401k Plan data: DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN plan

DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN
Plan identification number	501

DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

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

Company Name: DOUBLEDUTCH, INC.

Employer identification number (EIN): 900646860

NAIC Classification: 511210
NAIC Description: Software Publishers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2016-12-01 LAWRENCE COBURN LAWRENCE COBURN 2018-09-04
501 2015-12-01 LAWRENCE COBURN
501 2014-12-01 BROOKE GRECO

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2016-12-01	LAWRENCE COBURN	LAWRENCE COBURN	2018-09-04
501	2015-12-01	LAWRENCE COBURN
501	2014-12-01	BROOKE GRECO

Plan Statistics for DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN

401k plan membership statisitcs for DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN

Measure Date Value
2016: DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-12-01 155
Total number of active participants reported on line 7a of the Form 5500 2016-12-01 65
Number of retired or separated participants receiving benefits 2016-12-01 0
Number of other retired or separated participants entitled to future benefits 2016-12-01 0
Total of all active and inactive participants 2016-12-01 65
2015: DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-12-01 200
Total number of active participants reported on line 7a of the Form 5500 2015-12-01 148
Number of retired or separated participants receiving benefits 2015-12-01 7
Number of other retired or separated participants entitled to future benefits 2015-12-01 0
Total of all active and inactive participants 2015-12-01 155
2014: DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-12-01 118
Total number of active participants reported on line 7a of the Form 5500 2014-12-01 197
Number of retired or separated participants receiving benefits 2014-12-01 3
Number of other retired or separated participants entitled to future benefits 2014-12-01 0
Total of all active and inactive participants 2014-12-01 200

Measure	Date	Value
2016: DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-12-01	155
Total number of active participants reported on line 7a of the Form 5500	2016-12-01	65
Number of retired or separated participants receiving benefits	2016-12-01	0
Number of other retired or separated participants entitled to future benefits	2016-12-01	0
Total of all active and inactive participants	2016-12-01	65
2015: DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-12-01	200
Total number of active participants reported on line 7a of the Form 5500	2015-12-01	148
Number of retired or separated participants receiving benefits	2015-12-01	7
Number of other retired or separated participants entitled to future benefits	2015-12-01	0
Total of all active and inactive participants	2015-12-01	155
2014: DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-12-01	118
Total number of active participants reported on line 7a of the Form 5500	2014-12-01	197
Number of retired or separated participants receiving benefits	2014-12-01	3
Number of other retired or separated participants entitled to future benefits	2014-12-01	0
Total of all active and inactive participants	2014-12-01	200

Form 5500 Responses for DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN

2016: DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-12-01	Type of plan entity	Single employer plan
2016-12-01	Submission has been amended	No
2016-12-01	This submission is the final filing	No
2016-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-12-01	Plan is a collectively bargained plan	No
2016-12-01	Plan funding arrangement – Insurance	Yes
2016-12-01	Plan benefit arrangement – Insurance	Yes
2015: DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-12-01	Type of plan entity	Single employer plan
2015-12-01	Submission has been amended	No
2015-12-01	This submission is the final filing	No
2015-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-12-01	Plan is a collectively bargained plan	No
2015-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-12-01	Plan benefit arrangement – Insurance	Yes
2014: DOUBLEDUTCH, INC. WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-12-01	Type of plan entity	Single employer plan
2014-12-01	First time form 5500 has been submitted	Yes
2014-12-01	Submission has been amended	No
2014-12-01	This submission is the final filing	No
2014-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-12-01	Plan is a collectively bargained plan	No
2014-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-12-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	DOUBLEDUTCH, INC.
Employer identification number (EIN):	900646860
NAIC Classification:	511210
NAIC Description:	Software Publishers