401k Plan data: MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN plan

MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN
Plan identification number	003

MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING 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

MARK HANCOCK DEVELOPMENT CORPORATION DBA CAMELOT HOMES has sponsored the creation of one or more 401k plans.

Company Name: MARK HANCOCK DEVELOPMENT CORPORATION DBA CAMELOT HOMES

Employer identification number (EIN): 860277586

NAIC Classification: 236110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2022-01-01 JOHN MARK HANCOCK 2023-10-13
003 2021-01-01 JOHN MARK HANCOCK 2022-10-14
003 2021-01-01 JOHN MARK HANCOCK 2023-09-29
003 2020-01-01 JOHN MARK HANCOCK 2021-10-13
003 2019-01-01 JOHN MARK HANCOCK 2020-10-15
003 2019-01-01 JOHN MARK HANCOCK 2020-12-31
003 2018-01-01 JOHN MARK HANCOCK 2019-10-10
003 2017-01-01 JOHN MARK HANCOCK
003 2016-01-01 JOHN MARK HANCOCK
003 2015-01-01 JOHN MARK HANCOCK
003 2014-01-01 JOHN MARK HANCOCK
003 2013-01-01 JOHN MARK HANCOCK
003 2012-01-01 JOHN MARK HANCOCK JOHN MARK HANCOCK 2013-10-10
003 2011-01-01 MARK HANCOCK 2012-07-24 MARK HANCOCK 2012-07-24
003 2010-01-01 JOHN MARK HANCOCK 2011-09-13 JOHN MARK HANCOCK 2011-09-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
003	2022-01-01	JOHN MARK HANCOCK	2023-10-13
003	2021-01-01	JOHN MARK HANCOCK	2022-10-14
003	2021-01-01	JOHN MARK HANCOCK	2023-09-29
003	2020-01-01	JOHN MARK HANCOCK	2021-10-13
003	2019-01-01	JOHN MARK HANCOCK	2020-10-15
003	2019-01-01	JOHN MARK HANCOCK	2020-12-31
003	2018-01-01	JOHN MARK HANCOCK	2019-10-10
003	2017-01-01	JOHN MARK HANCOCK
003	2016-01-01	JOHN MARK HANCOCK
003	2015-01-01	JOHN MARK HANCOCK
003	2014-01-01	JOHN MARK HANCOCK
003	2013-01-01	JOHN MARK HANCOCK
003	2012-01-01	JOHN MARK HANCOCK		JOHN MARK HANCOCK	2013-10-10
003	2011-01-01	MARK HANCOCK	2012-07-24	MARK HANCOCK	2012-07-24
003	2010-01-01	JOHN MARK HANCOCK	2011-09-13	JOHN MARK HANCOCK	2011-09-13

