401k Plan data: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN plan

FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	002

FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
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

FOX RIVER MILLS, INC. has sponsored the creation of one or more 401k plans.

Company Name: FOX RIVER MILLS, INC.

Employer identification number (EIN): 390288200

NAIC Classification: 315100
NAIC Description: Apparel Knitting Mills

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-01-01 MIKE DOLAN
002 2016-01-01 MIKE DOLAN
002 2015-01-01 BECKY LESSARD
002 2014-01-01 BECKY LESSARD
002 2013-01-01 BECKY LESSARD
002 2012-01-01 BECKY LESSARD
002 2011-01-01 BECKY LESSARD
002 2010-01-01 BECKY LESSARD
002 2009-01-01 BECKY LESSARD

Plan id#	Filing Submission Date	Name of Administrator
002	2016-01-01	MIKE DOLAN
002	2016-01-01	MIKE DOLAN
002	2015-01-01	BECKY LESSARD
002	2014-01-01	BECKY LESSARD
002	2013-01-01	BECKY LESSARD
002	2012-01-01	BECKY LESSARD
002	2011-01-01	BECKY LESSARD
002	2010-01-01	BECKY LESSARD
002	2009-01-01	BECKY LESSARD

Plan Statistics for FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2016: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 132
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 26
Total of all active and inactive participants 2016-01-01 158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 158
Number of participants with account balances 2016-01-01 140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 161
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 146
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 27
Total of all active and inactive participants 2015-01-01 173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 173
Number of participants with account balances 2015-01-01 150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 153
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 136
Number of other retired or separated participants entitled to future benefits 2014-01-01 25
Total of all active and inactive participants 2014-01-01 161
Total participants 2014-01-01 161
Number of participants with account balances 2014-01-01 145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 183
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 122
Number of retired or separated participants receiving benefits 2013-01-01 2
Number of other retired or separated participants entitled to future benefits 2013-01-01 29
Total of all active and inactive participants 2013-01-01 153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 153
Number of participants with account balances 2013-01-01 141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 2
2012: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 194
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 155
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 27
Total of all active and inactive participants 2012-01-01 183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 183
Number of participants with account balances 2012-01-01 161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 185
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 165
Number of retired or separated participants receiving benefits 2011-01-01 2
Number of other retired or separated participants entitled to future benefits 2011-01-01 26
Total of all active and inactive participants 2011-01-01 193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 193
Number of participants with account balances 2011-01-01 167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 197
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 157
Number of retired or separated participants receiving benefits 2010-01-01 1
Number of other retired or separated participants entitled to future benefits 2010-01-01 24
Total of all active and inactive participants 2010-01-01 182
Total participants 2010-01-01 182
Number of participants with account balances 2010-01-01 163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 1
2009: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 236
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 171
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 26
Total of all active and inactive participants 2009-01-01 197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 197
Number of participants with account balances 2009-01-01 179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2016: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	132
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	26
Total of all active and inactive participants	2016-01-01	158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	158
Number of participants with account balances	2016-01-01	140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	161
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	146
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	27
Total of all active and inactive participants	2015-01-01	173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	173
Number of participants with account balances	2015-01-01	150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	153
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	136
Number of other retired or separated participants entitled to future benefits	2014-01-01	25
Total of all active and inactive participants	2014-01-01	161
Total participants	2014-01-01	161
Number of participants with account balances	2014-01-01	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	183
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	122
Number of retired or separated participants receiving benefits	2013-01-01	2
Number of other retired or separated participants entitled to future benefits	2013-01-01	29
Total of all active and inactive participants	2013-01-01	153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	153
Number of participants with account balances	2013-01-01	141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	2
2012: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	194
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	155
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	27
Total of all active and inactive participants	2012-01-01	183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	183
Number of participants with account balances	2012-01-01	161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	185
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	165
Number of retired or separated participants receiving benefits	2011-01-01	2
Number of other retired or separated participants entitled to future benefits	2011-01-01	26
Total of all active and inactive participants	2011-01-01	193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	193
Number of participants with account balances	2011-01-01	167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	197
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	157
Number of retired or separated participants receiving benefits	2010-01-01	1
Number of other retired or separated participants entitled to future benefits	2010-01-01	24
Total of all active and inactive participants	2010-01-01	182
Total participants	2010-01-01	182
Number of participants with account balances	2010-01-01	163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	1
2009: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	236
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	171
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	26
Total of all active and inactive participants	2009-01-01	197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	197
Number of participants with account balances	2009-01-01	179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2016 : FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$1,470,350
Total of all expenses incurred	2016-12-31	$699,748
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$690,613
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$229,918
Value of total assets at end of year	2016-12-31	$18,970,647
Value of total assets at beginning of year	2016-12-31	$18,200,045
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$9,135
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$215,352
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$14,566
Other income not declared elsewhere	2016-12-31	$36,780
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$770,602
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$18,970,647
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$18,200,045
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$18,961,185
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$18,145,399
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$9,462
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$54,646
Net investment gain/loss from pooled separate accounts	2016-12-31	$1,203,652
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$690,613
Contract administrator fees	2016-12-31	$9,135
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	FRIEDMAN LLP
Accountancy firm EIN	2016-12-31	131610809
2015 : FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$255,962
Total of all expenses incurred	2015-12-31	$111,050
