401k Plan data: B. C. SZERLIP INSURANCE AGENCY, INC. PROFIT SHARING PLAN plan

B. C. SZERLIP INSURANCE AGENCY, INC. PROFIT SHARING PLAN 401k Plan overview

Plan Name	B. C. SZERLIP INSURANCE AGENCY, INC. PROFIT SHARING PLAN
Plan identification number	002

B. C. SZERLIP INSURANCE AGENCY, INC. PROFIT SHARING PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Profit-sharing 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

B. C. SZERLIP INSURANCE AGENCY, INC. has sponsored the creation of one or more 401k plans.

Company Name: B. C. SZERLIP INSURANCE AGENCY, INC.

Employer identification number (EIN): 223413832

NAIC Classification: 524210
NAIC Description: Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan B. C. SZERLIP INSURANCE AGENCY, INC. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-01-01 BURT SZERLIP 2016-10-06
002 2015-01-01 BURT SZERLIP 2016-10-06
002 2014-01-01 BURT SZERLIP 2015-10-09
002 2013-01-01 BRUCE SZERLIP 2014-09-03
002 2012-01-01 BURT SZERLIP 2013-10-03
002 2011-01-01 BURT SZERLIP 2013-05-23
002 2010-01-01 BURT SZERLIP 2013-05-23
002 2008-01-01 BURT SZERLIP

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2016-01-01	BURT SZERLIP	2016-10-06
002	2015-01-01	BURT SZERLIP	2016-10-06
002	2014-01-01	BURT SZERLIP	2015-10-09
002	2013-01-01	BRUCE SZERLIP	2014-09-03
002	2012-01-01	BURT SZERLIP	2013-10-03
002	2011-01-01	BURT SZERLIP	2013-05-23
002	2010-01-01	BURT SZERLIP	2013-05-23
002	2008-01-01	BURT SZERLIP

Plan Statistics for B. C. SZERLIP INSURANCE AGENCY, INC. PROFIT SHARING PLAN

401k plan membership statisitcs for B. C. SZERLIP INSURANCE AGENCY, INC. PROFIT SHARING PLAN

Measure Date Value
2008: B. C. SZERLIP INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2008 401k membership
Total participants, beginning-of-year 2008-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 5
Number of retired or separated participants receiving benefits 2008-01-01 0
Number of other retired or separated participants entitled to future benefits 2008-01-01 0
Total of all active and inactive participants 2008-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-01-01 0
Total participants 2008-01-01 5
Number of participants with account balances 2008-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-01-01 0

Measure	Date	Value
2008: B. C. SZERLIP INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	5
Number of retired or separated participants receiving benefits	2008-01-01	0
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-01-01	0
Total participants	2008-01-01	5
Number of participants with account balances	2008-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-01-01	0

Financial Data on B. C. SZERLIP INSURANCE AGENCY, INC. PROFIT SHARING PLAN

Measure	Date	Value
2008 : B. C. SZERLIP INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2008 401k financial data
Transfers to/from the plan	2008-12-31	$0
Total plan liabilities at end of year	2008-12-31	$0
Total plan liabilities at beginning of year	2008-12-31	$0
Total income from all sources	2008-12-31	$38,133
Expenses. Total of all expenses incurred	2008-12-31	$0
Benefits paid (including direct rollovers)	2008-12-31	$0
Total plan assets at end of year	2008-12-31	$244,518
Total plan assets at beginning of year	2008-12-31	$206,385
Value of fidelity bond covering the plan	2008-12-31	$0
Assets. Value of tangible personal property	2008-12-31	$0
Total contributions received or receivable from participants	2008-12-31	$0
Assets. Value of loans (other than to participants)	2008-12-31	$0
Expenses. Other expenses not covered elsewhere	2008-12-31	$0
Contributions received from other sources (not participants or employers)	2008-12-31	$0
Other income received	2008-12-31	$2
Noncash contributions received	2008-12-31	$0
Net income (gross income less expenses)	2008-12-31	$38,133
Net plan assets at end of year (total assets less liabilities)	2008-12-31	$244,518
Net plan assets at beginning of year (total assets less liabilities)	2008-12-31	$206,385
Assets. Value of participant loans	2008-12-31	$0
Value of loans by the plan or fixed income obligations due to the plan which were in default or classified as uncollectible at the close of the plan year	2008-12-31	$0
Value of leases to which the plan was a party in default or classified as uncollectible during the plan year	2008-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2008-12-31	$0
Assets. Value of real-estate (other than employer real property)	2008-12-31	$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2008-12-31	$0
Assets. Value of employer securities	2008-12-31	$0
Assets. Value of employer real property	2008-12-31	$0
Total contributions received or receivable from employer(s)	2008-12-31	$38,131
Value of certain deemed distributions of participant loans	2008-12-31	$0
Value of corrective distributions	2008-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2008-12-31	$0

Form 5500 Responses for B. C. SZERLIP INSURANCE AGENCY, INC. PROFIT SHARING PLAN

2008: B. C. SZERLIP INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – Trust	Yes
2008-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	B. C. SZERLIP INSURANCE AGENCY, INC.
Employer identification number (EIN):	223413832
NAIC Classification:	524210
NAIC Description:	Insurance Agencies and Brokerages