401k Plan data: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN plan

QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 401k Plan overview

Plan Name	QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN
Plan identification number	001

QUINN L. LUNDBERG, JR. PROFIT SHARING 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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan covering Self-Employed individuals.
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.
Life insurance

401k Sponsoring company profile

QUINN L. LUNDBERG, JR. DMD has sponsored the creation of one or more 401k plans.

Company Name: QUINN L. LUNDBERG, JR. DMD

Employer identification number (EIN): 251154683

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01 QUINN LUNDBERG
001 2017-01-01 QUINN LUNDBERG
001 2016-01-01 QUINN LUNDBERG
001 2015-01-01 QUINN LUNDBERG
001 2014-01-01 QUINN LUNDBERG JR. 2015-09-23
001 2013-01-01 QUINN LUNDBERG JR. 2014-10-13
001 2012-01-01 QUINN L LUNDBERG JR 2013-06-18
001 2011-01-01 QUINN L LUNDBERG JR
001 2010-01-01 QUINN L LUNDBERG JR
001 2009-01-01 QUINN L LUNDBERG JR

Plan Statistics for QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN

401k plan membership statisitcs for QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN

Measure Date Value
2023: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 0
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 0
Total participants 2023-01-01 0
Number of participants with account balances 2023-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 0
2022: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 2
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 2
Total of all active and inactive participants 2022-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 4
Number of participants with account balances 2022-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 2
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 2
Total of all active and inactive participants 2021-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 4
Number of participants with account balances 2021-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 3
Number of other retired or separated participants entitled to future benefits 2020-01-01 2
Total of all active and inactive participants 2020-01-01 5
Total participants 2020-01-01 5
Number of participants with account balances 2020-01-01 5
2019: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 5
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 0
Total of all active and inactive participants 2019-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 5
Number of participants with account balances 2019-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 4
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 0
Total of all active and inactive participants 2018-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 4
Number of participants with account balances 2018-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 5
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 1
Total of all active and inactive participants 2017-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 6
Number of participants with account balances 2017-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 5
Number of other retired or separated participants entitled to future benefits 2016-01-01 1
Total of all active and inactive participants 2016-01-01 6
Total participants 2016-01-01 6
Number of participants with account balances 2016-01-01 6
2015: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 5
Number of other retired or separated participants entitled to future benefits 2015-01-01 1
Total of all active and inactive participants 2015-01-01 6
Total participants 2015-01-01 6
Number of participants with account balances 2015-01-01 6
2011: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 4
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 2
Total of all active and inactive participants 2011-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 6
Number of participants with account balances 2011-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2010: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 3
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 2
Total of all active and inactive participants 2010-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 5
Number of participants with account balances 2010-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 4
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 4
Number of participants with account balances 2009-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2023: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	0
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	0
Total participants	2023-01-01	0
Number of participants with account balances	2023-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	0
2022: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	2
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	2
Total of all active and inactive participants	2022-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	4
Number of participants with account balances	2022-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	2
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	2
Total of all active and inactive participants	2021-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	4
Number of participants with account balances	2021-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	3
Number of other retired or separated participants entitled to future benefits	2020-01-01	2
Total of all active and inactive participants	2020-01-01	5
Total participants	2020-01-01	5
Number of participants with account balances	2020-01-01	5
2019: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	5
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	0
Total of all active and inactive participants	2019-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	5
Number of participants with account balances	2019-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	4
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	0
Total of all active and inactive participants	2018-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	4
Number of participants with account balances	2018-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	5
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	1
Total of all active and inactive participants	2017-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	6
Number of participants with account balances	2017-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	5
Number of other retired or separated participants entitled to future benefits	2016-01-01	1
Total of all active and inactive participants	2016-01-01	6
Total participants	2016-01-01	6
Number of participants with account balances	2016-01-01	6
2015: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	5
Number of other retired or separated participants entitled to future benefits	2015-01-01	1
Total of all active and inactive participants	2015-01-01	6
Total participants	2015-01-01	6
Number of participants with account balances	2015-01-01	6
2011: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	4
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	2
Total of all active and inactive participants	2011-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	6
Number of participants with account balances	2011-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2010: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	3
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	2
Total of all active and inactive participants	2010-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	5
Number of participants with account balances	2010-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	4
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	4
Number of participants with account balances	2009-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN

