401k Plan data: UPSTATE ADJUSTERS, INC. PROFIT SHARING PLAN plan

UPSTATE ADJUSTERS, INC. PROFIT SHARING PLAN 401k Plan overview

Plan Name	UPSTATE ADJUSTERS, INC. PROFIT SHARING PLAN
Plan identification number	001

UPSTATE ADJUSTERS, INC. 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

401k Sponsoring company profile

UPSTATE ADJUSTERS, INC. has sponsored the creation of one or more 401k plans.

Company Name: UPSTATE ADJUSTERS, INC.

Employer identification number (EIN): 521741739

NAIC Classification: 524210
NAIC Description: Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UPSTATE ADJUSTERS, INC. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-07-01 W. KARL PRODOEHL 2014-08-18 W. KARL PRODOEHL 2014-08-18
001 2012-07-01 W. KARL PRODOEHL 2013-10-01
001 2011-07-01 W. KARL PRODOEHL 2012-10-31 W. KARL PRODOEHL 2012-10-31
001 2010-07-01 W. KARL PRODOEHL 2011-08-31 W. KARL PRODOEHL 2011-08-31
001 2009-07-01 W. KARL PRODOEHL W. KARL PRODOEHL 2010-08-20

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2013-07-01	W. KARL PRODOEHL	2014-08-18	W. KARL PRODOEHL	2014-08-18
001	2012-07-01	W. KARL PRODOEHL	2013-10-01
001	2011-07-01	W. KARL PRODOEHL	2012-10-31	W. KARL PRODOEHL	2012-10-31
001	2010-07-01	W. KARL PRODOEHL	2011-08-31	W. KARL PRODOEHL	2011-08-31
001	2009-07-01	W. KARL PRODOEHL		W. KARL PRODOEHL	2010-08-20

Plan Statistics for UPSTATE ADJUSTERS, INC. PROFIT SHARING PLAN

401k plan membership statisitcs for UPSTATE ADJUSTERS, INC. PROFIT SHARING PLAN

Measure Date Value
2009: UPSTATE ADJUSTERS, INC. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 3
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 3
Number of retired or separated participants receiving benefits 2009-07-01 0
Number of other retired or separated participants entitled to future benefits 2009-07-01 0
Total of all active and inactive participants 2009-07-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 3
Number of participants with account balances 2009-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 0

Measure	Date	Value
2009: UPSTATE ADJUSTERS, INC. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	3
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	3
Number of retired or separated participants receiving benefits	2009-07-01	0
Number of other retired or separated participants entitled to future benefits	2009-07-01	0
Total of all active and inactive participants	2009-07-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	3
Number of participants with account balances	2009-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	0

Form 5500 Responses for UPSTATE ADJUSTERS, INC. PROFIT SHARING PLAN

2009: UPSTATE ADJUSTERS, INC. PROFIT SHARING PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

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Company Name:	UPSTATE ADJUSTERS, INC.
Employer identification number (EIN):	521741739
NAIC Classification:	524210
NAIC Description:	Insurance Agencies and Brokerages