401k Plan data: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN plan

MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	001

MADISON ET CIE, 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).
Offset plan - Plan benefits are subject to offset for retirement benefits provided in another plan or arrangement of the employer.
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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

MADISON ET CIE, INC. has sponsored the creation of one or more 401k plans.

Company Name: MADISON ET CIE, INC.

Employer identification number (EIN): 954553566

NAIC Classification: 448120
NAIC Description: Women's Clothing Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MADISON ET CIE, 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 2021-01-01 EMILY GOLDSTEIN 2021-12-06 EMILY GOLDSTEIN 2021-12-06
001 2020-01-01
001 2020-01-01
001 2019-01-01
001 2019-01-01
001 2018-01-01 MARK GOLDSTEIN MARK GOLDSTEIN 2019-07-03
001 2018-01-01
001 2017-01-01 EMILY R GOLDSTEIN EMILY R GOLDSTEIN 2018-04-03
001 2017-01-01
001 2016-01-01 MARK GOLDSTEIN MARK GOLDSTEIN 2017-04-28
001 2016-01-01
001 2015-01-01 EMILY GOLDSTEIN EMILY GOLDSTEIN 2016-07-19
001 2014-01-01 MARK GOLDSTEIN MARK GOLDSTEIN 2015-07-28
001 2013-01-01 EMILY GOLDSTEIN EMILY GOLDSTEIN 2014-05-29
001 2012-01-01 MARK GOLDSTEIN MARK GOLDSTEIN 2013-05-21
001 2011-01-01 MARK GOLDSTEIN MARK GOLDSTEIN 2012-10-13
001 2009-01-01 MARK GOLDSTEIN MARK GOLDSTEIN 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2021-01-01	EMILY GOLDSTEIN	2021-12-06	EMILY GOLDSTEIN	2021-12-06
001	2020-01-01
001	2020-01-01
001	2019-01-01
001	2019-01-01
001	2018-01-01	MARK GOLDSTEIN		MARK GOLDSTEIN	2019-07-03
001	2018-01-01
001	2017-01-01	EMILY R GOLDSTEIN		EMILY R GOLDSTEIN	2018-04-03
001	2017-01-01
001	2016-01-01	MARK GOLDSTEIN		MARK GOLDSTEIN	2017-04-28
001	2016-01-01
001	2015-01-01	EMILY GOLDSTEIN		EMILY GOLDSTEIN	2016-07-19
001	2014-01-01	MARK GOLDSTEIN		MARK GOLDSTEIN	2015-07-28
001	2013-01-01	EMILY GOLDSTEIN		EMILY GOLDSTEIN	2014-05-29
001	2012-01-01	MARK GOLDSTEIN		MARK GOLDSTEIN	2013-05-21
001	2011-01-01	MARK GOLDSTEIN		MARK GOLDSTEIN	2012-10-13
001	2009-01-01	MARK GOLDSTEIN		MARK GOLDSTEIN	2010-10-14

Plan Statistics for MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2020: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 8
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 2
Total of all active and inactive participants 2020-01-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 10
Number of participants with account balances 2020-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 10
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 2
Total of all active and inactive participants 2019-01-01 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 12
Number of participants with account balances 2019-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 12
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 12
Number of participants with account balances 2018-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 26
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 11
Number of other retired or separated participants entitled to future benefits 2017-01-01 2
Total of all active and inactive participants 2017-01-01 13
Total participants 2017-01-01 13
Number of participants with account balances 2017-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
2016: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 26
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 13
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 11
Total of all active and inactive participants 2016-01-01 24
Total participants 2016-01-01 24
Number of participants with account balances 2016-01-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
2015: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 37
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 16
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 7
Total of all active and inactive participants 2015-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 23
Number of participants with account balances 2015-01-01 20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 3
2014: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 35
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 7
Total of all active and inactive participants 2014-01-01 34
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 34
Number of participants with account balances 2014-01-01 29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 2
2013: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 38
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 30
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 4
Total of all active and inactive participants 2013-01-01 34
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 34
Number of participants with account balances 2013-01-01 24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 3
2012: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 37
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 32
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 1
Total of all active and inactive participants 2012-01-01 33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 33
Number of participants with account balances 2012-01-01 25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 31
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 33
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 33
Number of participants with account balances 2011-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 30
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 18
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 8
Total of all active and inactive participants 2009-01-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 26
Number of participants with account balances 2009-01-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 3

Measure	Date	Value
2020: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	8
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	2
Total of all active and inactive participants	2020-01-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	10
Number of participants with account balances	2020-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	10
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	2
Total of all active and inactive participants	2019-01-01	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	12
Number of participants with account balances	2019-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	12
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	12
Number of participants with account balances	2018-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	26
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	11
Number of other retired or separated participants entitled to future benefits	2017-01-01	2
Total of all active and inactive participants	2017-01-01	13
Total participants	2017-01-01	13
Number of participants with account balances	2017-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
2016: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	26
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	13
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	11
Total of all active and inactive participants	2016-01-01	24
Total participants	2016-01-01	24
Number of participants with account balances	2016-01-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
2015: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	37
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	16
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	7
Total of all active and inactive participants	2015-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	23
Number of participants with account balances	2015-01-01	20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	3
2014: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	35
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	7
Total of all active and inactive participants	2014-01-01	34
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	34
Number of participants with account balances	2014-01-01	29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	2
2013: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	38
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	30
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	4
Total of all active and inactive participants	2013-01-01	34
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	34
Number of participants with account balances	2013-01-01	24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	3
2012: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	37
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	32
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	1
Total of all active and inactive participants	2012-01-01	33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	33
Number of participants with account balances	2012-01-01	25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	31
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	33
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	33
Number of participants with account balances	2011-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	30
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	18
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	8
Total of all active and inactive participants	2009-01-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	26
Number of participants with account balances	2009-01-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	3

Financial Data on MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2020 : MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total income from all sources	2020-12-31	$79,506
Expenses. Total of all expenses incurred	2020-12-31	$2,067
Total plan assets at end of year	2020-12-31	$1,031,573
Total plan assets at beginning of year	2020-12-31	$954,134
Value of fidelity bond covering the plan	2020-12-31	$790,000
Other income received	2020-12-31	$79,506
Net income (gross income less expenses)	2020-12-31	$77,439
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$1,031,573
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$954,134
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$2,067
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$297,101
Expenses. Total of all expenses incurred	2019-12-31	$1,971
Total plan assets at end of year	2019-12-31	$954,134
Total plan assets at beginning of year	2019-12-31	$659,004
Value of fidelity bond covering the plan	2019-12-31	$680,000
Other income received	2019-12-31	$297,101
Net income (gross income less expenses)	2019-12-31	$295,130
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$954,134
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$659,004
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$1,971
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Transfers to/from the plan	2018-12-31	$0
Total plan liabilities at end of year	2018-12-31	$0
Total plan liabilities at beginning of year	2018-12-31	$0
Total income from all sources	2018-12-31	$-2,205
Expenses. Total of all expenses incurred	2018-12-31	$2,032
Benefits paid (including direct rollovers)	2018-12-31	$111
Total plan assets at end of year	2018-12-31	$659,004
Total plan assets at beginning of year	2018-12-31	$663,241
Value of fidelity bond covering the plan	2018-12-31	$450,000
Total contributions received or receivable from participants	2018-12-31	$0
Expenses. Other expenses not covered elsewhere	2018-12-31	$2,061
Contributions received from other sources (not participants or employers)	2018-12-31	$0
Other income received	2018-12-31	$-2,205
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$-4,237
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$659,004
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$663,241
Total contributions received or receivable from employer(s)	2018-12-31	$0
Value of certain deemed distributions of participant loans	2018-12-31	$0
Value of corrective distributions	2018-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$1,921
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$120,052
Expenses. Total of all expenses incurred	2017-12-31	$42,149
Benefits paid (including direct rollovers)	2017-12-31	$39,943
Total plan assets at end of year	2017-12-31	$663,241
Total plan assets at beginning of year	2017-12-31	$585,338
Value of fidelity bond covering the plan	2017-12-31	$270,000
Total contributions received or receivable from participants	2017-12-31	$0
Expenses. Other expenses not covered elsewhere	2017-12-31	$2,134
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$120,052
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$77,903
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$663,241
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$585,338
Assets. Value of participant loans	2017-12-31	$0
Total contributions received or receivable from employer(s)	2017-12-31	$0
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$2,206
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$135,776
Expenses. Total of all expenses incurred	2016-12-31	$2,103
Benefits paid (including direct rollovers)	2016-12-31	$0
Total plan assets at end of year	2016-12-31	$585,338
Total plan assets at beginning of year	2016-12-31	$451,665
Value of fidelity bond covering the plan	2016-12-31	$270,000
Total contributions received or receivable from participants	2016-12-31	$0
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$135,776
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$133,673
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$585,338
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$451,665
Assets. Value of participant loans	2016-12-31	$3,879
Total contributions received or receivable from employer(s)	2016-12-31	$0
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$2,103
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total income from all sources	2015-12-31	$15,888
Expenses. Total of all expenses incurred	2015-12-31	$22,499
Benefits paid (including direct rollovers)	2015-12-31	$20,377
Total plan assets at end of year	2015-12-31	$451,665
Total plan assets at beginning of year	2015-12-31	$458,276
Value of fidelity bond covering the plan	2015-12-31	$270,000
Total contributions received or receivable from participants	2015-12-31	$857
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$15,031
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$-6,611
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$451,665
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$458,276
Assets. Value of participant loans	2015-12-31	$3,720
Total contributions received or receivable from employer(s)	2015-12-31	$0
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$2,122
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$61,561
Expenses. Total of all expenses incurred	2014-12-31	$2,151
Benefits paid (including direct rollovers)	2014-12-31	$70
Total plan assets at end of year	2014-12-31	$458,276
Total plan assets at beginning of year	2014-12-31	$398,866
Value of fidelity bond covering the plan	2014-12-31	$330,000
Total contributions received or receivable from participants	2014-12-31	$822
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$60,739
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$59,410
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$458,276
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$398,866
Assets. Value of participant loans	2014-12-31	$5,086
Total contributions received or receivable from employer(s)	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$2,081
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$-79,067
Expenses. Total of all expenses incurred	2013-12-31	$2,209
Benefits paid (including direct rollovers)	2013-12-31	$486
Total plan assets at end of year	2013-12-31	$398,866
Total plan assets at beginning of year	2013-12-31	$480,142
Value of fidelity bond covering the plan	2013-12-31	$330,000
Total contributions received or receivable from participants	2013-12-31	$4,194
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$-83,261
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$-81,276
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$398,866
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$480,142
Assets. Value of participant loans	2013-12-31	$7,072
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$222,265
Total contributions received or receivable from employer(s)	2013-12-31	$0
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$1,723
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$-44,207
Expenses. Total of all expenses incurred	2012-12-31	$1,453
Benefits paid (including direct rollovers)	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$480,142
Total plan assets at beginning of year	2012-12-31	$525,802
Value of fidelity bond covering the plan	2012-12-31	$1,800,000
Total contributions received or receivable from participants	2012-12-31	$901
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$-45,108
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$-45,660
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$480,142
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$525,802
Assets. Value of participant loans	2012-12-31	$8,879
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$325,426
Total contributions received or receivable from employer(s)	2012-12-31	$0
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$1,453
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$-303,645
Expenses. Total of all expenses incurred	2011-12-31	$4,270
Benefits paid (including direct rollovers)	2011-12-31	$217
Total plan assets at end of year	2011-12-31	$525,802
Total plan assets at beginning of year	2011-12-31	$833,717
Value of fidelity bond covering the plan	2011-12-31	$510,000
Total contributions received or receivable from participants	2011-12-31	$0
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-303,645
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$-307,915
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$525,802
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$833,717
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$383,977
Total contributions received or receivable from employer(s)	2011-12-31	$0
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$4,053
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$-1,087,379
Expenses. Total of all expenses incurred	2010-12-31	$2,610
Benefits paid (including direct rollovers)	2010-12-31	$1,566
Total plan assets at end of year	2010-12-31	$833,717
Total plan assets at beginning of year	2010-12-31	$1,923,706
Value of fidelity bond covering the plan	2010-12-31	$510,000
Total contributions received or receivable from participants	2010-12-31	$0
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$-1,087,379
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$-1,089,989
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$833,717
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,923,706
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$686,318
Total contributions received or receivable from employer(s)	2010-12-31	$0
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$1,044
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for MADISON ET CIE, INC. 401(K) PROFIT SHARING PLAN

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

26940

Policy instance

Insurance contract or identification number	26940
Number of Individuals Covered	7
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $47
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	47
Additional information about fees paid to insurance broker	TPA COMPENSATION AND OTHER ALLOWANCES
Insurance broker organization code?	5

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

Policy contract number

26940

Policy instance

Insurance contract or identification number	26940
Number of Individuals Covered	7
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $73
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	73
Additional information about fees paid to insurance broker	TPA COMPENSATION AND OTHER ALLOWANCES
Insurance broker organization code?	5

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

Policy contract number

26490

Policy instance

Insurance contract or identification number	26490
Number of Individuals Covered	7
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $90
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	90
Additional information about fees paid to insurance broker	TPA COMPENSATION AND OTHER ALLOWANCES
Insurance broker organization code?	5

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

Policy contract number

26490

Policy instance

Insurance contract or identification number	26490
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $82
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	82
Additional information about fees paid to insurance broker	TPA COMPENSATIONS
Insurance broker organization code?	5
Number of Individuals Covered	9
Commission paid to Insurance Broker	USD $0
Insurance broker name	PENSION PLANNING CONSULTANTS

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

Policy contract number

26490

Policy instance

Insurance contract or identification number	26490
Number of Individuals Covered	21
Insurance policy start date	2016-01-01
Insurance policy end date	2016-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $84
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	84
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker organization code?	5

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

Policy contract number

26490

Policy instance

Insurance contract or identification number	26490
Number of Individuals Covered	21
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $91
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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	91
Additional information about fees paid to insurance broker	TPA FORUM COMPENSATION
Insurance broker organization code?	5
Insurance broker name	PENSION PLANNING CONSULTANTS

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

Policy contract number

26490

Policy instance

Insurance contract or identification number	26490
Number of Individuals Covered	23
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $16
Total amount of fees paid to insurance company	USD $102
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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	102
Additional information about fees paid to insurance broker	TPA FORUM COMPENSATION
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $16
Insurance broker name	LINDA A. BUTLER

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

Policy contract number

26490

Policy instance

Insurance contract or identification number	26490
Number of Individuals Covered	23
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $88
Total amount of fees paid to insurance company	USD $84
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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	84
Additional information about fees paid to insurance broker	TPA FORUM COMPENSATION
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $88
Insurance broker name	LINDA A. BUTLER

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

Policy contract number

26490

Policy instance

Insurance contract or identification number	26490
Number of Individuals Covered	10
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $14
Total amount of fees paid to insurance company	USD $188
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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	188
Additional information about fees paid to insurance broker	TPA FORUM COMPENSATION
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $14
Insurance broker name	LINDA A. BUTLER

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

Policy contract number

26490

Policy instance

Insurance contract or identification number	26490
Number of Individuals Covered	9
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $48
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

26490

Policy instance

Insurance contract or identification number	26490
Number of Individuals Covered	10
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $43
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes

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Company Name:	MADISON ET CIE, INC.
Employer identification number (EIN):	954553566
NAIC Classification:	448120
NAIC Description:	Women's Clothing Stores