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$102,330
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$236,862
Value of total assets at end of year	2015-12-31	$18,200,045
Value of total assets at beginning of year	2015-12-31	$18,055,133
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$8,720
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Administrative expenses professional fees incurred	2015-12-31	$8,640
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
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	$236,862
Other income not declared elsewhere	2015-12-31	$36,511
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	$144,912
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$18,200,045
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$18,055,133
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
Value of interest in pooled separate accounts at end of year	2015-12-31	$18,145,399
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$18,028,342
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$54,646
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$26,791
Net investment gain/loss from pooled separate accounts	2015-12-31	$-17,411
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$102,330
Contract administrator fees	2015-12-31	$80
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	RSM US LLP
Accountancy firm EIN	2015-12-31	420714325
2014 : FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$1,778,961
Total of all expenses incurred	2014-12-31	$1,411,083
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,411,033
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$214,188
Value of total assets at end of year	2014-12-31	$18,055,133
Value of total assets at beginning of year	2014-12-31	$17,687,255
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$50
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	$1,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$212,747
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$1,441
Other income not declared elsewhere	2014-12-31	$16,323
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	$367,878
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$18,055,133
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$17,687,255
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
Value of interest in pooled separate accounts at end of year	2014-12-31	$18,028,342
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$17,676,780
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$26,791
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$10,475
Net investment gain/loss from pooled separate accounts	2014-12-31	$1,548,450
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,411,033
Contract administrator fees	2014-12-31	$50
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	MCGLADREY LLP
Accountancy firm EIN	2014-12-31	420714325
2013 : FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$3,066,147
Total of all expenses incurred	2013-12-31	$1,316,655
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,300,905
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$208,144
Value of total assets at end of year	2013-12-31	$17,687,255
Value of total assets at beginning of year	2013-12-31	$15,937,763
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$15,750
Total interest from all sources	2013-12-31	$16,788
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	$1,000,000
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	$208,051
Participant contributions at beginning of year	2013-12-31	$0
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	$1,749,492
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$17,687,255
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$15,937,763
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
Value of interest in pooled separate accounts at end of year	2013-12-31	$17,676,780
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$15,928,331
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$16,788
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$10,475
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$9,432
Net investment gain/loss from pooled separate accounts	2013-12-31	$2,841,215
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	$93
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,300,905
Contract administrator fees	2013-12-31	$15,750
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	MCGLADREY LLP
Accountancy firm EIN	2013-12-31	420714325
2012 : FOX RIVER MILLS, INC. 401(K) PROFIT SHARING 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	$1,852,125
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$1,286,475
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,279,850
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$229,372
Value of total assets at end of year	2012-12-31	$15,937,763
Value of total assets at beginning of year	2012-12-31	$15,372,113
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$6,625
Total interest from all sources	2012-12-31	$0
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	$1,000,000
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	$217,795
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$8,510
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$11,577
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	$565,650
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$15,937,763
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$15,372,113
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
Value of interest in pooled separate accounts at end of year	2012-12-31	$15,928,331
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$15,363,603
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$9,432
Net investment gain/loss from pooled separate accounts	2012-12-31	$1,622,753
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	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$1,279,850
Contract administrator fees	2012-12-31	$6,625
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	2012-12-31	No
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	MCGLADREY LLP
Accountancy firm EIN	2012-12-31	420714325
2011 : FOX RIVER MILLS, INC. 401(K) PROFIT SHARING 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	$369,380
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$636,727
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$621,072
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$229,156
Value of total assets at end of year	2011-12-31	$15,372,113
Value of total assets at beginning of year	2011-12-31	$15,639,460
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$15,655
Total interest from all sources	2011-12-31	$0
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	$1,000,000
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	$229,156
Participant contributions at end of year	2011-12-31	$8,510
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	$-267,347
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$15,372,113
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$15,639,460
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
Value of interest in pooled separate accounts at end of year	2011-12-31	$15,363,603
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$15,639,460
Net investment gain/loss from pooled separate accounts	2011-12-31	$140,224
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$621,072
Contract administrator fees	2011-12-31	$15,655
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	MCGLADREY LLP
Accountancy firm EIN	2011-12-31	420714325
2010 : FOX RIVER MILLS, INC. 401(K) PROFIT SHARING 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	$2,220,570
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$1,250,867
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$1,221,726
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$204,915
Value of total assets at end of year	2010-12-31	$15,639,460
Value of total assets at beginning of year	2010-12-31	$14,669,757
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$29,141
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	$1,000,000
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	$204,915
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	$969,703
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$15,639,460
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$14,669,757
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 interest in pooled separate accounts at end of year	2010-12-31	$15,639,460
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$14,669,757
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$0
Net investment gain/loss from pooled separate accounts	2010-12-31	$2,015,655
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	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$1,221,726
Contract administrator fees	2010-12-31	$29,141
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	MCGLADREY & PULLEN, LLP
Accountancy firm EIN	2010-12-31	420714325
2009 : FOX RIVER MILLS, INC. 401(K) 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 FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN

2016: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
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: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
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
2014: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: FOX RIVER MILLS, INC. 401(K) PROFIT SHARING 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 funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: FOX RIVER MILLS, INC. 401(K) 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: FOX RIVER MILLS, INC. 401(K) 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: FOX RIVER MILLS, INC. 401(K) 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

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

990373-000

Policy instance

Insurance contract or identification number	990373-000
Number of Individuals Covered	150
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

990373-000

Policy instance

Insurance contract or identification number	990373-000
Number of Individuals Covered	145
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $5,771
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,771
Insurance broker organization code?	3
Insurance broker name	DOMINIC MARASCO

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

990373-000

Policy instance

Insurance contract or identification number	990373-000
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $16,738
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $16,738
Insurance broker organization code?	3
Insurance broker name	DOMINIC MARASCO

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

990373-000

Policy instance

Insurance contract or identification number	990373-000
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $16,112
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?	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
Commission paid to Insurance Broker	USD $16,112
Insurance broker organization code?	3
Insurance broker name	DOMINIC MARASCO

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

990373-000

Policy instance

Insurance contract or identification number	990373-000
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $15,695
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?	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

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

990373-000

Policy instance

Insurance contract or identification number	990373-000
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $14,780
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?	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
Commission paid to Insurance Broker	USD $14,780
Insurance broker organization code?	3
Insurance broker name	DOMINIC MARASCO

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Company Name:	FOX RIVER MILLS, INC.
Employer identification number (EIN):	390288200
NAIC Classification:	315100
NAIC Description:	Apparel Knitting Mills