401k Plan data: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN plan

PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 401k Plan overview

Plan Name	PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN
Plan identification number	001

PAWNEE TRIBAL DEVELOPMENT CORPORATION 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

PAWNEE TRIBAL DEVELOPMENT CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: PAWNEE TRIBAL DEVELOPMENT CORPORATION

Employer identification number (EIN): 731387750

NAIC Classification: 812990
NAIC Description: All Other Personal Services

Additional information about PAWNEE TRIBAL DEVELOPMENT CORPORATION

Jurisdiction of Incorporation: Oklahoma Secretary Of State

Incorporation Date:

Company Identification Number: 2312027214

More information about PAWNEE TRIBAL DEVELOPMENT CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN

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 JAIME MALTSBERGER 2021-10-14
001 2019-01-01 JAIME MALTSBERGER 2020-10-05
001 2018-01-01 JAIME MALTSBERGER 2019-10-14
001 2017-01-01
001 2016-01-01
001 2016-01-01 CLAY RAUN 2017-10-16

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01	JAIME MALTSBERGER	2021-10-14
001	2019-01-01	JAIME MALTSBERGER	2020-10-05
001	2018-01-01	JAIME MALTSBERGER	2019-10-14
001	2017-01-01
001	2016-01-01
001	2016-01-01	CLAY RAUN	2017-10-16

Plan Statistics for PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN

401k plan membership statisitcs for PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN

Measure Date Value
2022: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 106
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 85
Number of retired or separated participants receiving benefits 2022-01-01 34
Number of other retired or separated participants entitled to future benefits 2022-01-01 14
Total of all active and inactive participants 2022-01-01 133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 133
Number of participants with account balances 2022-01-01 85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 106
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 0
Total of all active and inactive participants 2021-01-01 106
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 106
Number of participants with account balances 2021-01-01 69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 167
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 110
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 23
Total of all active and inactive participants 2020-01-01 133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 133
Number of participants with account balances 2020-01-01 87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 25
2019: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 203
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 132
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 28
Total of all active and inactive participants 2019-01-01 160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 160
Number of participants with account balances 2019-01-01 102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 22
2018: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 204
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 149
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 51
Total of all active and inactive participants 2018-01-01 200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 200
Number of participants with account balances 2018-01-01 120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 30
2017: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 160
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 37
Total of all active and inactive participants 2017-01-01 197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 198
Number of participants with account balances 2017-01-01 119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 17
2016: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 216
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 151
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 12
Total of all active and inactive participants 2016-01-01 163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 1
Total participants 2016-01-01 164
Number of participants with account balances 2016-01-01 104
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 26

Measure	Date	Value
2022: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	106
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	85
Number of retired or separated participants receiving benefits	2022-01-01	34
Number of other retired or separated participants entitled to future benefits	2022-01-01	14
Total of all active and inactive participants	2022-01-01	133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	133
Number of participants with account balances	2022-01-01	85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	106
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	0
Total of all active and inactive participants	2021-01-01	106
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	106
Number of participants with account balances	2021-01-01	69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	167
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	110
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	23
Total of all active and inactive participants	2020-01-01	133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	133
Number of participants with account balances	2020-01-01	87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	25
2019: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	203
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	132
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	28
Total of all active and inactive participants	2019-01-01	160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	160
Number of participants with account balances	2019-01-01	102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	22
2018: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	204
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	149
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	51
Total of all active and inactive participants	2018-01-01	200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	200
Number of participants with account balances	2018-01-01	120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	30
2017: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	160
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	37
Total of all active and inactive participants	2017-01-01	197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	198
Number of participants with account balances	2017-01-01	119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	17
2016: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	216
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	151
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	12
Total of all active and inactive participants	2016-01-01	163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	1
Total participants	2016-01-01	164
Number of participants with account balances	2016-01-01	104
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	26

