401k Plan data: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN plan

ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	001

ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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

ROCKYS GASKET SHOP, INC. has sponsored the creation of one or more 401k plans.

Company Name: ROCKYS GASKET SHOP, INC.

Employer identification number (EIN): 943124635

NAIC Classification: 326200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-10-01
001 2020-10-01 LISA SOUTHARD 2022-06-07
001 2019-10-01 LISA SOUTHARD 2021-04-26
001 2018-10-01 LISA SOUTHARD 2020-04-08
001 2017-10-01 LISA SOUTHARD 2019-04-22
001 2016-10-01
001 2015-10-01
001 2014-10-01
001 2013-10-01 LISA SOUTHARD
001 2012-10-01 RAY SHOJINAGA
001 2011-10-01 LISA SOUTHARD LISA SOUTHARD 2013-06-18
001 2010-10-01 LISA SOUTHARD LISA SOUTHARD 2012-04-16
001 2009-10-01 LISA SOUTHARD LISA SOUTHARD 2011-04-04

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2021-10-01
001	2020-10-01	LISA SOUTHARD	2022-06-07
001	2019-10-01	LISA SOUTHARD	2021-04-26
001	2018-10-01	LISA SOUTHARD	2020-04-08
001	2017-10-01	LISA SOUTHARD	2019-04-22
001	2016-10-01
001	2015-10-01
001	2014-10-01
001	2013-10-01	LISA SOUTHARD
001	2012-10-01	RAY SHOJINAGA
001	2011-10-01	LISA SOUTHARD		LISA SOUTHARD	2013-06-18
001	2010-10-01	LISA SOUTHARD		LISA SOUTHARD	2012-04-16
001	2009-10-01	LISA SOUTHARD		LISA SOUTHARD	2011-04-04

