401k Plan data: SHINN PAINT 401(K) PLAN plan

SHINN PAINT 401(K) PLAN 401k Plan overview

Plan Name	SHINN PAINT 401(K) PLAN
Plan identification number	003

SHINN PAINT 401(K) PLAN 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.
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

B. FRANK SHINN PAINT CO. has sponsored the creation of one or more 401k plans.

Company Name: B. FRANK SHINN PAINT CO.

Employer identification number (EIN): 510045890

NAIC Classification: 444120
NAIC Description: Paint and Wallpaper Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHINN PAINT 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2016-01-01 JAMES J. SHINN 2016-12-22 JAMES J. SHINN 2016-12-22
003 2015-01-01 JAMES J. SHINN 2016-07-18 JAMES J. SHINN 2016-07-18
003 2014-01-01 JAMES J. SHINN
003 2013-01-01 JAMES SHINN JAMES SHINN 2014-07-16
003 2012-01-01 JAMES SHINN JAMES SHINN 2013-07-16
003 2011-01-01 JAMES SHINN
003 2010-01-01 JAMES SHINN JAMES SHINN 2011-07-19
003 2009-01-01 JAMES SHINN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
003	2016-01-01	JAMES J. SHINN	2016-12-22	JAMES J. SHINN	2016-12-22
003	2015-01-01	JAMES J. SHINN	2016-07-18	JAMES J. SHINN	2016-07-18
003	2014-01-01	JAMES J. SHINN
003	2013-01-01	JAMES SHINN		JAMES SHINN	2014-07-16
003	2012-01-01	JAMES SHINN		JAMES SHINN	2013-07-16
003	2011-01-01	JAMES SHINN
003	2010-01-01	JAMES SHINN		JAMES SHINN	2011-07-19
003	2009-01-01	JAMES SHINN

Plan Statistics for SHINN PAINT 401(K) PLAN

401k plan membership statisitcs for SHINN PAINT 401(K) PLAN

Measure Date Value
2014: SHINN PAINT 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 19
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 14
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 4
Total of all active and inactive participants 2014-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 18
Number of participants with account balances 2014-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 2
2013: SHINN PAINT 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 19
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 19
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 3
Total of all active and inactive participants 2013-01-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 22
Number of participants with account balances 2013-01-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: SHINN PAINT 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 22
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 19
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 4
Total of all active and inactive participants 2012-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 23
Number of participants with account balances 2012-01-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 2
2011: SHINN PAINT 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 21
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 3
Total of all active and inactive participants 2011-01-01 24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 24
Number of participants with account balances 2011-01-01 24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: SHINN PAINT 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 20
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 10
Total of all active and inactive participants 2010-01-01 30
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 30
Number of participants with account balances 2010-01-01 30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: SHINN PAINT 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 31
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 23
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 10
Total of all active and inactive participants 2009-01-01 33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 33
Number of participants with account balances 2009-01-01 33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2014: SHINN PAINT 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	19
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	14
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	4
Total of all active and inactive participants	2014-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	18
Number of participants with account balances	2014-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	2
2013: SHINN PAINT 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	19
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	19
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	3
Total of all active and inactive participants	2013-01-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	22
Number of participants with account balances	2013-01-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: SHINN PAINT 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	22
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	19
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	4
Total of all active and inactive participants	2012-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	23
Number of participants with account balances	2012-01-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	2
2011: SHINN PAINT 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	21
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	3
Total of all active and inactive participants	2011-01-01	24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	24
Number of participants with account balances	2011-01-01	24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: SHINN PAINT 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	20
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	10
Total of all active and inactive participants	2010-01-01	30
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	30
Number of participants with account balances	2010-01-01	30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: SHINN PAINT 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	31
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	23
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	10
Total of all active and inactive participants	2009-01-01	33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	33
Number of participants with account balances	2009-01-01	33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on SHINN PAINT 401(K) PLAN

