401k Plan data: TIMBERLAND PARTNERS, INC. VISION PLAN plan

TIMBERLAND PARTNERS, INC. VISION PLAN 401k Plan overview

Plan Name	TIMBERLAND PARTNERS, INC. VISION PLAN
Plan identification number	504

TIMBERLAND PARTNERS, INC. VISION PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Vision Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

TIMBERLAND PARTNERS, INC. has sponsored the creation of one or more 401k plans.

Company Name: TIMBERLAND PARTNERS, INC.

Employer identification number (EIN): 411927567

NAIC Classification: 531210
NAIC Description: Offices of Real Estate Agents and Brokers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TIMBERLAND PARTNERS, INC. VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2015-01-01 DAN HOIBY
504 2009-01-01 DAN HOIBY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
504	2015-01-01	DAN HOIBY
504	2009-01-01	DAN HOIBY

Plan Statistics for TIMBERLAND PARTNERS, INC. VISION PLAN

401k plan membership statisitcs for TIMBERLAND PARTNERS, INC. VISION PLAN

Measure Date Value
2015: TIMBERLAND PARTNERS, INC. VISION PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
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 0
2009: TIMBERLAND PARTNERS, INC. VISION PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 26
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 19
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 19

Measure	Date	Value
2015: TIMBERLAND PARTNERS, INC. VISION PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
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	0
2009: TIMBERLAND PARTNERS, INC. VISION PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	26
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	19
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	19

Form 5500 Responses for TIMBERLAND PARTNERS, INC. VISION PLAN

2015: TIMBERLAND PARTNERS, INC. VISION 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	Yes
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
2009: TIMBERLAND PARTNERS, INC. VISION 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 – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

9709627

Policy instance

Insurance contract or identification number	9709627
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $936
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $9,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $936
Insurance broker organization code?	3
Insurance broker name	ASSOCIATED FINANCIAL GROUP

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Company Name:	TIMBERLAND PARTNERS, INC.
Employer identification number (EIN):	411927567
NAIC Classification:	531210
NAIC Description:	Offices of Real Estate Agents and Brokers