Plan Statistics for ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2020: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-10-01 21
Total number of active participants reported on line 7a of the Form 5500 2020-10-01 9
Number of retired or separated participants receiving benefits 2020-10-01 0
Number of other retired or separated participants entitled to future benefits 2020-10-01 13
Total of all active and inactive participants 2020-10-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-10-01 0
Total participants 2020-10-01 22
Number of participants with account balances 2020-10-01 21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-10-01 1
2019: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-10-01 23
Total number of active participants reported on line 7a of the Form 5500 2019-10-01 10
Number of retired or separated participants receiving benefits 2019-10-01 1
Number of other retired or separated participants entitled to future benefits 2019-10-01 10
Total of all active and inactive participants 2019-10-01 21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-10-01 0
Total participants 2019-10-01 21
Number of participants with account balances 2019-10-01 21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-10-01 2
2018: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-10-01 23
Total number of active participants reported on line 7a of the Form 5500 2018-10-01 13
Number of retired or separated participants receiving benefits 2018-10-01 1
Number of other retired or separated participants entitled to future benefits 2018-10-01 8
Total of all active and inactive participants 2018-10-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-10-01 0
Total participants 2018-10-01 22
Number of participants with account balances 2018-10-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-10-01 0
2017: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-10-01 23
Total number of active participants reported on line 7a of the Form 5500 2017-10-01 13
Number of retired or separated participants receiving benefits 2017-10-01 1
Number of other retired or separated participants entitled to future benefits 2017-10-01 9
Total of all active and inactive participants 2017-10-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-10-01 0
Total participants 2017-10-01 23
Number of participants with account balances 2017-10-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-10-01 0
2016: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-10-01 23
Total number of active participants reported on line 7a of the Form 5500 2016-10-01 13
Number of retired or separated participants receiving benefits 2016-10-01 10
Number of other retired or separated participants entitled to future benefits 2016-10-01 0
Total of all active and inactive participants 2016-10-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-10-01 0
Total participants 2016-10-01 23
Number of participants with account balances 2016-10-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-10-01 0
2015: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 22
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 15
Number of retired or separated participants receiving benefits 2015-10-01 0
Number of other retired or separated participants entitled to future benefits 2015-10-01 8
Total of all active and inactive participants 2015-10-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-10-01 0
Total participants 2015-10-01 23
Number of participants with account balances 2015-10-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-10-01 0
2014: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 22
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 11
Number of retired or separated participants receiving benefits 2014-10-01 0
Number of other retired or separated participants entitled to future benefits 2014-10-01 7
Total of all active and inactive participants 2014-10-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-10-01 1
Total participants 2014-10-01 19
Number of participants with account balances 2014-10-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-10-01 0
2013: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 19
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 14
Number of retired or separated participants receiving benefits 2013-10-01 0
Number of other retired or separated participants entitled to future benefits 2013-10-01 9
Total of all active and inactive participants 2013-10-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-10-01 0
Total participants 2013-10-01 23
Number of participants with account balances 2013-10-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-10-01 1
2012: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-10-01 19
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 11
Number of retired or separated participants receiving benefits 2012-10-01 0
Number of other retired or separated participants entitled to future benefits 2012-10-01 8
Total of all active and inactive participants 2012-10-01 19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-10-01 0
Total participants 2012-10-01 19
Number of participants with account balances 2012-10-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-10-01 4
2011: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-10-01 19
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 12
Number of retired or separated participants receiving benefits 2011-10-01 0
Number of other retired or separated participants entitled to future benefits 2011-10-01 7
Total of all active and inactive participants 2011-10-01 19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-10-01 0
Total participants 2011-10-01 19
Number of participants with account balances 2011-10-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-10-01 2
2010: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-10-01 19
Total number of active participants reported on line 7a of the Form 5500 2010-10-01 13
Number of retired or separated participants receiving benefits 2010-10-01 0
Number of other retired or separated participants entitled to future benefits 2010-10-01 6
Total of all active and inactive participants 2010-10-01 19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-10-01 0
Total participants 2010-10-01 19
Number of participants with account balances 2010-10-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-10-01 0
2009: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-10-01 19
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 10
Number of retired or separated participants receiving benefits 2009-10-01 0
Number of other retired or separated participants entitled to future benefits 2009-10-01 9
Total of all active and inactive participants 2009-10-01 19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-10-01 0
Total participants 2009-10-01 19
Number of participants with account balances 2009-10-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-10-01 0

