ELLENSBURG DOWNTOWN PHARMACY, INC. has sponsored the creation of one or more 401k plans.
Additional information about ELLENSBURG DOWNTOWN PHARMACY, INC.
Submission information for form 5500 for 401k plan ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN
401k plan membership statisitcs for ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN
| Measure | Date | Value |
|---|
| 2018: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 2 |
| Total of all active and inactive participants | 2018-01-01 | 0 |
| Total participants | 2018-01-01 | 0 |
| 2017: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 2 |
| Total of all active and inactive participants | 2017-01-01 | 2 |
| Total participants | 2017-01-01 | 2 |
| Number of participants with account balances | 2017-01-01 | 2 |
| 2016: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 4 |
| Total of all active and inactive participants | 2016-01-01 | 4 |
| Total participants | 2016-01-01 | 4 |
| Number of participants with account balances | 2016-01-01 | 4 |
| 2015: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 5 |
| Total of all active and inactive participants | 2015-01-01 | 5 |
| Total participants | 2015-01-01 | 5 |
| 2014: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 5 |
| Total of all active and inactive participants | 2014-01-01 | 5 |
| Total participants | 2014-01-01 | 5 |
| 2013: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 5 |
| Total of all active and inactive participants | 2013-01-01 | 5 |
| Total participants | 2013-01-01 | 5 |
| Number of participants with account balances | 2013-01-01 | 5 |
| 2012: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 4 |
| Total of all active and inactive participants | 2012-01-01 | 4 |
| Total participants | 2012-01-01 | 4 |
| Number of participants with account balances | 2012-01-01 | 4 |
| 2011: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 4 |
| Total of all active and inactive participants | 2011-01-01 | 4 |
| Total participants | 2011-01-01 | 4 |
| Number of participants with account balances | 2011-01-01 | 4 |
| 2009: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 4 |
| Total of all active and inactive participants | 2009-01-01 | 4 |
| Total participants | 2009-01-01 | 4 |
| Number of participants with account balances | 2009-01-01 | 4 |
| 2007: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-01-01 | 4 |
| Total of all active and inactive participants | 2007-01-01 | 4 |
| Total participants | 2007-01-01 | 4 |
| Number of participants with account balances | 2007-01-01 | 4 |
| Measure | Date | Value |
|---|
| 2018 : ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $5,883 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $846,599 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $846,578 |
| Total plan assets at end of year | 2018-12-31 | $0 |
| Total plan assets at beginning of year | 2018-12-31 | $840,716 |
| Value of fidelity bond covering the plan | 2018-12-31 | $120,000 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $21 |
| Other income received | 2018-12-31 | $5,883 |
| Net income (gross income less expenses) | 2018-12-31 | $-840,716 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $840,716 |
| 2017 : ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $115,984 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $159,960 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $159,718 |
| Total plan assets at end of year | 2017-12-31 | $840,716 |
| Total plan assets at beginning of year | 2017-12-31 | $884,692 |
| Value of fidelity bond covering the plan | 2017-12-31 | $120,000 |
| Expenses. Other expenses not covered elsewhere | 2017-12-31 | $242 |
| Other income received | 2017-12-31 | $115,984 |
| Net income (gross income less expenses) | 2017-12-31 | $-43,976 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $840,716 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $884,692 |
| 2016 : ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $60,073 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $132,656 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $132,426 |
| Total plan assets at end of year | 2016-12-31 | $884,692 |
| Total plan assets at beginning of year | 2016-12-31 | $957,275 |
| Value of fidelity bond covering the plan | 2016-12-31 | $120,000 |
| Expenses. Other expenses not covered elsewhere | 2016-12-31 | $230 |
| Other income received | 2016-12-31 | $60,073 |
| Net income (gross income less expenses) | 2016-12-31 | $-72,583 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $884,692 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $957,275 |
| 2015 : ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $-19,506 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $6,260 |
| Total plan assets at end of year | 2015-12-31 | $957,275 |
| Total plan assets at beginning of year | 2015-12-31 | $983,041 |
| Value of fidelity bond covering the plan | 2015-12-31 | $120,000 |
| Expenses. Other expenses not covered elsewhere | 2015-12-31 | $6,260 |
| Other income received | 2015-12-31 | $-19,506 |
| Net income (gross income less expenses) | 2015-12-31 | $-25,766 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $957,275 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $983,041 |
| 2014 : ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $45,700 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $270,469 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $258,047 |
| Total plan assets at end of year | 2014-12-31 | $983,041 |
| Total plan assets at beginning of year | 2014-12-31 | $1,207,810 |
| Value of fidelity bond covering the plan | 2014-12-31 | $120,000 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $12,422 |
| Other income received | 2014-12-31 | $17,817 |
| Net income (gross income less expenses) | 2014-12-31 | $-224,769 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $983,041 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,207,810 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $27,883 |
| 2013 : ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $133,558 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $16,910 |
| Total plan assets at end of year | 2013-12-31 | $1,207,810 |
| Total plan assets at beginning of year | 2013-12-31 | $1,091,162 |
| Value of fidelity bond covering the plan | 2013-12-31 | $120,000 |
| Expenses. Other expenses not covered elsewhere | 2013-12-31 | $16,910 |
| Other income received | 2013-12-31 | $78,518 |
| Net income (gross income less expenses) | 2013-12-31 | $116,648 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $1,207,810 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $1,091,162 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $55,040 |
| 2012 : ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-31 | $126,605 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $10,881 |
| Total plan assets at end of year | 2012-12-31 | $1,091,162 |
