401k Plan data: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. plan

EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 401k Plan overview

Plan Name	EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC.
Plan identification number	001

EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 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

INCA COMMUNITY SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: INCA COMMUNITY SERVICES, INC.

Employer identification number (EIN): 730785941

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2020-01-01
001 2019-01-01 LAQUITA THORNLEY 2020-07-28
001 2018-01-01 LAQUITA THORNLEY 2019-07-16
001 2017-01-01 LAQUITA THORNLEY
001 2016-01-01 LAQUITA THORNLEY 2017-04-04 LAQUITA THORNLEY 2017-04-04
001 2015-01-01 LAQUITA THORNLEY 2016-06-01 LAQUITA THORNLEY 2016-06-01
001 2014-01-01 LAQUITA THORNLEY 2015-05-14 LAQUITA THORNLEY 2015-05-14
001 2013-01-01 LAQUITA THORNLEY LAQUITA THORNLEY 2014-08-20
001 2012-01-01 LAQUITA THORNLEY 2013-06-12 LAQUITA THORNLEY 2013-06-12
001 2011-01-01 LAQUITA THORNLEY
001 2009-01-01 LAQUITA THORNLEY LAQUITA THORNLEY 2010-07-26

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2020-01-01
001	2019-01-01	LAQUITA THORNLEY	2020-07-28
001	2018-01-01	LAQUITA THORNLEY	2019-07-16
001	2017-01-01	LAQUITA THORNLEY
001	2016-01-01	LAQUITA THORNLEY	2017-04-04	LAQUITA THORNLEY	2017-04-04
001	2015-01-01	LAQUITA THORNLEY	2016-06-01	LAQUITA THORNLEY	2016-06-01
001	2014-01-01	LAQUITA THORNLEY	2015-05-14	LAQUITA THORNLEY	2015-05-14
001	2013-01-01	LAQUITA THORNLEY		LAQUITA THORNLEY	2014-08-20
001	2012-01-01	LAQUITA THORNLEY	2013-06-12	LAQUITA THORNLEY	2013-06-12
001	2011-01-01	LAQUITA THORNLEY
001	2009-01-01	LAQUITA THORNLEY		LAQUITA THORNLEY	2010-07-26

Plan Statistics for EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC.

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC.

Measure Date Value
2022: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2022 401k membership
Total participants, beginning-of-year 2022-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 60
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 53
Total of all active and inactive participants 2022-01-01 113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 113
Number of participants with account balances 2022-01-01 113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 1
2021: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2021 401k membership
Total participants, beginning-of-year 2021-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 62
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 47
Total of all active and inactive participants 2021-01-01 109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 2
Total participants 2021-01-01 111
Number of participants with account balances 2021-01-01 111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 5
2020: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2020 401k membership
Total participants, beginning-of-year 2020-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 64
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 47
Total of all active and inactive participants 2020-01-01 111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 2
Total participants 2020-01-01 113
Number of participants with account balances 2020-01-01 112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 2
2017: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2017 401k membership
Total participants, beginning-of-year 2017-01-01 104
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 58
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 36
Total of all active and inactive participants 2017-01-01 94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 95
Number of participants with account balances 2017-01-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 3
2013: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2013 401k membership
Total participants, beginning-of-year 2013-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 65
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 26
Total of all active and inactive participants 2013-01-01 91
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 91
Number of participants with account balances 2013-01-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 3
2012: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2012 401k membership
Total participants, beginning-of-year 2012-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 61
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 42
Total of all active and inactive participants 2012-01-01 103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 103
Number of participants with account balances 2012-01-01 61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 44
2011: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2011 401k membership
Total participants, beginning-of-year 2011-01-01 98
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 67
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 19
Total of all active and inactive participants 2011-01-01 86
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 86
Number of participants with account balances 2011-01-01 86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2009 401k membership
Total participants, beginning-of-year 2009-01-01 101
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 70
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 24
Total of all active and inactive participants 2009-01-01 94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 94
Number of participants with account balances 2009-01-01 81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 3