Measure	Date	Value
2020: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-10-01	21
Total number of active participants reported on line 7a of the Form 5500	2020-10-01	9
Number of retired or separated participants receiving benefits	2020-10-01	0
Number of other retired or separated participants entitled to future benefits	2020-10-01	13
Total of all active and inactive participants	2020-10-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-10-01	0
Total participants	2020-10-01	22
Number of participants with account balances	2020-10-01	21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-10-01	1
2019: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-10-01	23
Total number of active participants reported on line 7a of the Form 5500	2019-10-01	10
Number of retired or separated participants receiving benefits	2019-10-01	1
Number of other retired or separated participants entitled to future benefits	2019-10-01	10
Total of all active and inactive participants	2019-10-01	21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-10-01	0
Total participants	2019-10-01	21
Number of participants with account balances	2019-10-01	21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-10-01	2
2018: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-10-01	23
Total number of active participants reported on line 7a of the Form 5500	2018-10-01	13
Number of retired or separated participants receiving benefits	2018-10-01	1
Number of other retired or separated participants entitled to future benefits	2018-10-01	8
Total of all active and inactive participants	2018-10-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-10-01	0
Total participants	2018-10-01	22
Number of participants with account balances	2018-10-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-10-01	0
2017: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-10-01	23
Total number of active participants reported on line 7a of the Form 5500	2017-10-01	13
Number of retired or separated participants receiving benefits	2017-10-01	1
Number of other retired or separated participants entitled to future benefits	2017-10-01	9
Total of all active and inactive participants	2017-10-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-10-01	0
Total participants	2017-10-01	23
Number of participants with account balances	2017-10-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-10-01	0
2016: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-10-01	23
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	13
Number of retired or separated participants receiving benefits	2016-10-01	10
Number of other retired or separated participants entitled to future benefits	2016-10-01	0
Total of all active and inactive participants	2016-10-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-10-01	0
Total participants	2016-10-01	23
Number of participants with account balances	2016-10-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-10-01	0
2015: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	22
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	15
Number of retired or separated participants receiving benefits	2015-10-01	0
Number of other retired or separated participants entitled to future benefits	2015-10-01	8
Total of all active and inactive participants	2015-10-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-10-01	0
Total participants	2015-10-01	23
Number of participants with account balances	2015-10-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-10-01	0
2014: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	22
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	11
Number of retired or separated participants receiving benefits	2014-10-01	0
Number of other retired or separated participants entitled to future benefits	2014-10-01	7
Total of all active and inactive participants	2014-10-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-10-01	1
Total participants	2014-10-01	19
Number of participants with account balances	2014-10-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-10-01	0
2013: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	19
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	14
Number of retired or separated participants receiving benefits	2013-10-01	0
Number of other retired or separated participants entitled to future benefits	2013-10-01	9
Total of all active and inactive participants	2013-10-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-10-01	0
Total participants	2013-10-01	23
Number of participants with account balances	2013-10-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-10-01	1
2012: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-10-01	19
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	11
Number of retired or separated participants receiving benefits	2012-10-01	0
Number of other retired or separated participants entitled to future benefits	2012-10-01	8
Total of all active and inactive participants	2012-10-01	19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-10-01	0
Total participants	2012-10-01	19
Number of participants with account balances	2012-10-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-10-01	4
2011: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-10-01	19
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	12
Number of retired or separated participants receiving benefits	2011-10-01	0
Number of other retired or separated participants entitled to future benefits	2011-10-01	7
Total of all active and inactive participants	2011-10-01	19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-10-01	0
Total participants	2011-10-01	19
Number of participants with account balances	2011-10-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-10-01	2
2010: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-10-01	19
Total number of active participants reported on line 7a of the Form 5500	2010-10-01	13
Number of retired or separated participants receiving benefits	2010-10-01	0
Number of other retired or separated participants entitled to future benefits	2010-10-01	6
Total of all active and inactive participants	2010-10-01	19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-10-01	0
Total participants	2010-10-01	19
Number of participants with account balances	2010-10-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-10-01	0
2009: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-10-01	19
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	10
Number of retired or separated participants receiving benefits	2009-10-01	0
Number of other retired or separated participants entitled to future benefits	2009-10-01	9
Total of all active and inactive participants	2009-10-01	19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-10-01	0
Total participants	2009-10-01	19
Number of participants with account balances	2009-10-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-10-01	0

