401k Plan data: FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST plan

FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST
Plan identification number	001

FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
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.
Participant-directed brokerage accounts provided as an investment option under the plan.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

FIRST STATE BANK has sponsored the creation of one or more 401k plans.

Company Name: FIRST STATE BANK

Employer identification number (EIN): 470162800

NAIC Classification: 525990
NAIC Description: Other Financial Vehicles

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2020-01-01
001 2019-01-01
001 2018-01-01 RICHARD TUGGLE
001 2017-01-01 RICHARD TUGGLE
001 2016-01-01 RICHARD TUGGLE 2017-06-16
001 2015-01-01 RICHARD TUGGLE 2016-06-01
001 2014-01-01 RICHARD TUGGLE 2015-06-03
001 2013-01-01 RICHARD TUGGLE 2014-07-09 RICHARD TUGGLE 2014-07-09
001 2012-01-01 RICHARD TUGGLE 2013-05-21 RICHARD TUGGLE 2013-05-21
001 2011-01-01 RICHARD TUGGLE 2012-07-11
001 2010-01-01 RICHARD TUGGLE 2011-07-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2020-01-01
001	2019-01-01
001	2018-01-01	RICHARD TUGGLE
001	2017-01-01	RICHARD TUGGLE
001	2016-01-01	RICHARD TUGGLE	2017-06-16
001	2015-01-01	RICHARD TUGGLE	2016-06-01
001	2014-01-01	RICHARD TUGGLE	2015-06-03
001	2013-01-01	RICHARD TUGGLE	2014-07-09	RICHARD TUGGLE	2014-07-09
001	2012-01-01	RICHARD TUGGLE	2013-05-21	RICHARD TUGGLE	2013-05-21
001	2011-01-01	RICHARD TUGGLE	2012-07-11
001	2010-01-01	RICHARD TUGGLE	2011-07-14

Plan Statistics for FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST

Measure Date Value
2020: FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 96
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 78
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 21
Total of all active and inactive participants 2020-01-01 99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 99
Number of participants with account balances 2020-01-01 98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 5
2019: FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year 2019-01-01 98
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 79
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 16
Total of all active and inactive participants 2019-01-01 95
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 95
Number of participants with account balances 2019-01-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 1
2018: FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year 2018-01-01 101
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 79
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 19
Total of all active and inactive participants 2018-01-01 98
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 98
Number of participants with account balances 2018-01-01 97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 3
2017: FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year 2017-01-01 98
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 81
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 20
Total of all active and inactive participants 2017-01-01 101
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 101
Number of participants with account balances 2017-01-01 89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 6

Measure	Date	Value
2020: FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	96
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	78
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	21
Total of all active and inactive participants	2020-01-01	99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	99
Number of participants with account balances	2020-01-01	98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	5
2019: FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	98
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	79
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	16
Total of all active and inactive participants	2019-01-01	95
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	95
Number of participants with account balances	2019-01-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	1
2018: FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	101
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	79
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	19
Total of all active and inactive participants	2018-01-01	98
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	98
Number of participants with account balances	2018-01-01	97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	3
2017: FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year	2017-01-01	98
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	81
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	20
Total of all active and inactive participants	2017-01-01	101
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	101
Number of participants with account balances	2017-01-01	89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	6

Financial Data on FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2020 : FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k financial data
Total income from all sources	2020-12-31	$1,339,642
Expenses. Total of all expenses incurred	2020-12-31	$470,811
Benefits paid (including direct rollovers)	2020-12-31	$439,173
Total plan assets at end of year	2020-12-31	$11,656,829
Total plan assets at beginning of year	2020-12-31	$10,787,998
Value of fidelity bond covering the plan	2020-12-31	$3,500,000
Total contributions received or receivable from participants	2020-12-31	$276,573
Contributions received from other sources (not participants or employers)	2020-12-31	$903
Other income received	2020-12-31	$903,566
Net income (gross income less expenses)	2020-12-31	$868,831
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$11,656,829
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$10,787,998
Assets. Value of assets in partnership/joint-venture interests	2020-12-31	$31,001
Total contributions received or receivable from employer(s)	2020-12-31	$158,600
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$31,638
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k financial data
Total income from all sources	2019-12-31	$1,918,551
Expenses. Total of all expenses incurred	2019-12-31	$56,877
Benefits paid (including direct rollovers)	2019-12-31	$27,235
Total plan assets at end of year	2019-12-31	$10,787,998
Total plan assets at beginning of year	2019-12-31	$8,926,324
Value of fidelity bond covering the plan	2019-12-31	$3,500,000
Total contributions received or receivable from participants	2019-12-31	$264,529
Contributions received from other sources (not participants or employers)	2019-12-31	$1,811
Other income received	2019-12-31	$1,478,611
Net income (gross income less expenses)	2019-12-31	$1,861,674
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$10,787,998
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$8,926,324
Assets. Value of assets in partnership/joint-venture interests	2019-12-31	$3,996
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2019-12-31	$188
Total contributions received or receivable from employer(s)	2019-12-31	$173,600
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$29,642
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2018 401k financial data
Total income from all sources	2018-12-31	$129,233
Expenses. Total of all expenses incurred	2018-12-31	$918,683
Benefits paid (including direct rollovers)	2018-12-31	$883,623
Total plan assets at end of year	2018-12-31	$8,926,324
Total plan assets at beginning of year	2018-12-31	$9,715,774
Value of fidelity bond covering the plan	2018-12-31	$3,500,000
Total contributions received or receivable from participants	2018-12-31	$244,660
Other income received	2018-12-31	$-311,427
Net income (gross income less expenses)	2018-12-31	$-789,450
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$8,926,324
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$9,715,774
Assets. Value of assets in partnership/joint-venture interests	2018-12-31	$3,691
Total contributions received or receivable from employer(s)	2018-12-31	$196,000
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$35,060
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2017 401k financial data
Total income from all sources	2017-12-31	$1,664,144
Expenses. Total of all expenses incurred	2017-12-31	$174,343
Benefits paid (including direct rollovers)	2017-12-31	$158,860
Total plan assets at end of year	2017-12-31	$9,715,774
Total plan assets at beginning of year	2017-12-31	$8,225,973
Value of fidelity bond covering the plan	2017-12-31	$3,500,000
Total contributions received or receivable from participants	2017-12-31	$216,489
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$1,269,155
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$1,489,801
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$9,715,774
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$8,225,973
Assets. Value of assets in partnership/joint-venture interests	2017-12-31	$5,250
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2017-12-31	$5,044
Total contributions received or receivable from employer(s)	2017-12-31	$178,500
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$15,483
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0

Form 5500 Responses for FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST

2020: FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: FIRST STATE BANK 401(K) PROFIT SHARING PLAN AND TRUST 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	FIRST STATE BANK
Employer identification number (EIN):	470162800
NAIC Classification:	525990
NAIC Description:	Other Financial Vehicles