401k Plan data: LAKESHORE ESTATES 401(K) PLAN plan

LAKESHORE ESTATES 401(K) PLAN 401k Plan overview

Plan Name	LAKESHORE ESTATES 401(K) PLAN
Plan identification number	001

LAKESHORE ESTATES 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

LAKESHORE ESTATES, INC. has sponsored the creation of one or more 401k plans.

Company Name: LAKESHORE ESTATES, INC.

Employer identification number (EIN): 620604630

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about LAKESHORE ESTATES, INC.

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division

Incorporation Date: 2006-02-17

Company Identification Number: 34174896

Legal Registered Office Address: 34360 COLORADO LAKE DR #1103

CORVALLIS
United States of America (USA)
97333

More information about LAKESHORE ESTATES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAKESHORE ESTATES 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 W. BLAKE BROCK
001 2016-01-01 W. BLAKE BROCK
001 2015-01-01 DENNIS LAWS
001 2014-01-01 DENNIS LAWS
001 2013-01-01 DENNIS LAWS
001 2012-01-01 JOHN DENNISON
001 2011-01-01 JOHN DENNISON
001 2010-01-01 DAVID A. SCIORTINO
001 2009-01-01 DAVID A. SCIORTINO

Plan id#	Filing Submission Date	Name of Administrator
001	2017-01-01	W. BLAKE BROCK
001	2016-01-01	W. BLAKE BROCK
001	2015-01-01	DENNIS LAWS
001	2014-01-01	DENNIS LAWS
001	2013-01-01	DENNIS LAWS
001	2012-01-01	JOHN DENNISON
001	2011-01-01	JOHN DENNISON
001	2010-01-01	DAVID A. SCIORTINO
001	2009-01-01	DAVID A. SCIORTINO

Plan Statistics for LAKESHORE ESTATES 401(K) PLAN

401k plan membership statisitcs for LAKESHORE ESTATES 401(K) PLAN

Measure Date Value
2017: LAKESHORE ESTATES 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
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 0
Total of all active and inactive participants 2017-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
Number of participants with account balances 2017-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: LAKESHORE ESTATES 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 104
Number of retired or separated participants receiving benefits 2016-01-01 4
Number of other retired or separated participants entitled to future benefits 2016-01-01 22
Total of all active and inactive participants 2016-01-01 130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 130
Number of participants with account balances 2016-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 3
2015: LAKESHORE ESTATES 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 168
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 120
Number of retired or separated participants receiving benefits 2015-01-01 4
Number of other retired or separated participants entitled to future benefits 2015-01-01 29
Total of all active and inactive participants 2015-01-01 153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 153
Number of participants with account balances 2015-01-01 68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 4
2014: LAKESHORE ESTATES 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 121
Number of retired or separated participants receiving benefits 2014-01-01 5
Number of other retired or separated participants entitled to future benefits 2014-01-01 24
Total of all active and inactive participants 2014-01-01 150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 151
Number of participants with account balances 2014-01-01 68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 8
2013: LAKESHORE ESTATES 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 161
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 136
Number of retired or separated participants receiving benefits 2013-01-01 3
Number of other retired or separated participants entitled to future benefits 2013-01-01 19
Total of all active and inactive participants 2013-01-01 158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 158
Number of participants with account balances 2013-01-01 67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 4
2012: LAKESHORE ESTATES 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 146
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 122
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 21
Total of all active and inactive participants 2012-01-01 143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 143
Number of participants with account balances 2012-01-01 64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 3
2011: LAKESHORE ESTATES 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 154
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 117
Number of other retired or separated participants entitled to future benefits 2011-01-01 18
Total of all active and inactive participants 2011-01-01 135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 135
Number of participants with account balances 2011-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 6
2010: LAKESHORE ESTATES 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 187
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 114
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 22
Total of all active and inactive participants 2010-01-01 136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 136
Number of participants with account balances 2010-01-01 64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 16
2009: LAKESHORE ESTATES 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 189
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 145
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 18
Total of all active and inactive participants 2009-01-01 163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 163
Number of participants with account balances 2009-01-01 64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 3

