,235
Value of interest in pooled separate accounts at beginning of year2021-12-31$3,999,796
Interest earned on other investments2021-12-31$723
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$56,909
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$42,505
Net investment gain/loss from pooled separate accounts2021-12-31$652,706
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$124,939
Employer contributions (assets) at end of year2021-12-31$10,842
Employer contributions (assets) at beginning of year2021-12-31$8,284
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$19,838
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31No
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31COHEN & TRENKAMP CPA'S PLLC
Accountancy firm EIN2021-12-31274296060
2020 : LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2020 401k financial data
Total income from all sources (including contributions)2020-12-31$840,740
Total of all expenses incurred2020-12-31$406,434
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$382,649
Value of total corrective distributions2020-12-31$3,551
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$305,346
Value of total assets at end of year2020-12-31$4,062,569
Value of total assets at beginning of year2020-12-31$3,628,263
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$20,234
Total interest from all sources2020-12-31$577
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$80,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$188,562
Participant contributions at end of year2020-12-31$11,984
Participant contributions at beginning of year2020-12-31$8,451
Administrative expenses (other) incurred2020-12-31$20,234
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$434,306
Value of net assets at end of year (total assets less liabilities)2020-12-31$4,062,569
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$3,628,263
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in pooled separate accounts at end of year2020-12-31$3,999,796
Value of interest in pooled separate accounts at beginning of year2020-12-31$3,574,814
Interest earned on other investments2020-12-31$577
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$42,505
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$39,594
Net investment gain/loss from pooled separate accounts2020-12-31$534,817
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$116,784
Employer contributions (assets) at end of year2020-12-31$8,284
Employer contributions (assets) at beginning of year2020-12-31$5,404
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$382,649
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31No
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31COHEN & TRENKAMP CPA'S PLLC
Accountancy firm EIN2020-12-31274296060
2019 : LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$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$926,245
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$272,185
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$253,919
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$272,483
Value of total assets at end of year2019-12-31$3,628,263
Value of total assets at beginning of year2019-12-31$2,974,203
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$18,266
Total interest from all sources2019-12-31$857
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 year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$80,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$164,622
Participant contributions at end of year2019-12-31$8,451
Participant contributions at beginning of year2019-12-31$12,595
Administrative expenses (other) incurred2019-12-31$18,266
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$654,060
Value of net assets at end of year (total assets less liabilities)2019-12-31$3,628,263
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$2,974,203
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in pooled separate accounts at end of year2019-12-31$3,574,814
Value of interest in pooled separate accounts at beginning of year2019-12-31$2,917,845
Interest earned on other investments2019-12-31$857
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$39,594
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$35,185
Net investment gain/loss from pooled separate accounts2019-12-31$652,905
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$107,861
Employer contributions (assets) at end of year2019-12-31$5,404
Employer contributions (assets) at beginning of year2019-12-31$8,578
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$253,919
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31COHEN & TRENKAMP CPA'S PLLC
Accountancy firm EIN2019-12-31274296060
2018 : LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2018 401k financial data
Total income from all sources (including contributions)2018-12-31$16,896
Total of all expenses incurred2018-12-31$66,294
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$48,594
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$258,904
Value of total assets at end of year2018-12-31$2,974,203
Value of total assets at beginning of year2018-12-31$3,023,601
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$17,700
Total interest from all sources2018-12-31$419
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$80,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$151,437
Participant contributions at end of year2018-12-31$12,595
Participant contributions at beginning of year2018-12-31$13,249
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$7,437
Administrative expenses (other) incurred2018-12-31$17,700
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-49,398
Value of net assets at end of year (total assets less liabilities)2018-12-31$2,974,203
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,023,601
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in pooled separate accounts at end of year2018-12-31$2,917,845
Value of interest in pooled separate accounts at beginning of year2018-12-31$2,969,013
Interest earned on other investments2018-12-31$419
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$35,185
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$30,897
Net investment gain/loss from pooled separate accounts2018-12-31$-242,427
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31Yes
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$100,030
Employer contributions (assets) at end of year2018-12-31$8,578
Employer contributions (assets) at beginning of year2018-12-31$10,442
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$48,594
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31COHEN & TRENKAMP CPA'S PLLC
Accountancy firm EIN2018-12-31274296060
2017 : LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2017 401k financial data
Total income from all sources (including contributions)2017-12-31$722,337
Total of all expenses incurred2017-12-31$149,279
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$131,872
Expenses. Certain deemed distributions of participant loans2017-12-31$631
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$289,541
Value of total assets at end of year2017-12-31$3,023,601
Value of total assets at beginning of year2017-12-31$2,450,543
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$16,776
Total interest from all sources2017-12-31$316
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$80,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$161,007
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$1,047
Participant contributions at end of year2017-12-31$13,249
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$15,474
Administrative expenses (other) incurred2017-12-31$16,776
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$573,058
Value of net assets at end of year (total assets less liabilities)2017-12-31$3,023,601
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,450,543
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in pooled separate accounts at end of year2017-12-31$2,969,013
Value of interest in pooled separate accounts at beginning of year2017-12-31$2,432,344
Interest on participant loans2017-12-31$36
Interest earned on other investments2017-12-31$280
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$30,897
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$17,152
Net investment gain/loss from pooled separate accounts2017-12-31$432,480
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$113,060
Employer contributions (assets) at end of year2017-12-31$10,442
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$131,872
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31BELGER AND ASSOCIATES, P.C.