Measure	Date	Value
2022: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2022 401k membership
Total participants, beginning-of-year	2022-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	60
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	53
Total of all active and inactive participants	2022-01-01	113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	113
Number of participants with account balances	2022-01-01	113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	1
2021: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2021 401k membership
Total participants, beginning-of-year	2021-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	62
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	47
Total of all active and inactive participants	2021-01-01	109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	2
Total participants	2021-01-01	111
Number of participants with account balances	2021-01-01	111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	5
2020: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2020 401k membership
Total participants, beginning-of-year	2020-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	64
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	47
Total of all active and inactive participants	2020-01-01	111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	2
Total participants	2020-01-01	113
Number of participants with account balances	2020-01-01	112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	2
2017: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2017 401k membership
Total participants, beginning-of-year	2017-01-01	104
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	58
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	36
Total of all active and inactive participants	2017-01-01	94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	95
Number of participants with account balances	2017-01-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	3
2013: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2013 401k membership
Total participants, beginning-of-year	2013-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	65
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	26
Total of all active and inactive participants	2013-01-01	91
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	91
Number of participants with account balances	2013-01-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	3
2012: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2012 401k membership
Total participants, beginning-of-year	2012-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	61
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	42
Total of all active and inactive participants	2012-01-01	103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	103
Number of participants with account balances	2012-01-01	61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	44
2011: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2011 401k membership
Total participants, beginning-of-year	2011-01-01	98
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	67
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	19
Total of all active and inactive participants	2011-01-01	86
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	86
Number of participants with account balances	2011-01-01	86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2009 401k membership
Total participants, beginning-of-year	2009-01-01	101
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	70
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	24
Total of all active and inactive participants	2009-01-01	94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	94
Number of participants with account balances	2009-01-01	81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	3

Financial Data on EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC.