Measure	Date	Value
2017: LAKESHORE ESTATES 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
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	0
Total of all active and inactive participants	2017-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
Number of participants with account balances	2017-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: LAKESHORE ESTATES 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	104
Number of retired or separated participants receiving benefits	2016-01-01	4
Number of other retired or separated participants entitled to future benefits	2016-01-01	22
Total of all active and inactive participants	2016-01-01	130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	130
Number of participants with account balances	2016-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	3
2015: LAKESHORE ESTATES 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	168
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	120
Number of retired or separated participants receiving benefits	2015-01-01	4
Number of other retired or separated participants entitled to future benefits	2015-01-01	29
Total of all active and inactive participants	2015-01-01	153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	153
Number of participants with account balances	2015-01-01	68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	4
2014: LAKESHORE ESTATES 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	121
Number of retired or separated participants receiving benefits	2014-01-01	5
Number of other retired or separated participants entitled to future benefits	2014-01-01	24
Total of all active and inactive participants	2014-01-01	150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	151
Number of participants with account balances	2014-01-01	68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	8
2013: LAKESHORE ESTATES 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	161
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	136
Number of retired or separated participants receiving benefits	2013-01-01	3
Number of other retired or separated participants entitled to future benefits	2013-01-01	19
Total of all active and inactive participants	2013-01-01	158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	158
Number of participants with account balances	2013-01-01	67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	4
2012: LAKESHORE ESTATES 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	146
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	122
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	21
Total of all active and inactive participants	2012-01-01	143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	143
Number of participants with account balances	2012-01-01	64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	3
2011: LAKESHORE ESTATES 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	154
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	117
Number of other retired or separated participants entitled to future benefits	2011-01-01	18
Total of all active and inactive participants	2011-01-01	135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	135
Number of participants with account balances	2011-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	6
2010: LAKESHORE ESTATES 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	187
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	114
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	22
Total of all active and inactive participants	2010-01-01	136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	136
Number of participants with account balances	2010-01-01	64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	16
2009: LAKESHORE ESTATES 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	189
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	145
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	18
Total of all active and inactive participants	2009-01-01	163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	163
Number of participants with account balances	2009-01-01	64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	3