Financial Data on ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2021 : ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total plan liabilities at beginning of year	2021-09-30	$0
Total income from all sources	2021-09-30	$270,213
Expenses. Total of all expenses incurred	2021-09-30	$1,465
Benefits paid (including direct rollovers)	2021-09-30	$0
Total plan assets at end of year	2021-09-30	$2,057,045
Total plan assets at beginning of year	2021-09-30	$1,788,297
Value of fidelity bond covering the plan	2021-09-30	$250,000
Total contributions received or receivable from participants	2021-09-30	$46,802
Expenses. Other expenses not covered elsewhere	2021-09-30	$1,465
Contributions received from other sources (not participants or employers)	2021-09-30	$889
Other income received	2021-09-30	$220,671
Noncash contributions received	2021-09-30	$0
Net income (gross income less expenses)	2021-09-30	$268,748
Net plan assets at end of year (total assets less liabilities)	2021-09-30	$2,057,045
Net plan assets at beginning of year (total assets less liabilities)	2021-09-30	$1,788,297
Total contributions received or receivable from employer(s)	2021-09-30	$1,851
Value of certain deemed distributions of participant loans	2021-09-30	$0
Value of corrective distributions	2021-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-09-30	$0
2020 : ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total plan liabilities at end of year	2020-09-30	$0
Total plan liabilities at beginning of year	2020-09-30	$0
Total income from all sources	2020-09-30	$147,231
Expenses. Total of all expenses incurred	2020-09-30	$393,648
Benefits paid (including direct rollovers)	2020-09-30	$392,060
Total plan assets at end of year	2020-09-30	$1,788,297
Total plan assets at beginning of year	2020-09-30	$2,034,714
Value of fidelity bond covering the plan	2020-09-30	$250,000
Total contributions received or receivable from participants	2020-09-30	$44,143
Expenses. Other expenses not covered elsewhere	2020-09-30	$0
Contributions received from other sources (not participants or employers)	2020-09-30	$0
Other income received	2020-09-30	$100,268
Noncash contributions received	2020-09-30	$0
Net income (gross income less expenses)	2020-09-30	$-246,417
Net plan assets at end of year (total assets less liabilities)	2020-09-30	$1,788,297
Net plan assets at beginning of year (total assets less liabilities)	2020-09-30	$2,034,714
Total contributions received or receivable from employer(s)	2020-09-30	$2,820
Value of certain deemed distributions of participant loans	2020-09-30	$0
Value of corrective distributions	2020-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-09-30	$1,588
2019 : ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total plan liabilities at end of year	2019-09-30	$0
Total plan liabilities at beginning of year	2019-09-30	$0
Total income from all sources	2019-09-30	$94,656
Expenses. Total of all expenses incurred	2019-09-30	$12,736
Benefits paid (including direct rollovers)	2019-09-30	$11,000
Total plan assets at end of year	2019-09-30	$2,034,714
Total plan assets at beginning of year	2019-09-30	$1,952,794
Value of fidelity bond covering the plan	2019-09-30	$250,000
Total contributions received or receivable from participants	2019-09-30	$33,413
Expenses. Other expenses not covered elsewhere	2019-09-30	$0
Contributions received from other sources (not participants or employers)	2019-09-30	$0
Other income received	2019-09-30	$58,457
Noncash contributions received	2019-09-30	$0
Net income (gross income less expenses)	2019-09-30	$81,920
Net plan assets at end of year (total assets less liabilities)	2019-09-30	$2,034,714
Net plan assets at beginning of year (total assets less liabilities)	2019-09-30	$1,952,794
Total contributions received or receivable from employer(s)	2019-09-30	$2,786
Value of certain deemed distributions of participant loans	2019-09-30	$1,736
Value of corrective distributions	2019-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-09-30	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-09-30	$0
2018 : ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-09-30	$0
2017 : ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total plan liabilities at beginning of year	2017-09-30	$0
Total income from all sources	2017-09-30	$299,717
Expenses. Total of all expenses incurred	2017-09-30	$1,495
Benefits paid (including direct rollovers)	2017-09-30	$0
Total plan assets at end of year	2017-09-30	$1,764,424
Total plan assets at beginning of year	2017-09-30	$1,466,202
Value of fidelity bond covering the plan	2017-09-30	$149,000
Total contributions received or receivable from participants	2017-09-30	$31,433
Expenses. Other expenses not covered elsewhere	2017-09-30	$0
Contributions received from other sources (not participants or employers)	2017-09-30	$0
Other income received	2017-09-30	$118,284
Noncash contributions received	2017-09-30	$0
Net income (gross income less expenses)	2017-09-30	$298,222
Net plan assets at end of year (total assets less liabilities)	2017-09-30	$1,764,424
Net plan assets at beginning of year (total assets less liabilities)	2017-09-30	$1,466,202
Total contributions received or receivable from employer(s)	2017-09-30	$150,000
Value of certain deemed distributions of participant loans	2017-09-30	$0
Value of corrective distributions	2017-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-09-30	$1,495
2016 : ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total plan liabilities at end of year	2016-09-30	$0
Total plan liabilities at beginning of year	2016-09-30	$0
Total income from all sources	2016-09-30	$200,134
Expenses. Total of all expenses incurred	2016-09-30	$223,040
Benefits paid (including direct rollovers)	2016-09-30	$221,676
Total plan assets at end of year	2016-09-30	$1,466,202
Total plan assets at beginning of year	2016-09-30	$1,489,108
Value of fidelity bond covering the plan	2016-09-30	$149,000
Total contributions received or receivable from participants	2016-09-30	$33,153
Expenses. Other expenses not covered elsewhere	2016-09-30	$0
Contributions received from other sources (not participants or employers)	2016-09-30	$0
Other income received	2016-09-30	$90,306
Noncash contributions received	2016-09-30	$0
Net income (gross income less expenses)	2016-09-30	$-22,906
Net plan assets at end of year (total assets less liabilities)	2016-09-30	$1,466,202
Net plan assets at beginning of year (total assets less liabilities)	2016-09-30	$1,489,108
Total contributions received or receivable from employer(s)	2016-09-30	$76,675
Value of certain deemed distributions of participant loans	2016-09-30	$0
Value of corrective distributions	2016-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-09-30	$1,364
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-09-30	$0
2015 : ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at end of year	2015-09-30	$0
Total plan liabilities at beginning of year	2015-09-30	$0
Total income from all sources	2015-09-30	$24,716
Expenses. Total of all expenses incurred	2015-09-30	$13,335
Benefits paid (including direct rollovers)	2015-09-30	$11,827
Total plan assets at end of year	2015-09-30	$1,489,108
Total plan assets at beginning of year	2015-09-30	$1,477,727
Value of fidelity bond covering the plan	2015-09-30	$149,000
Total contributions received or receivable from participants	2015-09-30	$44,105
Expenses. Other expenses not covered elsewhere	2015-09-30	$0
Contributions received from other sources (not participants or employers)	2015-09-30	$0
Other income received	2015-09-30	$-20,105
Noncash contributions received	2015-09-30	$0
Net income (gross income less expenses)	2015-09-30	$11,381
Net plan assets at end of year (total assets less liabilities)	2015-09-30	$1,489,108
Net plan assets at beginning of year (total assets less liabilities)	2015-09-30	$1,477,727
Total contributions received or receivable from employer(s)	2015-09-30	$716
Value of certain deemed distributions of participant loans	2015-09-30	$0
Value of corrective distributions	2015-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-09-30	$1,508
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-09-30	$0
2014 : ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year	2014-09-30	$0
Total plan liabilities at beginning of year	2014-09-30	$0
Total income from all sources	2014-09-30	$126,526
Expenses. Total of all expenses incurred	2014-09-30	$11,093
Benefits paid (including direct rollovers)	2014-09-30	$9,642
Total plan assets at end of year	2014-09-30	$1,477,727
Total plan assets at beginning of year	2014-09-30	$1,362,294
Value of fidelity bond covering the plan	2014-09-30	$100,000
Total contributions received or receivable from participants	2014-09-30	$35,448
Contributions received from other sources (not participants or employers)	2014-09-30	$0
Other income received	2014-09-30	$91,078
Noncash contributions received	2014-09-30	$0
Net income (gross income less expenses)	2014-09-30	$115,433
Net plan assets at end of year (total assets less liabilities)	2014-09-30	$1,477,727
Net plan assets at beginning of year (total assets less liabilities)	2014-09-30	$1,362,294