| Total plan assets at beginning of year | 2012-12-31 | $975,438 |
| Expenses. Other expenses not covered elsewhere | 2012-12-31 | $10,881 |
| Other income received | 2012-12-31 | $76,908 |
| Net income (gross income less expenses) | 2012-12-31 | $115,724 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $1,091,162 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $975,438 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $49,697 |
| 2011 : ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2011 401k financial data |
|---|
| Total income from all sources | 2011-12-31 | $62,772 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $16,050 |
| Total plan assets at end of year | 2011-12-31 | $975,438 |
| Total plan assets at beginning of year | 2011-12-31 | $928,716 |
| Expenses. Other expenses not covered elsewhere | 2011-12-31 | $16,050 |
| Other income received | 2011-12-31 | $15,675 |
| Net income (gross income less expenses) | 2011-12-31 | $46,722 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $975,438 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $928,716 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $47,097 |
| 2010 : ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2010 401k financial data |
|---|
| Total income from all sources | 2010-12-31 | $74,418 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $15,357 |
| Total plan assets at end of year | 2010-12-31 | $928,716 |
| Total plan assets at beginning of year | 2010-12-31 | $869,655 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $15,357 |
| Other income received | 2010-12-31 | $28,426 |
| Net income (gross income less expenses) | 2010-12-31 | $59,061 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $928,716 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $869,655 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $45,992 |
| 2018: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | This submission is the final filing | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| 2007: ELLENSBURG DOWNTOWN PHARMACY BASIC PROFIT SHARING PLAN 2007 form 5500 responses |
|---|
| 2007-01-01 | Type of plan entity | Single employer plan |
| 2007-01-01 | Submission has been amended | No |
| 2007-01-01 | This submission is the final filing | No |
| 2007-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-01-01 | Plan is a collectively bargained plan | No |
| 2007-01-01 | Plan funding arrangement – Trust | Yes |
| 2007-01-01 | Plan benefit arrangement - Trust | Yes |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559301 |
| Policy instance | 1 |
| Insurance contract or identification number | 000559301 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-04-28 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 951017284 |
| Policy instance | 3 |
| Insurance contract or identification number | 951017284 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559302 |
| Policy instance | 2 |
| Insurance contract or identification number | 000559302 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-06-30 | | Total amount of fees paid to insurance company | USD $6,205 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 6205 | | Additional information about fees paid to insurance broker | COMMISSION AND ADVISORY FEES | | Insurance broker organization code? | 3 | | Insurance broker name | GORDON F WOLLEN |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559301 |
| Policy instance | 1 |
| Insurance contract or identification number | 000559301 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559301 |
| Policy instance | 1 |
| Insurance contract or identification number | 000559301 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of fees paid to insurance company | USD $12,095 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 12095 | | Additional information about fees paid to insurance broker | COMMISSION AND ADVISORY FEES | | Insurance broker organization code? | 3 | | Insurance broker name | GORDON F WOLLEN |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559302 |
| Policy instance | 2 |
| Insurance contract or identification number | 000559302 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 951017284 |
| Policy instance | 3 |
| Insurance contract or identification number | 951017284 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 951017284 |
| Policy instance | 1 |
| Insurance contract or identification number | 951017284 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559303 |
| Policy instance | 4 |
| Insurance contract or identification number | 000559303 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of fees paid to insurance company | USD $10,880 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 10880 | | Additional information about fees paid to insurance broker | COMMISSION AND ADVISORY FEES | | Insurance broker organization code? | 3 | | Insurance broker name | GORDON F WOLLEN |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559301 |
| Policy instance | 3 |
| Insurance contract or identification number | 000559301 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559302 |
| Policy instance | 2 |
| Insurance contract or identification number | 000559302 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559301 |
| Policy instance | 3 |
| Insurance contract or identification number | 000559301 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559302 |
| Policy instance | 2 |
| Insurance contract or identification number | 000559302 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 951017284 |
| Policy instance | 1 |
| Insurance contract or identification number | 951017284 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559303 |
| Policy instance | 4 |
| Insurance contract or identification number | 000559303 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of fees paid to insurance company | USD $16,050 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559301 |
| Policy instance | 2 |
| Insurance contract or identification number | 000559301 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2009-10-01 | | Insurance policy end date | 2010-09-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559302 |
| Policy instance | 1 |
| Insurance contract or identification number | 000559302 | | Insurance policy start date | 2009-10-01 | | Insurance policy end date | 2010-09-30 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 000559303 |
| Policy instance | 3 |
| Insurance contract or identification number | 000559303 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2009-10-01 | | Insurance policy end date | 2010-09-30 | | Total amount of commissions paid to insurance broker | USD $6,781 | | Are there contracts with allocated funds for individual policies? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,781 | | Insurance broker organization code? | 3 | | Insurance broker name | GORDON F WOOLEN |
|