Financial Data on PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN

Measure	Date	Value
2022 : PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	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	$85,371
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$152,292
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$142,748
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$186,025
Value of total assets at end of year	2022-12-31	$594,727
Value of total assets at beginning of year	2022-12-31	$661,648
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$9,544
Total interest from all sources	2022-12-31	$10,916
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
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$50,000
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	$113,974
Participant contributions at end of year	2022-12-31	$69,303
Participant contributions at beginning of year	2022-12-31	$63,437
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$12,285
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
Value of net income/loss	2022-12-31	$-66,921
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$594,727
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$661,648
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$515,761
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$596,739
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$10,916
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$9,663
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,472
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-111,570
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	Yes
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	$59,766
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$142,748
Contract administrator fees	2022-12-31	$9,544
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
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	ROSE ROCK CPAS, PLLC
Accountancy firm EIN	2022-12-31	260852716
2021 : PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 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	$187,024
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$49,820
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$38,913
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$134,454
Value of total assets at end of year	2021-12-31	$661,648
Value of total assets at beginning of year	2021-12-31	$524,444
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$10,907
Total interest from all sources	2021-12-31	$0
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	Yes
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	$91,043
Participant contributions at end of year	2021-12-31	$63,437
Participant contributions at beginning of year	2021-12-31	$45,104
Participant contributions at beginning of year	2021-12-31	$3,862
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	$137,204
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$661,648
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$524,444
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	$596,739
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$424,965
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,472
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$48,863
Net investment gain/loss from pooled separate accounts	2021-12-31	$52,570
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	Yes
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	$43,411
Employer contributions (assets) at beginning of year	2021-12-31	$1,650
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$38,913
Contract administrator fees	2021-12-31	$10,907
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2021-12-31	Yes
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	Disclaimer
Accountancy firm name	2021-12-31	FINLEY & COOK
Accountancy firm EIN	2021-12-31	730604334
2020 : PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 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	$204,893
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$127,442
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$116,168
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$145,338
Value of total assets at end of year	2020-12-31	$524,444
Value of total assets at beginning of year	2020-12-31	$446,993
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$11,274
Total interest from all sources	2020-12-31	$2,470
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	Yes
Value of fidelity bond cover	2020-12-31	$50,000
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	$98,885
Participant contributions at end of year	2020-12-31	$45,104
Participant contributions at beginning of year	2020-12-31	$44,752
Participant contributions at end of year	2020-12-31	$3,862
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	$77,451
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$524,444
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$446,993
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 pooled separate accounts at end of year	2020-12-31	$424,965
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$359,072
Interest on participant loans	2020-12-31	$2,302
Interest earned on other investments	2020-12-31	$168
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$48,863
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$43,169
Net investment gain/loss from pooled separate accounts	2020-12-31	$57,085
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	$46,453
Employer contributions (assets) at end of year	2020-12-31	$1,650
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$116,168
Contract administrator fees	2020-12-31	$11,274
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
Accountancy firm name	2020-12-31	FINLEY & COOK, PLLC
Accountancy firm EIN	2020-12-31	730604334
2019 : PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$204,421
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$107,749
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$93,096
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$138,710
Value of total assets at end of year	2019-12-31	$446,993
Value of total assets at beginning of year	2019-12-31	$350,321
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$14,653
Total interest from all sources	2019-12-31	$1,832
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$50,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$92,098
Participant contributions at end of year	2019-12-31	$44,752
Participant contributions at beginning of year	2019-12-31	$13,849
Participant contributions at beginning of year	2019-12-31	$3,413
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$3,610
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$96,672
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$446,993
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$350,321
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$359,072
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$291,361
Interest on participant loans	2019-12-31	$1,593
Interest earned on other investments	2019-12-31	$239
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$43,169
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$39,992
Net investment gain/loss from pooled separate accounts	2019-12-31	$63,879
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$43,002
Employer contributions (assets) at beginning of year	2019-12-31	$1,706
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$93,096
Contract administrator fees	2019-12-31	$14,653
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	FINLEY & COOK PLLC
Accountancy firm EIN	2019-12-31	730604334
2018 : PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$134,827
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$54,718
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$45,074
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$155,964
Value of total assets at end of year	2018-12-31	$350,321
Value of total assets at beginning of year	2018-12-31	$270,212
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$9,644
Total interest from all sources	2018-12-31	$246
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$50,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$103,610
Participant contributions at end of year	2018-12-31	$13,849
Participant contributions at beginning of year	2018-12-31	$0
Participant contributions at end of year	2018-12-31	$3,413
Participant contributions at beginning of year	2018-12-31	$15,545
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$1,914
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$80,109
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$350,321
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$270,212
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in pooled separate accounts at end of year	2018-12-31	$291,361
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$225,392
Interest on participant loans	2018-12-31	$207
Interest earned on other investments	2018-12-31	$39
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$39,992
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$21,503
Net investment gain/loss from pooled separate accounts	2018-12-31	$-21,383
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$50,440
Employer contributions (assets) at end of year	2018-12-31	$1,706
Employer contributions (assets) at beginning of year	2018-12-31	$7,772
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$45,074
Contract administrator fees	2018-12-31	$9,644
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	WIPFLI, LLP
Accountancy firm EIN	2018-12-31	390758449
2017 : PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 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	$184,175
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$44,644
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$38,999
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$158,246
Value of total assets at end of year	2017-12-31	$270,212
Value of total assets at beginning of year	2017-12-31	$130,681
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$5,645
Total interest from all sources	2017-12-31	$61
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	$50,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$105,496
Participant contributions at end of year	2017-12-31	$15,545
Participant contributions at beginning of year	2017-12-31	$3,774
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	$139,531
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$270,212
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$130,681
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 pooled separate accounts at end of year	2017-12-31	$225,392
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$115,072
Interest earned on other investments	2017-12-31	$61
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$21,503
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$9,948
Net investment gain/loss from pooled separate accounts	2017-12-31	$25,868
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	$52,750
Employer contributions (assets) at end of year	2017-12-31	$7,772
Employer contributions (assets) at beginning of year	2017-12-31	$1,887
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$38,999
Contract administrator fees	2017-12-31	$5,645
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	WIPFLI, LLP
Accountancy firm EIN	2017-12-31	390758449
2016 : PAWNEE TRIBAL DEVELOPMENT CORPORATION 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	$148,973
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$18,292
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$11,581
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$144,316
Value of total assets at end of year	2016-12-31	$130,681
Value of total assets at beginning of year	2016-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$6,711
Total interest from all sources	2016-12-31	$10
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	$50,000
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	$96,207
Participant contributions at end of year	2016-12-31	$3,774
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	$130,681
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$130,681
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$0
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	$115,072
Interest earned on other investments	2016-12-31	$10
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$9,948
Net investment gain/loss from pooled separate accounts	2016-12-31	$4,647
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	$48,109
Employer contributions (assets) at end of year	2016-12-31	$1,887
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$11,581
Contract administrator fees	2016-12-31	$6,711
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	WIPFLI, LLP
Accountancy firm EIN	2016-12-31	390758449