Financial Data on LAKESHORE ESTATES 401(K) PLAN

Measure	Date	Value
2017 : LAKESHORE ESTATES 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-05-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-05-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-05-31	$0
Total income from all sources (including contributions)	2017-05-31	$50,226
Total loss/gain on sale of assets	2017-05-31	$0
Total of all expenses incurred	2017-05-31	$644,450
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-05-31	$638,830
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-05-31	$10,317
Value of total assets at end of year	2017-05-31	$0
Value of total assets at beginning of year	2017-05-31	$594,224
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-05-31	$5,620
Total interest from all sources	2017-05-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-05-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-05-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-05-31	$0
Was this plan covered by a fidelity bond	2017-05-31	Yes
Value of fidelity bond cover	2017-05-31	$300,000
If this is an individual account plan, was there a blackout period	2017-05-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-05-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-05-31	No
Contributions received from participants	2017-05-31	$9,994
Participant contributions at end of year	2017-05-31	$0
Participant contributions at beginning of year	2017-05-31	$2,286
Income. Received or receivable in cash from other sources (including rollovers)	2017-05-31	$323
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-05-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-05-31	$0
Administrative expenses (other) incurred	2017-05-31	$3,219
Total non interest bearing cash at end of year	2017-05-31	$0
Total non interest bearing cash at beginning of year	2017-05-31	$1,003
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-05-31	No
Value of net income/loss	2017-05-31	$-594,224
Value of net assets at end of year (total assets less liabilities)	2017-05-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-05-31	$594,224
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-05-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-05-31	No
Were any leases to which the plan was party in default or uncollectible	2017-05-31	No
Value of interest in pooled separate accounts at end of year	2017-05-31	$0
Value of interest in pooled separate accounts at beginning of year	2017-05-31	$582,323
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-05-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-05-31	$0
Net investment gain/loss from pooled separate accounts	2017-05-31	$39,909
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-05-31	No
Was there a failure to transmit to the plan any participant contributions	2017-05-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-05-31	No
Employer contributions (assets) at end of year	2017-05-31	$0
Employer contributions (assets) at beginning of year	2017-05-31	$8,612
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-05-31	$638,830
Contract administrator fees	2017-05-31	$2,401
Did the plan have assets held for investment	2017-05-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-05-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-05-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-05-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-05-31	Disclaimer
Accountancy firm name	2017-05-31	BETTS & RUBIO, PLLC
Accountancy firm EIN	2017-05-31	621866112
2016 : LAKESHORE ESTATES 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$94,311
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$169,846
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$161,848
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$58,708
Value of total assets at end of year	2016-12-31	$594,224
Value of total assets at beginning of year	2016-12-31	$669,759
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$7,998
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$300,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$50,096
Participant contributions at end of year	2016-12-31	$2,286
Participant contributions at beginning of year	2016-12-31	$1,908
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Administrative expenses (other) incurred	2016-12-31	$840
Total non interest bearing cash at end of year	2016-12-31	$1,003
Total non interest bearing cash at beginning of year	2016-12-31	$104
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-75,535
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$594,224
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$669,759
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$582,323
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$657,006
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$0
Net investment gain/loss from pooled separate accounts	2016-12-31	$35,603
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$8,612
Employer contributions (assets) at end of year	2016-12-31	$8,612
Employer contributions (assets) at beginning of year	2016-12-31	$10,741
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$161,848
Contract administrator fees	2016-12-31	$7,158
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	BETTS & RUBIO, PLLC
Accountancy firm EIN	2016-12-31	621866112
2015 : LAKESHORE ESTATES 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$61,354
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$50,077
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$41,650
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$68,073
Value of total assets at end of year	2015-12-31	$669,759
Value of total assets at beginning of year	2015-12-31	$658,482
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$8,427
Total interest from all sources	2015-12-31	$5
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$275,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$57,432
Participant contributions at end of year	2015-12-31	$1,908
Participant contributions at beginning of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$0
Total non interest bearing cash at end of year	2015-12-31	$104
Total non interest bearing cash at beginning of year	2015-12-31	$104
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$11,277
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$669,759
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$658,482
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$657,006
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$646,329
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$5
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$0
Net investment gain/loss from pooled separate accounts	2015-12-31	$-6,724
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$10,641
Employer contributions (assets) at end of year	2015-12-31	$10,741
Employer contributions (assets) at beginning of year	2015-12-31	$12,049
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$41,650
Contract administrator fees	2015-12-31	$8,427
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	BLANKENSHIP CPA GROUP, PLLC
Accountancy firm EIN	2015-12-31	450491842
2014 : LAKESHORE ESTATES 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$108,643
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$72,287
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$64,242
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$80,388
Value of total assets at end of year	2014-12-31	$658,482
Value of total assets at beginning of year	2014-12-31	$622,126
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$8,045
Total interest from all sources	2014-12-31	$5
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$275,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$69,133
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$0
Total non interest bearing cash at end of year	2014-12-31	$104
Total non interest bearing cash at beginning of year	2014-12-31	$170
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$36,356
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$658,482
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$622,126
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in pooled separate accounts at end of year	2014-12-31	$646,329
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$609,557
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$5
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$294
Net investment gain/loss from pooled separate accounts	2014-12-31	$28,250
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$11,255
Employer contributions (assets) at end of year	2014-12-31	$12,049
Employer contributions (assets) at beginning of year	2014-12-31	$12,105
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$64,242
Contract administrator fees	2014-12-31	$8,045
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	BLANKENSHIP CPA GROUP, PLLC
Accountancy firm EIN	2014-12-31	450491842
2013 : LAKESHORE ESTATES 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$153,941
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$23,823
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$16,749
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$76,875
Value of total assets at end of year	2013-12-31	$622,126
Value of total assets at beginning of year	2013-12-31	$492,008
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$7,074
Total interest from all sources	2013-12-31	$10
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$275,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$65,443
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Total non interest bearing cash at end of year	2013-12-31	$170
Total non interest bearing cash at beginning of year	2013-12-31	$548
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$130,118
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$622,126
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$492,008
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in pooled separate accounts at end of year	2013-12-31	$609,557
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$479,702
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$10
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$294
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$310
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$77,056
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$11,432
Employer contributions (assets) at end of year	2013-12-31	$12,105
Employer contributions (assets) at beginning of year	2013-12-31	$11,448
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$16,749
Contract administrator fees	2013-12-31	$7,074
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	BLANKENSHIP CPA GROUP, PLLC
Accountancy firm EIN	2013-12-31	450491842
2012 : LAKESHORE ESTATES 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$131,151
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$86,920
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$80,557
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$76,584
Value of total assets at end of year	2012-12-31	$492,008
Value of total assets at beginning of year	2012-12-31	$447,777
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$6,363
Total interest from all sources	2012-12-31	$11
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$275,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$64,938
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$0
Total non interest bearing cash at end of year	2012-12-31	$548
Total non interest bearing cash at beginning of year	2012-12-31	$2,657
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$44,231
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$492,008
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$447,777
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$479,702
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$436,651
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$11
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$310
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$327
Net gain/loss from 103.12 investment entities	2012-12-31	$54,556
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$11,646
Employer contributions (assets) at end of year	2012-12-31	$11,448
Employer contributions (assets) at beginning of year	2012-12-31	$8,142
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$80,557
Contract administrator fees	2012-12-31	$6,363
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	FRASIER, DEAN & HOWARD, PLLC
Accountancy firm EIN	2012-12-31	621073578
2011 : LAKESHORE ESTATES 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$62,811
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$121,721
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$115,042
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$68,757
Value of total assets at end of year	2011-12-31	$447,777
Value of total assets at beginning of year	2011-12-31	$506,687
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$6,679
Total interest from all sources	2011-12-31	$51
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$30,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$60,615
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$0
Total non interest bearing cash at end of year	2011-12-31	$2,657
Total non interest bearing cash at beginning of year	2011-12-31	$1,761
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-58,910
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$447,777
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$506,687
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$436,651
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$461,378
Value of interest in pooled separate accounts at end of year	2011-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$51
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$327
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$32,351
Net investment gain/loss from pooled separate accounts	2011-12-31	$-5,997
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$8,142
Employer contributions (assets) at end of year	2011-12-31	$8,142
Employer contributions (assets) at beginning of year	2011-12-31	$11,197
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$115,042
Contract administrator fees	2011-12-31	$6,679
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	FRASIER, DEAN & HOWARD, PLLC
Accountancy firm EIN	2011-12-31	621073578
2010 : LAKESHORE ESTATES 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$134,101
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$89,254
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$81,795
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$81,607
Value of total assets at end of year	2010-12-31	$506,687
Value of total assets at beginning of year	2010-12-31	$461,840
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$7,459
Total interest from all sources	2010-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$30,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$70,410
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$141
Other income not declared elsewhere	2010-12-31	$259
Total non interest bearing cash at end of year	2010-12-31	$1,761
Total non interest bearing cash at beginning of year	2010-12-31	$1,007
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$44,847
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$506,687
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$461,840
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$461,378
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$423,881
Value of interest in pooled separate accounts at end of year	2010-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$32,351
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$24,351
Net investment gain/loss from pooled separate accounts	2010-12-31	$52,235
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$11,197
Employer contributions (assets) at end of year	2010-12-31	$11,197
Employer contributions (assets) at beginning of year	2010-12-31	$12,460
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$81,795
Contract administrator fees	2010-12-31	$7,459
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	FRASIER, DEAN & HOWARD, PLLC
Accountancy firm EIN	2010-12-31	621073578