Measure	Date	Value
2023 : QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2023 401k financial data
Transfers to/from the plan	2023-03-06	$0
Total plan liabilities at end of year	2023-03-06	$0
Total plan liabilities at beginning of year	2023-03-06	$0
Total income from all sources	2023-03-06	$59,344
Expenses. Total of all expenses incurred	2023-03-06	$1,039,279
Benefits paid (including direct rollovers)	2023-03-06	$1,036,238
Total plan assets at end of year	2023-03-06	$0
Total plan assets at beginning of year	2023-03-06	$979,935
Value of fidelity bond covering the plan	2023-03-06	$70,000
Total contributions received or receivable from participants	2023-03-06	$0
Expenses. Other expenses not covered elsewhere	2023-03-06	$0
Contributions received from other sources (not participants or employers)	2023-03-06	$0
Other income received	2023-03-06	$59,344
Noncash contributions received	2023-03-06	$0
Net income (gross income less expenses)	2023-03-06	$-979,935
Net plan assets at end of year (total assets less liabilities)	2023-03-06	$0
Net plan assets at beginning of year (total assets less liabilities)	2023-03-06	$979,935
Total contributions received or receivable from employer(s)	2023-03-06	$0
Value of certain deemed distributions of participant loans	2023-03-06	$0
Value of corrective distributions	2023-03-06	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2023-03-06	$3,041
2022 : QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2022 401k financial data
Transfers to/from the plan	2022-12-31	$0
Total plan liabilities at end of year	2022-12-31	$0
Total plan liabilities at beginning of year	2022-12-31	$0
Total income from all sources	2022-12-31	$-189,175
Expenses. Total of all expenses incurred	2022-12-31	$14,033
Benefits paid (including direct rollovers)	2022-12-31	$0
Total plan assets at end of year	2022-12-31	$979,935
Total plan assets at beginning of year	2022-12-31	$1,183,143
Value of fidelity bond covering the plan	2022-12-31	$70,000
Assets. Value of tangible personal property	2022-12-31	$0
Total contributions received or receivable from participants	2022-12-31	$4,468
Assets. Value of loans (other than to participants)	2022-12-31	$0
Expenses. Other expenses not covered elsewhere	2022-12-31	$0
Contributions received from other sources (not participants or employers)	2022-12-31	$0
Other income received	2022-12-31	$-196,543
Noncash contributions received	2022-12-31	$0
Net income (gross income less expenses)	2022-12-31	$-203,208
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$979,935
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$1,183,143
Assets. Value of participant loans	2022-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2022-12-31	$0
Assets. Value of real-estate (other than employer real property)	2022-12-31	$0
Assets. Value of employer securities	2022-12-31	$0
Assets. Value of employer real property	2022-12-31	$0
Total contributions received or receivable from employer(s)	2022-12-31	$2,900
Value of certain deemed distributions of participant loans	2022-12-31	$0
Value of corrective distributions	2022-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$14,033
2021 : QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2021 401k financial data
Transfers to/from the plan	2021-12-31	$0
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$130,554
Expenses. Total of all expenses incurred	2021-12-31	$28,785
Benefits paid (including direct rollovers)	2021-12-31	$15,000
Total plan assets at end of year	2021-12-31	$1,183,143
Total plan assets at beginning of year	2021-12-31	$1,081,374
Value of fidelity bond covering the plan	2021-12-31	$70,000
Total contributions received or receivable from participants	2021-12-31	$4,879
Expenses. Other expenses not covered elsewhere	2021-12-31	$0
Contributions received from other sources (not participants or employers)	2021-12-31	$0
Other income received	2021-12-31	$122,422
Noncash contributions received	2021-12-31	$0
Net income (gross income less expenses)	2021-12-31	$101,769
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$1,183,143
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$1,081,374
Total contributions received or receivable from employer(s)	2021-12-31	$3,253
Value of certain deemed distributions of participant loans	2021-12-31	$0
Value of corrective distributions	2021-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$13,785
2020 : QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2020 401k financial data
Transfers to/from the plan	2020-12-31	$0
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$157,309
Expenses. Total of all expenses incurred	2020-12-31	$11,275
Benefits paid (including direct rollovers)	2020-12-31	$0
Total plan assets at end of year	2020-12-31	$1,081,374
Total plan assets at beginning of year	2020-12-31	$935,340
Value of fidelity bond covering the plan	2020-12-31	$70,000
Assets. Value of tangible personal property	2020-12-31	$0
Total contributions received or receivable from participants	2020-12-31	$5,776
Assets. Value of loans (other than to participants)	2020-12-31	$0
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$0
Other income received	2020-12-31	$147,104
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$146,034
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$1,081,374
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$935,340
Assets. Value of participant loans	2020-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2020-12-31	$0
Assets. Value of real-estate (other than employer real property)	2020-12-31	$0
Assets. Value of employer securities	2020-12-31	$0
Assets. Value of employer real property	2020-12-31	$0
Total contributions received or receivable from employer(s)	2020-12-31	$4,429
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$11,275
2019 : QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2019 401k financial data
Transfers to/from the plan	2019-12-31	$0
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$178,788
Expenses. Total of all expenses incurred	2019-12-31	$17,920
