401k Plan data: CANTON CHRISTIAN HOME RETIREMENT PLAN plan

CANTON CHRISTIAN HOME RETIREMENT PLAN 401k Plan overview

Plan Name	CANTON CHRISTIAN HOME RETIREMENT PLAN
Plan identification number	002

CANTON CHRISTIAN HOME RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.

401k Sponsoring company profile

CANTON CHRISTIAN HOME has sponsored the creation of one or more 401k plans.

Company Name: CANTON CHRISTIAN HOME

Employer identification number (EIN): 341039414

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CANTON CHRISTIAN HOME RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-01-01 MICHAEL KERR 2020-02-03 MICHAEL KERR 2020-02-03
002 2016-01-01 MICHAEL H. KERR 2019-12-18 MICHAEL H. KERR 2019-12-18
002 2015-01-01 THOMAS STROBL
002 2014-01-01 THOMAS STROBL
002 2013-01-01 THOMAS STROBL
002 2012-01-01 THOMAS STROBL
002 2011-01-01 THOMAS STROBL
002 2010-01-01 THOMAS STROBL
002 2009-01-01 THOMAS STROBL THOMAS STROBL 2010-10-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2016-01-01	MICHAEL KERR	2020-02-03	MICHAEL KERR	2020-02-03
002	2016-01-01	MICHAEL H. KERR	2019-12-18	MICHAEL H. KERR	2019-12-18
002	2015-01-01	THOMAS STROBL
002	2014-01-01	THOMAS STROBL
002	2013-01-01	THOMAS STROBL
002	2012-01-01	THOMAS STROBL
002	2011-01-01	THOMAS STROBL
002	2010-01-01	THOMAS STROBL
002	2009-01-01	THOMAS STROBL		THOMAS STROBL	2010-10-15

Plan Statistics for CANTON CHRISTIAN HOME RETIREMENT PLAN

401k plan membership statisitcs for CANTON CHRISTIAN HOME RETIREMENT PLAN

Measure Date Value
2015: CANTON CHRISTIAN HOME RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 205
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 72
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 72
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 72
Number of participants with account balances 2015-01-01 72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: CANTON CHRISTIAN HOME RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 219
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 205
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 205
Number of participants with account balances 2014-01-01 69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: CANTON CHRISTIAN HOME RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 268
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 219
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 219
Total participants 2013-01-01 219
Number of participants with account balances 2013-01-01 75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: CANTON CHRISTIAN HOME RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 191
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 203
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 203
Number of participants with account balances 2012-01-01 76
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CANTON CHRISTIAN HOME RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 199
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 182
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 0
Total of all active and inactive participants 2011-01-01 182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 182
Number of participants with account balances 2011-01-01 74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: CANTON CHRISTIAN HOME RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 191
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 199
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 0
Total of all active and inactive participants 2010-01-01 199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 199
Number of participants with account balances 2010-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: CANTON CHRISTIAN HOME RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 195
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 192
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 2009-01-01 192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 192
Number of participants with account balances 2009-01-01 78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2015: CANTON CHRISTIAN HOME RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	205
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	72
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	72
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	72
Number of participants with account balances	2015-01-01	72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: CANTON CHRISTIAN HOME RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	219
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	205
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	205
Number of participants with account balances	2014-01-01	69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: CANTON CHRISTIAN HOME RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	268
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	219
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	219
Total participants	2013-01-01	219
Number of participants with account balances	2013-01-01	75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: CANTON CHRISTIAN HOME RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	191
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	203
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	203
Number of participants with account balances	2012-01-01	76
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CANTON CHRISTIAN HOME RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	199
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	182
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	0
Total of all active and inactive participants	2011-01-01	182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	182
Number of participants with account balances	2011-01-01	74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: CANTON CHRISTIAN HOME RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	191
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	199
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	0
Total of all active and inactive participants	2010-01-01	199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	199
Number of participants with account balances	2010-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: CANTON CHRISTIAN HOME RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	195
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	192
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	192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	192
Number of participants with account balances	2009-01-01	78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on CANTON CHRISTIAN HOME RETIREMENT PLAN