Plan Statistics for MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN

Measure Date Value
2017: MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 73
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 31
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 46
Total of all active and inactive participants 2017-01-01 77
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 77
Number of participants with account balances 2017-01-01 3
2016: MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 70
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 29
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 44
Total of all active and inactive participants 2016-01-01 73
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 73
Number of participants with account balances 2016-01-01 69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 1
2015: MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 71
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 27
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 42
Total of all active and inactive participants 2015-01-01 69
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 69
Number of participants with account balances 2015-01-01 62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 68
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 27
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 44
Total of all active and inactive participants 2014-01-01 71
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 71
Number of participants with account balances 2014-01-01 60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 64
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 25
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 42
Total of all active and inactive participants 2013-01-01 67
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 67
Number of participants with account balances 2013-01-01 60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 2
2012: MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 64
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 21
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 43
Total of all active and inactive participants 2012-01-01 64
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 64
Number of participants with account balances 2012-01-01 58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2017: MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	73
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	31
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	46
Total of all active and inactive participants	2017-01-01	77
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	77
Number of participants with account balances	2017-01-01	3
2016: MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	70
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	29
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	44
Total of all active and inactive participants	2016-01-01	73
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	73
Number of participants with account balances	2016-01-01	69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	1
2015: MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	71
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	27
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	42
Total of all active and inactive participants	2015-01-01	69
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	69
Number of participants with account balances	2015-01-01	62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	68
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	27
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	44
Total of all active and inactive participants	2014-01-01	71
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	71
Number of participants with account balances	2014-01-01	60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	64
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	25
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	42
Total of all active and inactive participants	2013-01-01	67
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	67
Number of participants with account balances	2013-01-01	60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	2
2012: MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	64
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	21
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	43
Total of all active and inactive participants	2012-01-01	64
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	64
Number of participants with account balances	2012-01-01	58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2017 : MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$1,349,776
Expenses. Total of all expenses incurred	2017-12-31	$102,514
Benefits paid (including direct rollovers)	2017-12-31	$101,943
Total plan assets at end of year	2017-12-31	$6,218,421
Total plan assets at beginning of year	2017-12-31	$4,971,159
Value of fidelity bond covering the plan	2017-12-31	$500,000
Total contributions received or receivable from participants	2017-12-31	$212,844
Expenses. Other expenses not covered elsewhere	2017-12-31	$571
Other income received	2017-12-31	$1,038,477
Net income (gross income less expenses)	2017-12-31	$1,247,262
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$6,218,421
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$4,971,159
Assets. Value of participant loans	2017-12-31	$75,756
Assets. Value of real-estate (other than employer real property)	2017-12-31	$290,699
Total contributions received or receivable from employer(s)	2017-12-31	$98,455
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$804,369
Expenses. Total of all expenses incurred	2016-12-31	$124,861
Benefits paid (including direct rollovers)	2016-12-31	$122,438
Total plan assets at end of year	2016-12-31	$4,971,159
Total plan assets at beginning of year	2016-12-31	$4,291,651
Value of fidelity bond covering the plan	2016-12-31	$500,000
Total contributions received or receivable from participants	2016-12-31	$213,592
Contributions received from other sources (not participants or employers)	2016-12-31	$477,211
Other income received	2016-12-31	$16,441
Net income (gross income less expenses)	2016-12-31	$679,508
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$4,971,159
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$4,291,651
Assets. Value of participant loans	2016-12-31	$84,626
Assets. Value of real-estate (other than employer real property)	2016-12-31	$255,000
Total contributions received or receivable from employer(s)	2016-12-31	$97,125
Value of certain deemed distributions of participant loans	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$2,423
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$300,461
Expenses. Total of all expenses incurred	2015-12-31	$82,809
Benefits paid (including direct rollovers)	2015-12-31	$75,362
Total plan assets at end of year	2015-12-31	$4,291,651
Total plan assets at beginning of year	2015-12-31	$4,073,999
Value of fidelity bond covering the plan	2015-12-31	$500,000
Total contributions received or receivable from participants	2015-12-31	$207,927
Contributions received from other sources (not participants or employers)	2015-12-31	$47,650
Other income received	2015-12-31	$-34,429
Net income (gross income less expenses)	2015-12-31	$217,652
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$4,291,651
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$4,073,999
Assets. Value of participant loans	2015-12-31	$31,978
Assets. Value of real-estate (other than employer real property)	2015-12-31	$347,500
Total contributions received or receivable from employer(s)	2015-12-31	$79,313
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$7,447
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$409,680
Expenses. Total of all expenses incurred	2014-12-31	$24,000
Benefits paid (including direct rollovers)	2014-12-31	$13,494
Total plan assets at end of year	2014-12-31	$4,073,999
Total plan assets at beginning of year	2014-12-31	$3,688,319
Value of fidelity bond covering the plan	2014-12-31	$350,000
Total contributions received or receivable from participants	2014-12-31	$142,141
Expenses. Other expenses not covered elsewhere	2014-12-31	$10,506
Contributions received from other sources (not participants or employers)	2014-12-31	$4,360
Other income received	2014-12-31	$209,819
Net income (gross income less expenses)	2014-12-31	$385,680
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$4,073,999
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$3,688,319
Assets. Value of participant loans	2014-12-31	$62,127
Assets. Value of real-estate (other than employer real property)	2014-12-31	$347,500
Total contributions received or receivable from employer(s)	2014-12-31	$53,360
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$621,244
Expenses. Total of all expenses incurred	2013-12-31	$117,734
Benefits paid (including direct rollovers)	2013-12-31	$108,424
Total plan assets at end of year	2013-12-31	$3,688,319
Total plan assets at beginning of year	2013-12-31	$3,184,809
Value of fidelity bond covering the plan	2013-12-31	$350,000
Total contributions received or receivable from participants	2013-12-31	$104,902
Expenses. Other expenses not covered elsewhere	2013-12-31	$9,310
Contributions received from other sources (not participants or employers)	2013-12-31	$45,326
Other income received	2013-12-31	$425,157
Net income (gross income less expenses)	2013-12-31	$503,510
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$3,688,319
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$3,184,809
Assets. Value of participant loans	2013-12-31	$74,824
Assets. Value of real-estate (other than employer real property)	2013-12-31	$347,000
Total contributions received or receivable from employer(s)	2013-12-31	$45,859
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$416,122
Expenses. Total of all expenses incurred	2012-12-31	$227,784
Benefits paid (including direct rollovers)	2012-12-31	$150,424
Total plan assets at end of year	2012-12-31	$3,184,809
Total plan assets at beginning of year	2012-12-31	$2,996,471
Value of fidelity bond covering the plan	2012-12-31	$350,000
Total contributions received or receivable from participants	2012-12-31	$47,843
Expenses. Other expenses not covered elsewhere	2012-12-31	$68,858
Other income received	2012-12-31	$356,159
Net income (gross income less expenses)	2012-12-31	$188,338
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$3,184,809
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$2,996,471
Assets. Value of participant loans	2012-12-31	$60,096
Assets. Value of real-estate (other than employer real property)	2012-12-31	$300,000
Total contributions received or receivable from employer(s)	2012-12-31	$12,120
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$8,502
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0