Form 5500 Responses for LAKESHORE ESTATES 401(K) PLAN

2017: LAKESHORE ESTATES 401(K) PLAN 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	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: LAKESHORE ESTATES 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: LAKESHORE ESTATES 401(K) 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	No
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 funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: LAKESHORE ESTATES 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
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: LAKESHORE ESTATES 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
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: LAKESHORE ESTATES 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
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: LAKESHORE ESTATES 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
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: LAKESHORE ESTATES 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
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: LAKESHORE ESTATES 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
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

29505

Policy instance

Insurance contract or identification number	29505
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-05-31
Total amount of commissions paid to insurance broker	USD $1,218
Total amount of fees paid to insurance company	USD $127
Are there contracts with allocated funds for individual policies?	0
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 $1,218
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	3
Insurance broker name	FSC AGENCY INC.

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

29505

Policy instance

Insurance contract or identification number	29505
Number of Individuals Covered	68
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $3,214
Total amount of fees paid to insurance company	USD $845
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 $3,214
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	3
Insurance broker name	ACUFF & ASSOCIATES, INC.

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

29505

Policy instance

Insurance contract or identification number	29505
Number of Individuals Covered	151
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $3,117
Total amount of fees paid to insurance company	USD $364
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 $3,117
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	3
Insurance broker name	ACUFF & ASSOCIATES, INC.

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

29505

Policy instance

Insurance contract or identification number	29505
Number of Individuals Covered	158
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $2,597
Total amount of fees paid to insurance company	USD $298
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 $2,597
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	3
Insurance broker name	ACUFF & ASSOCIATES, INC.

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

29505

Policy instance

Insurance contract or identification number	29505
Number of Individuals Covered	64
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,248
Total amount of fees paid to insurance company	USD $237
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 $2,248
Insurance broker organization code?	3
Amount paid for insurance broker fees	237
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker name	ACUFF & ASSOCIATES, INC.

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

29505

Policy instance

Insurance contract or identification number	29505
Number of Individuals Covered	135
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,167
Total amount of fees paid to insurance company	USD $260
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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

29505

Policy instance

Insurance contract or identification number	29505
Number of Individuals Covered	136
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,702
Total amount of fees paid to insurance company	USD $176
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 $1,702
Insurance broker organization code?	3
Amount paid for insurance broker fees	176
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker name	ACUFF & ASSOCIATES, INC.

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Company Name:	LAKESHORE ESTATES, INC.
Employer identification number (EIN):	620604630
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	Oregon Secretary of State Corporations Division
Incorporation Date:	2006-02-17
Company Identification Number:	34174896
Legal Registered Office Address:	34360 COLORADO LAKE DR #1103 CORVALLIS United States of America (USA) 97333