Measure	Date	Value
2014 : SHINN PAINT 401(K) PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$485
Total income from all sources	2014-12-31	$154,333
Expenses. Total of all expenses incurred	2014-12-31	$322,278
Benefits paid (including direct rollovers)	2014-12-31	$322,136
Total plan assets at end of year	2014-12-31	$1,338,937
Total plan assets at beginning of year	2014-12-31	$1,506,397
Value of fidelity bond covering the plan	2014-12-31	$140,000
Total contributions received or receivable from participants	2014-12-31	$48,139
Expenses. Other expenses not covered elsewhere	2014-12-31	$142
Contributions received from other sources (not participants or employers)	2014-12-31	$39,915
Other income received	2014-12-31	$66,279
Net income (gross income less expenses)	2014-12-31	$-167,945
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,338,937
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,506,397
Assets. Value of participant loans	2014-12-31	$63,006
Total contributions received or receivable from employer(s)	2014-12-31	$0
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2014-12-31	$0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	2014-12-31	$0
2013 : SHINN PAINT 401(K) PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total income from all sources	2013-12-31	$251,371
Expenses. Total of all expenses incurred	2013-12-31	$610,868
Benefits paid (including direct rollovers)	2013-12-31	$610,706
Total plan assets at end of year	2013-12-31	$1,506,397
Total plan assets at beginning of year	2013-12-31	$1,865,894
Value of fidelity bond covering the plan	2013-12-31	$100,000
Total contributions received or receivable from participants	2013-12-31	$50,322
Expenses. Other expenses not covered elsewhere	2013-12-31	$162
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$201,049
Net income (gross income less expenses)	2013-12-31	$-359,497
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,506,397
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,865,894
Assets. Value of participant loans	2013-12-31	$68,988
Total contributions received or receivable from employer(s)	2013-12-31	$0
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2013-12-31	$0
Minimum employer required contribution for this plan year	2013-12-31	$0
Amount contributed by the employer to the plan for this plan year	2013-12-31	$0
2012 : SHINN PAINT 401(K) PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$-1,340
Total income from all sources	2012-12-31	$222,188
Expenses. Total of all expenses incurred	2012-12-31	$156,087
Benefits paid (including direct rollovers)	2012-12-31	$155,753
Total plan assets at end of year	2012-12-31	$1,865,894
Total plan assets at beginning of year	2012-12-31	$1,801,133
Value of fidelity bond covering the plan	2012-12-31	$100,000
Total contributions received or receivable from participants	2012-12-31	$47,397
Expenses. Other expenses not covered elsewhere	2012-12-31	$334
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$173,451
Net income (gross income less expenses)	2012-12-31	$66,101
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,865,894
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,801,133
Assets. Value of participant loans	2012-12-31	$173,061
Total contributions received or receivable from employer(s)	2012-12-31	$1,340
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
2011 : SHINN PAINT 401(K) PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total income from all sources	2011-12-31	$35,270
Expenses. Total of all expenses incurred	2011-12-31	$4,077
Benefits paid (including direct rollovers)	2011-12-31	$3,987
Total plan assets at end of year	2011-12-31	$1,801,133
Total plan assets at beginning of year	2011-12-31	$1,769,940
Value of fidelity bond covering the plan	2011-12-31	$100,000
Total contributions received or receivable from participants	2011-12-31	$51,941
Expenses. Other expenses not covered elsewhere	2011-12-31	$90
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-17,949
Net income (gross income less expenses)	2011-12-31	$31,193
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,801,133
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,769,940
Assets. Value of participant loans	2011-12-31	$54,521
Total contributions received or receivable from employer(s)	2011-12-31	$1,278
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0
2010 : SHINN PAINT 401(K) PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total income from all sources	2010-12-31	$186,400
Expenses. Total of all expenses incurred	2010-12-31	$27,055
Benefits paid (including direct rollovers)	2010-12-31	$24,764
Total plan assets at end of year	2010-12-31	$1,769,939
Total plan assets at beginning of year	2010-12-31	$1,610,594
Value of fidelity bond covering the plan	2010-12-31	$100,000
Total contributions received or receivable from participants	2010-12-31	$52,374
Expenses. Other expenses not covered elsewhere	2010-12-31	$98
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$114,209
Net income (gross income less expenses)	2010-12-31	$159,345
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,769,939
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,610,594
Assets. Value of participant loans	2010-12-31	$55,354
Total contributions received or receivable from employer(s)	2010-12-31	$19,817
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$2,193
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$0
Amount contributed by the employer to the plan for this plan year	2010-12-31	$0

Form 5500 Responses for SHINN PAINT 401(K) PLAN

2014: SHINN PAINT 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: SHINN PAINT 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: SHINN PAINT 401(K) 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
2011: SHINN PAINT 401(K) 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
2010: SHINN PAINT 401(K) 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
2009: SHINN PAINT 401(K) 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

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-029784

Policy instance

Insurance contract or identification number	GA-029784
Number of Individuals Covered	18
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $3,771
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?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,771
Insurance broker organization code?	3
Insurance broker name	HORNOR TOWNSEND & KENT INC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-029784

Policy instance

Insurance contract or identification number	GA-029784
Number of Individuals Covered	22
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $4,510
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?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,510
Insurance broker organization code?	3
Insurance broker name	HORNOR TOWNSEND KENT INC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-029784

Policy instance

Insurance contract or identification number	GA-029784
Number of Individuals Covered	19
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $5,408
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?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,408
Insurance broker organization code?	3
Insurance broker name	HORNOR TOWNSEND KENT INC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-029784

Policy instance

Insurance contract or identification number	GA-029784
Number of Individuals Covered	24
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $5,217
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?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-029784

Policy instance

Insurance contract or identification number	GA-029784
Number of Individuals Covered	30
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $4,737
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?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,737
Insurance broker organization code?	3
Insurance broker name	HORNOR TOWNSEND KENT INC

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Company Name:	B. FRANK SHINN PAINT CO.
Employer identification number (EIN):	510045890
NAIC Classification:	444120
NAIC Description:	Paint and Wallpaper Stores