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| Plan Name | PETER S. ANDERSEN RETIREMENT PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Benefit Pension |
| Plan Features/Benefits |
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| Company Name: | PETER S ANDERSEN D/B/A SIMULATION ENGINEERING |
| Employer identification number (EIN): | 900764240 |
| NAIC Classification: | 541990 |
| NAIC Description: | All Other Professional, Scientific, and Technical Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2016-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2016: PETER S. ANDERSEN RETIREMENT PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-01-01 | 1 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 1 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 1 |
| Total of all active and inactive participants | 2016-01-01 | 2 |
| Total participants | 2016-01-01 | 2 |
| Number of participants with account balances | 2016-01-01 | 1 |
| Measure | Date | Value |
|---|---|---|
| 2016 : PETER S. ANDERSEN RETIREMENT PLAN 2016 401k financial data | ||
| Total income from all sources | 2016-12-31 | $54,009 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $0 |
| Net income (gross income less expenses) | 2016-12-31 | $54,009 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $54,009 |
| 2016: PETER S. ANDERSEN RETIREMENT 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 – Section 412(e)(3) insurance Contracts | Yes |
| 2016-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| HARTFORD LIFE & ANNUITY (National Association of Insurance Commissioners NAIC id number: 71153 ) | |||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | WA4700814 | ||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||
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