401k Plan data: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN plan

FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 401k Plan overview

Plan Name	FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN
Plan identification number	001

FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE 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

BLANKENSHIP BROTHERS INC. has sponsored the creation of one or more 401k plans.

Company Name: BLANKENSHIP BROTHERS INC.

Employer identification number (EIN): 731083195

NAIC Classification: 339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 ALLEN BLANKENSHIP 2018-07-11
001 2016-01-01 ALLEN BLANKENSHIP 2017-10-10
001 2016-01-01 ALLEN BLANKENSHIP 2018-07-11
001 2015-01-01 ALLEN BLANKENSHIP
001 2015-01-01
001 2014-01-01 ALLEN BLANKENSHIP
001 2013-01-01 ALLEN BLANKENSHIP
001 2012-01-01 ALLEN BLANKENSHIP
001 2011-01-01 ALLEN BLANKENSHIP
001 2010-01-01 ALLEN BLANKENSHIP
001 2009-01-01 ALLEN BLANKENSHIP

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2017-01-01	ALLEN BLANKENSHIP	2018-07-11
001	2016-01-01	ALLEN BLANKENSHIP	2017-10-10
001	2016-01-01	ALLEN BLANKENSHIP	2018-07-11
001	2015-01-01	ALLEN BLANKENSHIP
001	2015-01-01
001	2014-01-01	ALLEN BLANKENSHIP
001	2013-01-01	ALLEN BLANKENSHIP
001	2012-01-01	ALLEN BLANKENSHIP
001	2011-01-01	ALLEN BLANKENSHIP
001	2010-01-01	ALLEN BLANKENSHIP
001	2009-01-01	ALLEN BLANKENSHIP

Plan Statistics for FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN

401k plan membership statisitcs for FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN

Measure Date Value
2015: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 29
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 25
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 3
Total of all active and inactive participants 2015-01-01 28
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 28
Number of participants with account balances 2015-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 33
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 25
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 1
Total of all active and inactive participants 2014-01-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 26
Number of participants with account balances 2014-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 33
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 33
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 33
Number of participants with account balances 2013-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 22
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 1
Total of all active and inactive participants 2012-01-01 24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 24
Number of participants with account balances 2012-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 22
Number of retired or separated participants receiving benefits 2011-01-01 2
Number of other retired or separated participants entitled to future benefits 2011-01-01 1
Total of all active and inactive participants 2011-01-01 25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 25
Number of participants with account balances 2011-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 28
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 25
Number of retired or separated participants receiving benefits 2010-01-01 1
Number of other retired or separated participants entitled to future benefits 2010-01-01 1
Total of all active and inactive participants 2010-01-01 27
Total participants 2010-01-01 27
Number of participants with account balances 2010-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 1
2009: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 27
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 25
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 1
Total of all active and inactive participants 2009-01-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 26
Number of participants with account balances 2009-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2015: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	29
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	25
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	3
Total of all active and inactive participants	2015-01-01	28
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	28
Number of participants with account balances	2015-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	33
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	25
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	1
Total of all active and inactive participants	2014-01-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	26
Number of participants with account balances	2014-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	33
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	33
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	33
Number of participants with account balances	2013-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	22
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	1
Total of all active and inactive participants	2012-01-01	24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	24
Number of participants with account balances	2012-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	22
Number of retired or separated participants receiving benefits	2011-01-01	2
Number of other retired or separated participants entitled to future benefits	2011-01-01	1
Total of all active and inactive participants	2011-01-01	25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	25
Number of participants with account balances	2011-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	28
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	25
Number of retired or separated participants receiving benefits	2010-01-01	1
Number of other retired or separated participants entitled to future benefits	2010-01-01	1
Total of all active and inactive participants	2010-01-01	27
Total participants	2010-01-01	27
Number of participants with account balances	2010-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	1
2009: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	27
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	25
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	1
Total of all active and inactive participants	2009-01-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	26
Number of participants with account balances	2009-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN

Measure	Date	Value
2015 : FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$23,333
Total plan assets at end of year	2015-12-31	$247,974
Total plan assets at beginning of year	2015-12-31	$224,641
Value of fidelity bond covering the plan	2015-12-31	$50,000
Total contributions received or receivable from participants	2015-12-31	$21,853
Other income received	2015-12-31	$-5,695
Net income (gross income less expenses)	2015-12-31	$23,333
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$247,974
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$224,641
Total contributions received or receivable from employer(s)	2015-12-31	$7,175
2014 : FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$37,046
Expenses. Total of all expenses incurred	2014-12-31	$1,000
Benefits paid (including direct rollovers)	2014-12-31	$1,000
Total plan assets at end of year	2014-12-31	$224,641
Total plan assets at beginning of year	2014-12-31	$188,595
Value of fidelity bond covering the plan	2014-12-31	$50,000
Total contributions received or receivable from participants	2014-12-31	$20,640
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$9,315
Net income (gross income less expenses)	2014-12-31	$36,046
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$224,641
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$188,595
Total contributions received or receivable from employer(s)	2014-12-31	$7,091
Value of certain deemed distributions of participant loans	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$0
2013 : FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$65,310
Expenses. Total of all expenses incurred	2013-12-31	$0
Benefits paid (including direct rollovers)	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$188,595
Total plan assets at beginning of year	2013-12-31	$123,285
Total contributions received or receivable from participants	2013-12-31	$20,483
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$37,517
Net income (gross income less expenses)	2013-12-31	$65,310
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$188,595
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$123,285
Total contributions received or receivable from employer(s)	2013-12-31	$7,310
Value of certain deemed distributions of participant loans	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$0
2012 : FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$26,124
Expenses. Total of all expenses incurred	2012-12-31	$583
Benefits paid (including direct rollovers)	2012-12-31	$583
Total plan assets at end of year	2012-12-31	$123,285
Total plan assets at beginning of year	2012-12-31	$97,744
Total contributions received or receivable from participants	2012-12-31	$14,824
Other income received	2012-12-31	$10,822
Net income (gross income less expenses)	2012-12-31	$25,541
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$123,285
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$97,744
Total contributions received or receivable from employer(s)	2012-12-31	$478
2011 : FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$6,853
Total plan assets at end of year	2011-12-31	$97,744
Total plan assets at beginning of year	2011-12-31	$90,891
Total contributions received or receivable from participants	2011-12-31	$12,758
Other income received	2011-12-31	$-5,905
Net income (gross income less expenses)	2011-12-31	$6,853
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$97,744
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$90,891
2010 : FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2010 401k financial data
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$22,467
Expenses. Total of all expenses incurred	2010-12-31	$10,642
Benefits paid (including direct rollovers)	2010-12-31	$10,642
Total plan assets at end of year	2010-12-31	$90,891
Total plan assets at beginning of year	2010-12-31	$79,066
Total contributions received or receivable from participants	2010-12-31	$13,501
Other income received	2010-12-31	$8,782
Net income (gross income less expenses)	2010-12-31	$11,825
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$90,891
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$79,066
Total contributions received or receivable from employer(s)	2010-12-31	$184
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN

2015: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: FAST SIGNS AND RELATED EMPLOYERS SAVINGS INCENTIVE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-B0-KA98

Policy instance

Insurance contract or identification number	GAP-B0-KA98
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
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
Insurance broker organization code?	3
Insurance broker name	FIRST INDEPENDENT FINANCIALSERVICES

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-B0-KA98

Policy instance

Insurance contract or identification number	GAP-B0-KA98
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1
Commission paid to Insurance Broker	USD $1
Insurance broker organization code?	3
Insurance broker name	FIRST INDEPENDENT FINANCIALSERVICES

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-B0-KA98

Policy instance

Insurance contract or identification number	GAP-B0-KA98
Number of Individuals Covered	33
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $1
Insurance broker organization code?	3
Insurance broker name	FIRST INDEPENDENT FINANCIALSERVICES

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-B0-KA98

Policy instance

Insurance contract or identification number	GAP-B0-KA98
Number of Individuals Covered	4
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $2
Additional information about fees paid to insurance broker	AGENT OF RECORD
Insurance broker organization code?	3
Insurance broker name	FIRST INDEPENDENT FINANCIALSERVICES

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-B0-KA98

Policy instance

Insurance contract or identification number	GAP-B0-KA98
Number of Individuals Covered	4
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-B0-KA98

Policy instance

Insurance contract or identification number	GAP-B0-KA98
Number of Individuals Covered	4
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes

Potentially related plans

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Company Name:	BLANKENSHIP BROTHERS INC.
Employer identification number (EIN):	731083195
NAIC Classification:	339900