Measure	Date	Value
2022 : EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$0
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total transfer of assets to this plan	2022-12-31	$0
Total transfer of assets from this plan	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-247,330
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$188,152
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$187,723
Expenses. Certain deemed distributions of participant loans	2022-12-31	$0
Value of total corrective distributions	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$199,113
Value of total assets at end of year	2022-12-31	$2,948,012
Value of total assets at beginning of year	2022-12-31	$3,383,494
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$429
Total interest from all sources	2022-12-31	$5,581
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$0
Assets. Real estate other than employer real property at end of year	2022-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-12-31	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$100,936
Participant contributions at end of year	2022-12-31	$78,199
Participant contributions at beginning of year	2022-12-31	$86,608
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$57
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-12-31	$0
Assets. Loans (other than to participants) at end of year	2022-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2022-12-31	$0
Other income not declared elsewhere	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$429
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$-435,482
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$2,948,012
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$3,383,494
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Assets. partnership/joint venture interests at end of year	2022-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$2,515,414
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$2,957,771
Value of interest in pooled separate accounts at end of year	2022-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$0
Interest on participant loans	2022-12-31	$4,714
Income. Interest from loans (other than to participants)	2022-12-31	$0
Interest earned on other investments	2022-12-31	$867
Income. Interest from US Government securities	2022-12-31	$0
Income. Interest from corporate debt instruments	2022-12-31	$0
Value of interest in master investment trust accounts at end of year	2022-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2022-12-31	$0
Value of interest in common/collective trusts at end of year	2022-12-31	$0
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$354,399
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$339,115
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Asset value of US Government securities at end of year	2022-12-31	$0
Asset value of US Government securities at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$0
Net investment gain/loss from pooled separate accounts	2022-12-31	$-452,024
Net investment gain or loss from common/collective trusts	2022-12-31	$0
Net gain/loss from 103.12 investment entities	2022-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$98,120
Income. Dividends from preferred stock	2022-12-31	$0
Income. Dividends from common stock	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$187,723
Asset. Corporate debt instrument preferred debt at end of year	2022-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$0
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Aggregate proceeds on sale of assets	2022-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2022-12-31	$0
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	SAUNDERS & ASSOCIATES, PLLC
Accountancy firm EIN	2022-12-31	208209116
2021 : EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$583,240
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$68,824
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$66,704
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$214,077
Value of total assets at end of year	2021-12-31	$3,383,494
Value of total assets at beginning of year	2021-12-31	$2,869,078
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$2,120
Total interest from all sources	2021-12-31	$11,263
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$106,211
Participant contributions at end of year	2021-12-31	$86,608
Participant contributions at beginning of year	2021-12-31	$104,143
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$9,140
Other income not declared elsewhere	2021-12-31	$0
Administrative expenses (other) incurred	2021-12-31	$2,120
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$514,416
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$3,383,494
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,869,078
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$2,957,771
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$2,434,665
Interest on participant loans	2021-12-31	$5,496
Interest earned on other investments	2021-12-31	$5,767
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$339,115
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$330,270
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Net investment gain/loss from pooled separate accounts	2021-12-31	$357,900
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$98,726
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$66,704
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	SAUNDERS & ASSOCIATES, PLLC
Accountancy firm EIN	2021-12-31	208209116
2020 : EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$499,479
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$250,052
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$249,361
Expenses. Certain deemed distributions of participant loans	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$212,380
Value of total assets at end of year	2020-12-31	$2,869,078
Value of total assets at beginning of year	2020-12-31	$2,642,371
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$691
Total interest from all sources	2020-12-31	$8,502
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	No
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$110,442
Participant contributions at end of year	2020-12-31	$104,143
Participant contributions at beginning of year	2020-12-31	$126,156
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$0
Other income not declared elsewhere	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$691
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$249,427
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,869,078
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,642,371
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$2,434,665
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$2,328,035
Interest on participant loans	2020-12-31	$6,088
Interest earned on other investments	2020-12-31	$2,414
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$330,270
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$188,180
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from pooled separate accounts	2020-12-31	$278,597
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$101,938
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$249,361
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
2017 : EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$432,356
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$122,374
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$116,677
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$165,362
Value of total assets at end of year	2017-12-31	$2,309,751
Value of total assets at beginning of year	2017-12-31	$1,999,769
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$5,697
Total interest from all sources	2017-12-31	$3,290
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$200,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$84,595
Participant contributions at end of year	2017-12-31	$46,614
Participant contributions at beginning of year	2017-12-31	$56,595
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$0
Other income not declared elsewhere	2017-12-31	$1,350
Administrative expenses (other) incurred	2017-12-31	$5,697
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$309,982
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,309,751
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,999,769
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$2,107,647
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$1,807,207
Interest on participant loans	2017-12-31	$1,828
Interest earned on other investments	2017-12-31	$1,462
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$155,490
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$135,967
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from pooled separate accounts	2017-12-31	$262,354
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$80,767
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$116,677
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	SAUNDERS & ASSOCIATES, PLLC
Accountancy firm EIN	2017-12-31	208209116
2013 : EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$2,156,550
Expenses. Total of all expenses incurred	2013-12-31	$1,938,011
Benefits paid (including direct rollovers)	2013-12-31	$1,844,546
Total plan assets at end of year	2013-12-31	$1,779,313
Total plan assets at beginning of year	2013-12-31	$1,560,774
Value of fidelity bond covering the plan	2013-12-31	$50,000
Total contributions received or receivable from participants	2013-12-31	$80,924
Expenses. Other expenses not covered elsewhere	2013-12-31	$93,465
Contributions received from other sources (not participants or employers)	2013-12-31	$30,157
Other income received	2013-12-31	$1,968,756
Net income (gross income less expenses)	2013-12-31	$218,539
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,779,313
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,560,774
Assets. Value of participant loans	2013-12-31	$56,028
Total contributions received or receivable from employer(s)	2013-12-31	$76,713
Value of certain deemed distributions of participant loans	2013-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2012 401k financial data
Total income from all sources	2012-12-31	$335,805
Expenses. Total of all expenses incurred	2012-12-31	$111,574
Benefits paid (including direct rollovers)	2012-12-31	$110,276
Total plan assets at end of year	2012-12-31	$1,561,166
Total plan assets at beginning of year	2012-12-31	$1,336,935
Value of fidelity bond covering the plan	2012-12-31	$50,000
Total contributions received or receivable from participants	2012-12-31	$81,999
Expenses. Other expenses not covered elsewhere	2012-12-31	$1,298
Other income received	2012-12-31	$175,110
Net income (gross income less expenses)	2012-12-31	$224,231
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,561,166
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,336,935
Assets. Value of participant loans	2012-12-31	$58,111
Total contributions received or receivable from employer(s)	2012-12-31	$78,696
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 : EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total income from all sources	2011-12-31	$73,313
Expenses. Total of all expenses incurred	2011-12-31	$159,184
Benefits paid (including direct rollovers)	2011-12-31	$157,317
Total plan assets at end of year	2011-12-31	$1,336,935
Total plan assets at beginning of year	2011-12-31	$1,422,806
Value of fidelity bond covering the plan	2011-12-31	$50,000
Total contributions received or receivable from participants	2011-12-31	$76,041
Expenses. Other expenses not covered elsewhere	2011-12-31	$1,867
Contributions received from other sources (not participants or employers)	2011-12-31	$6,108
Other income received	2011-12-31	$-82,808
Net income (gross income less expenses)	2011-12-31	$-85,871
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,336,935
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,422,806
Assets. Value of participant loans	2011-12-31	$35,432
Total contributions received or receivable from employer(s)	2011-12-31	$73,972
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 : EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2010 401k financial data
Total income from all sources	2010-12-31	$333,355
Expenses. Total of all expenses incurred	2010-12-31	$209,232
Benefits paid (including direct rollovers)	2010-12-31	$209,022
Total plan assets at end of year	2010-12-31	$1,422,806
Total plan assets at beginning of year	2010-12-31	$1,298,683
Value of fidelity bond covering the plan	2010-12-31	$50,000
Total contributions received or receivable from participants	2010-12-31	$86,339
Expenses. Other expenses not covered elsewhere	2010-12-31	$210
Other income received	2010-12-31	$165,648
Net income (gross income less expenses)	2010-12-31	$124,123
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,422,806
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,298,683
Assets. Value of participant loans	2010-12-31	$26,489
Total contributions received or receivable from employer(s)	2010-12-31	$81,368
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
2009 : EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year	2009-12-31	$0
Minimum employer required contribution for this plan year	2009-12-31	$0
Amount contributed by the employer to the plan for this plan year	2009-12-31	$0