Assets. Value of participant loans	2014-09-30	$1,556
Total contributions received or receivable from employer(s)	2014-09-30	$0
Value of certain deemed distributions of participant loans	2014-09-30	$0
Value of corrective distributions	2014-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-09-30	$1,451
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-09-30	$0
2013 : ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan	2013-09-30	$0
Total plan liabilities at end of year	2013-09-30	$0
Total plan liabilities at beginning of year	2013-09-30	$0
Total income from all sources	2013-09-30	$128,886
Expenses. Total of all expenses incurred	2013-09-30	$8,440
Benefits paid (including direct rollovers)	2013-09-30	$7,208
Total plan assets at end of year	2013-09-30	$1,362,294
Total plan assets at beginning of year	2013-09-30	$1,241,848
Value of fidelity bond covering the plan	2013-09-30	$150,000
Total contributions received or receivable from participants	2013-09-30	$28,014
Expenses. Other expenses not covered elsewhere	2013-09-30	$0
Contributions received from other sources (not participants or employers)	2013-09-30	$0
Other income received	2013-09-30	$100,872
Noncash contributions received	2013-09-30	$0
Net income (gross income less expenses)	2013-09-30	$120,446
Net plan assets at end of year (total assets less liabilities)	2013-09-30	$1,362,294
Net plan assets at beginning of year (total assets less liabilities)	2013-09-30	$1,241,848
Assets. Value of participant loans	2013-09-30	$4,100
Total contributions received or receivable from employer(s)	2013-09-30	$0
Value of certain deemed distributions of participant loans	2013-09-30	$0
Value of corrective distributions	2013-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-09-30	$1,232
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-09-30	$0
2012 : ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-09-30	$0
Total plan liabilities at beginning of year	2012-09-30	$0
Total income from all sources	2012-09-30	$241,650
Expenses. Total of all expenses incurred	2012-09-30	$9,865
Benefits paid (including direct rollovers)	2012-09-30	$8,277
Total plan assets at end of year	2012-09-30	$1,241,848
Total plan assets at beginning of year	2012-09-30	$1,010,063
Value of fidelity bond covering the plan	2012-09-30	$175,000
Total contributions received or receivable from participants	2012-09-30	$26,057
Expenses. Other expenses not covered elsewhere	2012-09-30	$0
Contributions received from other sources (not participants or employers)	2012-09-30	$0
Other income received	2012-09-30	$95,593
Noncash contributions received	2012-09-30	$0
Net income (gross income less expenses)	2012-09-30	$231,785
Net plan assets at end of year (total assets less liabilities)	2012-09-30	$1,241,848
Net plan assets at beginning of year (total assets less liabilities)	2012-09-30	$1,010,063
Assets. Value of participant loans	2012-09-30	$6,537
Total contributions received or receivable from employer(s)	2012-09-30	$120,000
Value of certain deemed distributions of participant loans	2012-09-30	$0
Value of corrective distributions	2012-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-09-30	$1,588
2011 : ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan	2011-09-30	$0
Total plan liabilities at end of year	2011-09-30	$0
Total plan liabilities at beginning of year	2011-09-30	$0
Total income from all sources	2011-09-30	$164,794
Expenses. Total of all expenses incurred	2011-09-30	$6,634
Benefits paid (including direct rollovers)	2011-09-30	$6,610
Total plan assets at end of year	2011-09-30	$1,010,063
Total plan assets at beginning of year	2011-09-30	$851,903
Value of fidelity bond covering the plan	2011-09-30	$100,000
Total contributions received or receivable from participants	2011-09-30	$22,061
Expenses. Other expenses not covered elsewhere	2011-09-30	$0
Contributions received from other sources (not participants or employers)	2011-09-30	$0
Other income received	2011-09-30	$-2,267
Noncash contributions received	2011-09-30	$0
Net income (gross income less expenses)	2011-09-30	$158,160
Net plan assets at end of year (total assets less liabilities)	2011-09-30	$1,010,063
Net plan assets at beginning of year (total assets less liabilities)	2011-09-30	$851,903
Assets. Value of participant loans	2011-09-30	$8,874
Total contributions received or receivable from employer(s)	2011-09-30	$145,000
Value of certain deemed distributions of participant loans	2011-09-30	$0
Value of corrective distributions	2011-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-09-30	$24

Form 5500 Responses for ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN

2020: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-10-01	Type of plan entity	Single employer plan
2020-10-01	Submission has been amended	No
2020-10-01	This submission is the final filing	No
2020-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-10-01	Plan is a collectively bargained plan	No
2020-10-01	Plan funding arrangement – Insurance	Yes
2020-10-01	Plan funding arrangement – Trust	Yes
2020-10-01	Plan benefit arrangement – Insurance	Yes
2020-10-01	Plan benefit arrangement - Trust	Yes
2019: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-10-01	Type of plan entity	Single employer plan
2019-10-01	Submission has been amended	No
2019-10-01	This submission is the final filing	No
2019-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-10-01	Plan is a collectively bargained plan	No
2019-10-01	Plan funding arrangement – Insurance	Yes
2019-10-01	Plan funding arrangement – Trust	Yes
2019-10-01	Plan benefit arrangement – Insurance	Yes
2019-10-01	Plan benefit arrangement - Trust	Yes
2018: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-10-01	Type of plan entity	Single employer plan
2018-10-01	Submission has been amended	No
2018-10-01	This submission is the final filing	No
2018-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-10-01	Plan is a collectively bargained plan	No
2018-10-01	Plan funding arrangement – Insurance	Yes
2018-10-01	Plan funding arrangement – Trust	Yes
2018-10-01	Plan benefit arrangement – Insurance	Yes
2018-10-01	Plan benefit arrangement - Trust	Yes
2017: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-10-01	Type of plan entity	Single employer plan
2017-10-01	Submission has been amended	No
2017-10-01	This submission is the final filing	No
2017-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-10-01	Plan is a collectively bargained plan	No
2017-10-01	Plan funding arrangement – Insurance	Yes
2017-10-01	Plan funding arrangement – Trust	Yes
2017-10-01	Plan benefit arrangement – Insurance	Yes
2017-10-01	Plan benefit arrangement - Trust	Yes
2016: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-10-01	Type of plan entity	Single employer plan
2016-10-01	Submission has been amended	No
2016-10-01	This submission is the final filing	No
2016-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-10-01	Plan is a collectively bargained plan	No
2016-10-01	Plan funding arrangement – Insurance	Yes
2016-10-01	Plan funding arrangement – Trust	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement - Trust	Yes
2015: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Submission has been amended	No
2015-10-01	This submission is the final filing	No
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-10-01	Plan is a collectively bargained plan	No
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan funding arrangement – Trust	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement - Trust	Yes
2014: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan funding arrangement – Trust	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement - Trust	Yes
2013: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan funding arrangement – Trust	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement - Trust	Yes
2012: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan funding arrangement – Trust	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement - Trust	Yes
2011: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	No
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan funding arrangement – Trust	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement - Trust	Yes
2010: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-10-01	Type of plan entity	Single employer plan
2010-10-01	Submission has been amended	No
2010-10-01	This submission is the final filing	No
2010-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-10-01	Plan is a collectively bargained plan	No
2010-10-01	Plan funding arrangement – Insurance	Yes
2010-10-01	Plan funding arrangement – Trust	Yes
2010-10-01	Plan benefit arrangement – Insurance	Yes
2010-10-01	Plan benefit arrangement - Trust	Yes
2009: ROCKYS GASKET SHOP, INC. 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Submission has been amended	No
2009-10-01	This submission is the final filing	No
2009-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-10-01	Plan is a collectively bargained plan	No
2009-10-01	Plan funding arrangement – Insurance	Yes
2009-10-01	Plan funding arrangement – Trust	Yes
2009-10-01	Plan benefit arrangement – Insurance	Yes
2009-10-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

999736-000

Policy instance

Insurance contract or identification number	999736-000
Number of Individuals Covered	21
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $988
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	988
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

999736-000

Policy instance

Insurance contract or identification number	999736-000
Number of Individuals Covered	21
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $882
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	882
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

999736-000

Policy instance

Insurance contract or identification number	999736-000
Number of Individuals Covered	33
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $955
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	955
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

999736-000

Policy instance

Insurance contract or identification number	999736-000
Number of Individuals Covered	23
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $877
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ROCKYS GASKET SHOP, INC.
Employer identification number (EIN):	943124635
NAIC Classification:	326200