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| Plan Name | KLEBBA AGENCY ESOP |
| Plan identification number | 002 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | KLEBBA AGENCY, INC. |
| Employer identification number (EIN): | 381782155 |
| NAIC Classification: | 524210 |
| NAIC Description: | Insurance Agencies and Brokerages |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 002 | 2015-01-01 | WILLIAM ST. CHARLES |
| Measure | Date | Value |
|---|---|---|
| 2015: KLEBBA AGENCY ESOP 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-01-01 | 4 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 3 |
| Total of all active and inactive participants | 2015-01-01 | 3 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 1 |
| Total participants | 2015-01-01 | 4 |
| Measure | Date | Value |
|---|---|---|
| 2015 : KLEBBA AGENCY ESOP 2015 401k financial data | ||
| Expenses. Total of all expenses incurred | 2015-12-31 | $1,002,338 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $999,415 |
| Total plan assets at end of year | 2015-12-31 | $0 |
| Total plan assets at beginning of year | 2015-12-31 | $1,002,338 |
| Expenses. Other expenses not covered elsewhere | 2015-12-31 | $2,923 |
| Net income (gross income less expenses) | 2015-12-31 | $-1,002,338 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $1,002,338 |
| Assets. Value of employer securities | 2015-12-31 | $0 |
| 2015: KLEBBA AGENCY ESOP 2015 form 5500 responses | ||
|---|---|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | This submission is the final filing | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
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