Form 5500 Responses for PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN

2022: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	Yes
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 funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 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 funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
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 funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: PAWNEE TRIBAL DEVELOPMENT CORPORATION 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	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
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: PAWNEE TRIBAL DEVELOPMENT CORPORATION 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	First time form 5500 has been submitted	Yes
2016-01-01	Submission has been amended	Yes
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

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

515542-01

Policy instance

Insurance contract or identification number	515542-01
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 $0
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

515542-01

Policy instance

Insurance contract or identification number	515542-01
Number of Individuals Covered	133
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 $0
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
Welfare Benefit Premiums Paid to Carrier	USD $1,877,390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $54,013
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

810238

Policy instance

Insurance contract or identification number	810238
Number of Individuals Covered	133
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 $0
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

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

810238

Policy instance

Insurance contract or identification number	810238
Number of Individuals Covered	160
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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?	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

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

810238

Policy instance

Insurance contract or identification number	810238
Number of Individuals Covered	200
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $768
Total amount of fees paid to insurance company	USD $0
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 $768

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

810238

Policy instance

Insurance contract or identification number	810238
Number of Individuals Covered	198
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $670
Total amount of fees paid to insurance company	USD $0
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 $670
Insurance broker name	BROWN BROWN AGC INS PROF INC

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Company Name:	PAWNEE TRIBAL DEVELOPMENT CORPORATION
Employer identification number (EIN):	731387750
NAIC Classification:	812990
NAIC Description:	All Other Personal Services

Jurisdiction of Incorporation:	Oklahoma Secretary Of State
Incorporation Date:
Company Identification Number:	2312027214