Measure	Date	Value
2015 : CANTON CHRISTIAN HOME RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets from this plan	2015-12-31	$24,206
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$87,925
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$1,771,332
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,758,946
Value of total corrective distributions	2015-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$73,269
Value of total assets at end of year	2015-12-31	$2,387,186
Value of total assets at beginning of year	2015-12-31	$4,094,799
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$12,386
Total interest from all sources	2015-12-31	$17,944
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$450,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$58,823
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$26,940
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$2,108,852
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$3,452,207
Other income not declared elsewhere	2015-12-31	$-3,288
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-1,683,407
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$2,387,186
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$4,094,799
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Interest on participant loans	2015-12-31	$2,736
Interest earned on other investments	2015-12-31	$15,208
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$278,334
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$615,652
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$14,446
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,758,946
Contract administrator fees	2015-12-31	$12,386
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	No
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	REA AND ASSOCIATES
Accountancy firm EIN	2015-12-31	341310124
2014 : CANTON CHRISTIAN HOME RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$409,253
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$265,334
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$264,257
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$242,547
Value of total assets at end of year	2014-12-31	$4,094,799
Value of total assets at beginning of year	2014-12-31	$3,950,880
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$1,077
Total interest from all sources	2014-12-31	$21,255
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$450,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$192,199
Participant contributions at end of year	2014-12-31	$26,940
Participant contributions at beginning of year	2014-12-31	$27,256
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$3,452,207
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$3,245,219
Other income not declared elsewhere	2014-12-31	$145,451
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$143,919
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$4,094,799
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$3,950,880
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Interest on participant loans	2014-12-31	$1,148
Interest earned on other investments	2014-12-31	$20,107
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$615,652
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$678,405
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$50,348
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$264,257
Contract administrator fees	2014-12-31	$1,077
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	REA AND ASSOCIATES
Accountancy firm EIN	2014-12-31	341310124
2013 : CANTON CHRISTIAN HOME RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$805,897
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$334,313
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$332,770
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$255,187
Value of total assets at end of year	2013-12-31	$3,950,880
Value of total assets at beginning of year	2013-12-31	$3,479,296
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,543
Total interest from all sources	2013-12-31	$20,029
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$400,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$202,160
Participant contributions at end of year	2013-12-31	$27,256
Participant contributions at beginning of year	2013-12-31	$31,398
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$3,245,219
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$2,844,950
Other income not declared elsewhere	2013-12-31	$530,681
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$471,584
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$3,950,880
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$3,479,296
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Interest on participant loans	2013-12-31	$1,210
Interest earned on other investments	2013-12-31	$18,819
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$678,405
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$602,948
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$53,027
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$332,770
Contract administrator fees	2013-12-31	$1,543
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	REA AND ASSOCIATES
Accountancy firm EIN	2013-12-31	341310124
2012 : CANTON CHRISTIAN HOME RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$590,358
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$115,246
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$111,331
Value of total corrective distributions	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$276,743
Value of total assets at end of year	2012-12-31	$3,479,296
Value of total assets at beginning of year	2012-12-31	$3,004,184
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$3,915
Total interest from all sources	2012-12-31	$17,164
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$400,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$220,127
Participant contributions at end of year	2012-12-31	$31,398
Participant contributions at beginning of year	2012-12-31	$18,449
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$2,844,950
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$2,422,090
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$0
Other income not declared elsewhere	2012-12-31	$296,451
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$475,112
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$3,479,296
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$3,004,184
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$0
Interest on participant loans	2012-12-31	$426
Interest earned on other investments	2012-12-31	$16,738
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$602,948
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$563,645
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$56,616
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$111,331
Contract administrator fees	2012-12-31	$3,915
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	REA AND ASSOCIATES
Accountancy firm EIN	2012-12-31	341310124
2011 : CANTON CHRISTIAN HOME RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$300,417
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$167,860
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$165,210
Value of total corrective distributions	2011-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$276,160
Value of total assets at end of year	2011-12-31	$3,004,184
Value of total assets at beginning of year	2011-12-31	$2,871,627
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$2,650
Total interest from all sources	2011-12-31	$116,909
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$300,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$218,043
Participant contributions at end of year	2011-12-31	$18,449
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$2,422,090
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$2,551,806
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$0
Other income not declared elsewhere	2011-12-31	$-92,652
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$132,557
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$3,004,184
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$2,871,627
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Interest on participant loans	2011-12-31	$4,452
Interest earned on other investments	2011-12-31	$112,457
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$563,645
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$319,821
Net investment gain/loss from pooled separate accounts	2011-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$58,117
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$165,210
Contract administrator fees	2011-12-31	$2,650
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	REA AND ASSOCIATES
Accountancy firm EIN	2011-12-31	341310124
2010 : CANTON CHRISTIAN HOME RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$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	$636,977
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$360,490
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$353,889
Value of total corrective distributions	2010-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$323,909
Value of total assets at end of year	2010-12-31	$2,871,627
Value of total assets at beginning of year	2010-12-31	$2,595,140
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$6,601
Total interest from all sources	2010-12-31	$0
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 year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$300,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$242,593
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$2,551,806
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$2,210,365
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$6,337
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$0
Other income not declared elsewhere	2010-12-31	$313,068
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$276,487
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$2,871,627
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$2,595,140
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$319,821
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$384,775
Net investment gain/loss from pooled separate accounts	2010-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$74,979
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$353,889
Contract administrator fees	2010-12-31	$6,601
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	REA AND ASSOCIATES
Accountancy firm EIN	2010-12-31	341310124
2009 : CANTON CHRISTIAN HOME RETIREMENT 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 CANTON CHRISTIAN HOME RETIREMENT PLAN

2015: CANTON CHRISTIAN HOME RETIREMENT 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 benefit arrangement – Insurance	Yes
2014: CANTON CHRISTIAN HOME RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: CANTON CHRISTIAN HOME RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: CANTON CHRISTIAN HOME RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: CANTON CHRISTIAN HOME RETIREMENT 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 benefit arrangement – Insurance	Yes
2010: CANTON CHRISTIAN HOME RETIREMENT 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 benefit arrangement – Insurance	Yes
2009: CANTON CHRISTIAN HOME RETIREMENT 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 benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1009254-01

Policy instance

Insurance contract or identification number	1009254-01
Number of Individuals Covered	60
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $232
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $232
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1009254-01

Policy instance

Insurance contract or identification number	1009254-01
Number of Individuals Covered	69
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $19,121
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,121
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES INC

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1009254-01

Policy instance

Insurance contract or identification number	1009254-01
Number of Individuals Covered	75
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $18,568
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $18,568
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1009254-01

Policy instance

Insurance contract or identification number	1009254-01
Number of Individuals Covered	76
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $20,255
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,255
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

836901

Policy instance

Insurance contract or identification number	836901
Number of Individuals Covered	74
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
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?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

836901

Policy instance

Insurance contract or identification number	836901
Number of Individuals Covered	79
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	CANTON CHRISTIAN HOME
Employer identification number (EIN):	341039414
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities