401k Plan data: THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN plan

THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN 401k Plan overview

Plan Name	THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN
Plan identification number	002

THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
Plan covered by PBGC that was terminated and closed out for PBGC purposes - Before the end of the plan year (or a prior plan year), (1) the plan terminated in a standard (or distress) termination and completed the distribution of plan assets in satisfaction of all benefit liabilities (or all ERISA Title IV benefits for distress termination); or (2) a trustee was appointed for a terminated plan pursuant to ERISA section 4042.
Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

THE PEPPLER AGENCY, INC. has sponsored the creation of one or more 401k plans.

Company Name: THE PEPPLER AGENCY, INC.

Employer identification number (EIN): 382247018

NAIC Classification: 524210
NAIC Description: Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2012-01-01 JANET PEPPLER 2013-05-21
002 2011-01-01 JANET PEPPLER
002 2010-01-01 JANET PEPPLER 2011-07-12
002 2009-01-01 JANET PEPPLER
002 2009-01-01 JANET PEPPLER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2012-01-01	JANET PEPPLER	2013-05-21
002	2011-01-01	JANET PEPPLER
002	2010-01-01	JANET PEPPLER	2011-07-12
002	2009-01-01	JANET PEPPLER
002	2009-01-01	JANET PEPPLER

Plan Statistics for THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN

401k plan membership statisitcs for THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN

Measure Date Value
2011: THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 4
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 0
Total of all active and inactive participants 2011-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 4
2009: THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 4
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
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	4
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	0
Total of all active and inactive participants	2011-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	4
2009: THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	4
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
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN

Measure	Date	Value
2011 : THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$-19,470
Expenses. Total of all expenses incurred	2011-12-31	$5,684
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$848,713
Total plan assets at beginning of year	2011-12-31	$873,867
Value of fidelity bond covering the plan	2011-12-31	$125,000
Total contributions received or receivable from participants	2011-12-31	$0
Expenses. Other expenses not covered elsewhere	2011-12-31	$5,684
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-20,715
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$-25,154
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$848,713
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$873,867
Total contributions received or receivable from employer(s)	2011-12-31	$1,245
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2009 : THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION 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 THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN

2011: THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
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
2009: THE PEPPLER AGENCY, INC. DEFINED BENEFIT PENSION PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
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

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

VARIOUS

Policy instance

Insurance contract or identification number	VARIOUS
Number of Individuals Covered	4
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $25
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	THE PEPPLER AGENCY, INC.
Employer identification number (EIN):	382247018
NAIC Classification:	524210
NAIC Description:	Insurance Agencies and Brokerages