Form 5500 Responses for MARK HANCOCK DEVELOPMENT CORPORATION 401(K) PROFIT SHARING PLAN

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

Insurance Providers Used on plan

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

Policy contract number

010233346

Policy instance

Insurance contract or identification number	010233346
Number of Individuals Covered	76
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $5,088
Total amount of fees paid to insurance company	USD $7,946
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?	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 $5,088
Amount paid for insurance broker fees	5088
Additional information about fees paid to insurance broker	BROKER
Insurance broker organization code?	3
Insurance broker name	SOUTHEASTERN EMPLOYEE BENEFIT SERVI

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

Policy contract number

010233346

Policy instance

Insurance contract or identification number	010233346
Number of Individuals Covered	64
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,639
Total amount of fees paid to insurance company	USD $788
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,639
Insurance broker organization code?	3
Amount paid for insurance broker fees	788
Additional information about fees paid to insurance broker	TPA
Insurance broker name	SOUTHEASTERN EMPLOYEE BENEFIT SERVI

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

Policy contract number

010233346

Policy instance

Insurance contract or identification number	010233346
Number of Individuals Covered	62
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $4,686
Total amount of fees paid to insurance company	USD $970
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,686
Insurance broker organization code?	3
Amount paid for insurance broker fees	970
Additional information about fees paid to insurance broker	TPA
Insurance broker name	SOUTHEASTERN EMPLOYEE BENEFIT SERVI

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

Policy contract number

010233346

Policy instance

Insurance contract or identification number	010233346
Number of Individuals Covered	60
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,099
Total amount of fees paid to insurance company	USD $2,851
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,099
Insurance broker organization code?	3
Amount paid for insurance broker fees	2851
Additional information about fees paid to insurance broker	TPA
Insurance broker name	SOUTHEASTERN EMPLOYEE BENEFIT SERVI

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

Policy contract number

GA-026137

Policy instance

Insurance contract or identification number	GA-026137
Number of Individuals Covered	58
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,744
Total amount of fees paid to insurance company	USD $530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,744
Insurance broker organization code?	3
Amount paid for insurance broker fees	530
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker name	SUNWEST PENSIONS

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Company Name:	MARK HANCOCK DEVELOPMENT CORPORATION DBA CAMELOT HOMES
Employer identification number (EIN):	860277586
NAIC Classification:	236110