401k Plan data: HERITAGE BANK LIFE INSURANCE PLAN plan

HERITAGE BANK LIFE INSURANCE PLAN 401k Plan overview

Plan Name	HERITAGE BANK LIFE INSURANCE PLAN
Plan identification number	504

HERITAGE BANK LIFE INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover 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

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

Company Name: HERITAGE BANK

Employer identification number (EIN): 610229082

NAIC Classification: 522110
NAIC Description: Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HERITAGE BANK LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2013-01-01 MIKE WOOLFOLK
504 2012-01-01 MIKE WOOLFOLK
504 2011-01-01 MIKE WOOLFOLK
504 2010-01-01 MIKE WOOLFOLK
504 2009-01-01 MIKE WOOLFOLK

Plan id#	Filing Submission Date	Name of Administrator
504	2013-01-01	MIKE WOOLFOLK
504	2012-01-01	MIKE WOOLFOLK
504	2011-01-01	MIKE WOOLFOLK
504	2010-01-01	MIKE WOOLFOLK
504	2009-01-01	MIKE WOOLFOLK

Plan Statistics for HERITAGE BANK LIFE INSURANCE PLAN

401k plan membership statisitcs for HERITAGE BANK LIFE INSURANCE PLAN

Measure Date Value
2013: HERITAGE BANK LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 256
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
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 0
Total of all active and inactive participants 2013-01-01 0
2012: HERITAGE BANK LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 250
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 256
Total of all active and inactive participants 2012-01-01 256
2011: HERITAGE BANK LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 238
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 250
Total of all active and inactive participants 2011-01-01 250
2010: HERITAGE BANK LIFE INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 226
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 238
Total of all active and inactive participants 2010-01-01 238
2009: HERITAGE BANK LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 226
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 226
Total of all active and inactive participants 2009-01-01 226

Measure	Date	Value
2013: HERITAGE BANK LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	256
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
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	0
Total of all active and inactive participants	2013-01-01	0
2012: HERITAGE BANK LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	250
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	256
Total of all active and inactive participants	2012-01-01	256
2011: HERITAGE BANK LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	238
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	250
Total of all active and inactive participants	2011-01-01	250
2010: HERITAGE BANK LIFE INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	226
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	238
Total of all active and inactive participants	2010-01-01	238
2009: HERITAGE BANK LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	226
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	226
Total of all active and inactive participants	2009-01-01	226

Form 5500 Responses for HERITAGE BANK LIFE INSURANCE PLAN

2013: HERITAGE BANK LIFE INSURANCE 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	Yes
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 benefit arrangement – Insurance	Yes
2012: HERITAGE BANK LIFE INSURANCE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: HERITAGE BANK LIFE INSURANCE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: HERITAGE BANK LIFE INSURANCE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: HERITAGE BANK LIFE INSURANCE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	HERITAGE BANK
Employer identification number (EIN):	610229082
NAIC Classification:	522110
NAIC Description:	Commercial Banking