Accountancy firm EIN2017-12-31383321968
2016 : LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2016 401k financial data
Total income from all sources (including contributions)2016-12-31$499,465
Total of all expenses incurred2016-12-31$326,687
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$311,811
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$307,871
Value of total assets at end of year2016-12-31$2,450,543
Value of total assets at beginning of year2016-12-31$2,277,765
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$14,876
Total interest from all sources2016-12-31$265
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$80,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$201,139
Participant contributions at end of year2016-12-31$1,047
Participant contributions at beginning of year2016-12-31$1,794
Administrative expenses (other) incurred2016-12-31$14,876
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$172,778
Value of net assets at end of year (total assets less liabilities)2016-12-31$2,450,543
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,277,765
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in pooled separate accounts at end of year2016-12-31$2,432,344
Value of interest in pooled separate accounts at beginning of year2016-12-31$2,275,971
Interest on participant loans2016-12-31$58
Interest earned on other investments2016-12-31$207
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$17,152
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$0
Net investment gain/loss from pooled separate accounts2016-12-31$191,329
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$106,732
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$311,811
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31BELGER AND ASSOCIATES, P.C.
Accountancy firm EIN2016-12-31383321968
2010 : LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$230,417
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$114,968
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$102,175
Value of total corrective distributions2010-12-31$2,468
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$61,611
Value of total assets at end of year2010-12-31$1,559,385
Value of total assets at beginning of year2010-12-31$1,443,936
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$10,325
Total interest from all sources2010-12-31$2,948
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$1,250
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$80,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$61,611
Participant contributions at end of year2010-12-31$46,526
Participant contributions at beginning of year2010-12-31$58,229
Other income not declared elsewhere2010-12-31$1,511
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$115,449
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,559,385
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,443,936
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$9,075
Value of interest in pooled separate accounts at end of year2010-12-31$1,456,155
Value of interest in pooled separate accounts at beginning of year2010-12-31$1,329,829
Interest on participant loans2010-12-31$2,948
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$56,704
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$55,878
Net investment gain/loss from pooled separate accounts2010-12-31$164,347
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$102,175
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31BELGER AND ASSOCIATES, PC
Accountancy firm EIN2010-12-31383321968
2009 : LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN

2022: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2010: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes
2007: LAFATA MANAGEMENT, INC. EMPLOYEES' 401K PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedYes
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan funding arrangement – TrustYes
2007-01-01Plan benefit arrangement – InsuranceYes
2007-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number997075
Policy instance 1
Insurance contract or identification number997075
Number of Individuals Covered84
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $11,066
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,066
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number997075
Policy instance 1
Insurance contract or identification number997075
Number of Individuals Covered89
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $11,375
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,375
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number997075
Policy instance 1
Insurance contract or identification number997075
Number of Individuals Covered85
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $8,871
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,871
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number997075
Policy instance 1
Insurance contract or identification number997075
Number of Individuals Covered83
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $8,104
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $8,104
Amount paid for insurance broker fees0
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number997075
Policy instance 1
Insurance contract or identification number997075
Number of Individuals Covered71
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $7,802
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,802
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number997075
Policy instance 1
Insurance contract or identification number997075
Number of Individuals Covered70
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,776
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,776
Insurance broker organization code?3
Insurance broker nameRAYMOND JAMES INSURANCE GROUP INC
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number997075-000
Policy instance 1
Insurance contract or identification number997075-000
Number of Individuals Covered62
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,451
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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