Benefits paid (including direct rollovers)	2019-12-31	$7,500
Total plan assets at end of year	2019-12-31	$935,340
Total plan assets at beginning of year	2019-12-31	$774,472
Value of fidelity bond covering the plan	2019-12-31	$70,000
Total contributions received or receivable from participants	2019-12-31	$7,056
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$0
Other income received	2019-12-31	$166,163
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$160,868
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$935,340
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$774,472
Total contributions received or receivable from employer(s)	2019-12-31	$5,569
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$10,420
2018 : QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2018 401k financial data
Transfers to/from the plan	2018-12-31	$0
Total plan liabilities at end of year	2018-12-31	$0
Total plan liabilities at beginning of year	2018-12-31	$0
Total income from all sources	2018-12-31	$-43,720
Expenses. Total of all expenses incurred	2018-12-31	$20,822
Benefits paid (including direct rollovers)	2018-12-31	$10,283
Total plan assets at end of year	2018-12-31	$774,472
Total plan assets at beginning of year	2018-12-31	$839,014
Value of fidelity bond covering the plan	2018-12-31	$70,000
Total contributions received or receivable from participants	2018-12-31	$7,925
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$0
Other income received	2018-12-31	$-57,895
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$-64,542
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$774,472
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$839,014
Total contributions received or receivable from employer(s)	2018-12-31	$6,250
Value of certain deemed distributions of participant loans	2018-12-31	$0
Value of corrective distributions	2018-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$10,539
2017 : QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$110,289
Expenses. Total of all expenses incurred	2017-12-31	$9,212
Benefits paid (including direct rollovers)	2017-12-31	$0
Total plan assets at end of year	2017-12-31	$839,014
Total plan assets at beginning of year	2017-12-31	$737,937
Value of fidelity bond covering the plan	2017-12-31	$70,000
Total contributions received or receivable from participants	2017-12-31	$13,529
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$86,095
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$101,077
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$839,014
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$737,937
Total contributions received or receivable from employer(s)	2017-12-31	$10,665
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$9,212
2016 : QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$24,537
Expenses. Total of all expenses incurred	2016-12-31	$8,328
Benefits paid (including direct rollovers)	2016-12-31	$0
Total plan assets at end of year	2016-12-31	$737,937
Total plan assets at beginning of year	2016-12-31	$721,728
Value of fidelity bond covering the plan	2016-12-31	$70,000
Total contributions received or receivable from participants	2016-12-31	$2,134
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$20,720
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$16,209
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$737,937
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$721,728
Total contributions received or receivable from employer(s)	2016-12-31	$1,683
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$8,328
2015 : QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$-18,666
Expenses. Total of all expenses incurred	2015-12-31	$7,500
Benefits paid (including direct rollovers)	2015-12-31	$7,500
Total plan assets at end of year	2015-12-31	$721,728
Total plan assets at beginning of year	2015-12-31	$747,894
Value of fidelity bond covering the plan	2015-12-31	$70,000
Total contributions received or receivable from participants	2015-12-31	$7,464
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-32,155
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$-26,166
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$721,728
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$747,894
Total contributions received or receivable from employer(s)	2015-12-31	$6,025
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$0
2011 : QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$33,704
Expenses. Total of all expenses incurred	2011-12-31	$46,293
Benefits paid (including direct rollovers)	2011-12-31	$38,460
Total plan assets at end of year	2011-12-31	$638,468
Total plan assets at beginning of year	2011-12-31	$651,057
Value of fidelity bond covering the plan	2011-12-31	$150,000
Total contributions received or receivable from participants	2011-12-31	$2,370
Expenses. Other expenses not covered elsewhere	2011-12-31	$7,833
Other income received	2011-12-31	$-190
Net income (gross income less expenses)	2011-12-31	$-12,589
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$638,468
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$651,057
Total contributions received or receivable from employer(s)	2011-12-31	$31,524
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$92,651
Expenses. Total of all expenses incurred	2010-12-31	$8,312
Benefits paid (including direct rollovers)	2010-12-31	$20
Total plan assets at end of year	2010-12-31	$651,057
Total plan assets at beginning of year	2010-12-31	$566,718
Value of fidelity bond covering the plan	2010-12-31	$265,000
Total contributions received or receivable from participants	2010-12-31	$2,581
Expenses. Other expenses not covered elsewhere	2010-12-31	$8,292
Other income received	2010-12-31	$64,503
Net income (gross income less expenses)	2010-12-31	$84,339
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$651,057
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$566,718
Total contributions received or receivable from employer(s)	2010-12-31	$25,567
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN

2023: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	Yes
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	This submission is the final filing	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: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	This submission is the final filing	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: QUINN L. LUNDBERG, JR. PROFIT SHARING 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: QUINN L. LUNDBERG, JR. PROFIT SHARING 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: QUINN L. LUNDBERG, JR. PROFIT SHARING 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: QUINN L. LUNDBERG, JR. PROFIT SHARING 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: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2011: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: QUINN L. LUNDBERG, JR. PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

563200221

Policy instance

Insurance contract or identification number	563200221
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

563200221

Policy instance

Insurance contract or identification number	563200221
Number of Individuals Covered	1
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

563200221

Policy instance

Insurance contract or identification number	563200221
Number of Individuals Covered	1
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

563200221

Policy instance

Insurance contract or identification number	563200221
Number of Individuals Covered	1
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

563200221

Policy instance

Insurance contract or identification number	563200221
Number of Individuals Covered	1
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

563200221

Policy instance

Insurance contract or identification number	563200221
Number of Individuals Covered	1
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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

NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )

Policy contract number

0336550

Policy instance

Insurance contract or identification number	0336550
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $589
Total amount of fees paid to insurance company	USD $124
Are there contracts with allocated funds for individual policies?	Yes
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	Yes
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

NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )

Policy contract number

0336550

Policy instance

Insurance contract or identification number	0336550
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Are there contracts with allocated funds for individual policies?	Yes
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	Yes
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

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Company Name:	QUINN L. LUNDBERG, JR. DMD
Employer identification number (EIN):	251154683
NAIC Classification:	621210
NAIC Description:	Offices of Dentists