Form 5500 Responses for EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC.

2022: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	Yes
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2017: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2013: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 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: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 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: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 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
2009: EMPLOYEE BENEFIT PLAN OF INCA COMMUNITY SERVICES, INC. 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

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

059031

Policy instance

Insurance contract or identification number	059031
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $411
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	1
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?	No
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
Amount paid for insurance broker fees	411
Additional information about fees paid to insurance broker	INCENTIVE COMPENSATION
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

059031I

Policy instance

Insurance contract or identification number	059031I
Number of Individuals Covered	111
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $162
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	1
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?	No
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 $0
Amount paid for insurance broker fees	162
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

059031I

Policy instance

Insurance contract or identification number	059031I
Number of Individuals Covered	113
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $162
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	1
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?	No
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 $0
Amount paid for insurance broker fees	162
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

059031I

Policy instance

Insurance contract or identification number	059031I
Number of Individuals Covered	95
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $177
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	1
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?	No
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 $0
Amount paid for insurance broker fees	177
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?	3
Insurance broker name	DALLAS REGIONAL OFFICE

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

Policy contract number

GA-023890

Policy instance

Insurance contract or identification number	GA-023890
Number of Individuals Covered	0
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,486
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?	No
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
Commission paid to Insurance Broker	USD $3,486
Additional information about fees paid to insurance broker	SALES/MARKETING
Insurance broker organization code?	3
Insurance broker name	EDWARD D JONES & CO INSURANCE

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

059031I

Policy instance

Insurance contract or identification number	059031I
Number of Individuals Covered	91
Insurance policy start date	2013-07-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
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	1
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?	No
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-023890

Policy instance

Insurance contract or identification number	GA-023890
Number of Individuals Covered	86
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $4,264
Total amount of fees paid to insurance company	USD $1,181
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-023890

Policy instance

Insurance contract or identification number	GA-023890
Number of Individuals Covered	78
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,709
Total amount of fees paid to insurance company	USD $1,127
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 $3,709
Insurance broker organization code?	3
Amount paid for insurance broker fees	1127
Additional information about fees paid to insurance broker	SALES/MARKETING
Insurance broker name	EDWARD D JONES & CO

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Company Name:	INCA COMMUNITY SERVICES, INC.
Employer identification number (EIN):	730785941
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations