401k Plan data: SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK plan

SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 401k Plan overview

Plan Name	SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK
Plan identification number	002

SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
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

ADAMS COMMUNITY BANK has sponsored the creation of one or more 401k plans.

Company Name: ADAMS COMMUNITY BANK

Employer identification number (EIN): 041851620

NAIC Classification: 522120
NAIC Description: Savings Institutions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2012-01-01 THOMAS FORESE, JR.
002 2011-01-01 THOMAS FORESE JR.
002 2010-01-01 THOMAS FORESE JR.
002 2009-01-01 THOMAS FORESE, JR.

Plan id#	Filing Submission Date	Name of Administrator
002	2012-01-01	THOMAS FORESE, JR.
002	2011-01-01	THOMAS FORESE JR.
002	2010-01-01	THOMAS FORESE JR.
002	2009-01-01	THOMAS FORESE, JR.

Plan Statistics for SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK

401k plan membership statisitcs for SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK

Measure Date Value
2012: SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 2012 401k membership
Total participants, beginning-of-year 2012-01-01 61
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
Total of all active and inactive participants 2012-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 0
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 2011 401k membership
Total participants, beginning-of-year 2011-01-01 58
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 46
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 17
Total of all active and inactive participants 2011-01-01 63
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 63
Number of participants with account balances 2011-01-01 61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 2010 401k membership
Total participants, beginning-of-year 2010-01-01 55
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 44
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 14
Total of all active and inactive participants 2010-01-01 58
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 58
Number of participants with account balances 2010-01-01 57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 2009 401k membership
Total participants, beginning-of-year 2009-01-01 63
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 42
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 13
Total of all active and inactive participants 2009-01-01 55
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 55
Number of participants with account balances 2009-01-01 55
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2012: SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 2012 401k membership
Total participants, beginning-of-year	2012-01-01	61
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
Total of all active and inactive participants	2012-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	0
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 2011 401k membership
Total participants, beginning-of-year	2011-01-01	58
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	46
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	17
Total of all active and inactive participants	2011-01-01	63
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	63
Number of participants with account balances	2011-01-01	61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 2010 401k membership
Total participants, beginning-of-year	2010-01-01	55
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	44
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	14
Total of all active and inactive participants	2010-01-01	58
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	58
Number of participants with account balances	2010-01-01	57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 2009 401k membership
Total participants, beginning-of-year	2009-01-01	63
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	42
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	13
Total of all active and inactive participants	2009-01-01	55
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	55
Number of participants with account balances	2009-01-01	55
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK

Measure	Date	Value
2012 : SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 2012 401k financial data
Transfers to/from the plan	2012-09-03	$-3,828,318
Total income from all sources	2012-09-03	$389,873
Expenses. Total of all expenses incurred	2012-09-03	$19,232
Benefits paid (including direct rollovers)	2012-09-03	$14,500
Total plan assets at end of year	2012-09-03	$0
Total plan assets at beginning of year	2012-09-03	$3,457,677
Value of fidelity bond covering the plan	2012-09-03	$345,768
Total contributions received or receivable from participants	2012-09-03	$138,819
Contributions received from other sources (not participants or employers)	2012-09-03	$0
Other income received	2012-09-03	$185,355
Net income (gross income less expenses)	2012-09-03	$370,641
Net plan assets at end of year (total assets less liabilities)	2012-09-03	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-09-03	$3,457,677
Assets. Value of participant loans	2012-09-03	$0
Total contributions received or receivable from employer(s)	2012-09-03	$65,699
Value of certain deemed distributions of participant loans	2012-09-03	$4,732
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-09-03	$0
2011 : SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 2011 401k financial data
Total income from all sources	2011-12-31	$374,471
Expenses. Total of all expenses incurred	2011-12-31	$20,548
Benefits paid (including direct rollovers)	2011-12-31	$14,750
Total plan assets at end of year	2011-12-31	$3,457,677
Total plan assets at beginning of year	2011-12-31	$3,103,754
Value of fidelity bond covering the plan	2011-12-31	$310,375
Total contributions received or receivable from participants	2011-12-31	$191,597
Contributions received from other sources (not participants or employers)	2011-12-31	$89,098
Other income received	2011-12-31	$6,482
Net income (gross income less expenses)	2011-12-31	$353,923
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$3,457,677
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$3,103,754
Assets. Value of participant loans	2011-12-31	$53,940
Total contributions received or receivable from employer(s)	2011-12-31	$87,294
Value of certain deemed distributions of participant loans	2011-12-31	$112
Value of corrective distributions	2011-12-31	$5,686
2010 : SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 2010 401k financial data
Total income from all sources	2010-12-31	$572,538
Expenses. Total of all expenses incurred	2010-12-31	$40,643
Benefits paid (including direct rollovers)	2010-12-31	$35,172
Total plan assets at end of year	2010-12-31	$3,103,754
Total plan assets at beginning of year	2010-12-31	$2,571,859
Value of fidelity bond covering the plan	2010-12-31	$257,186
Total contributions received or receivable from participants	2010-12-31	$181,394
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$348,099
Net income (gross income less expenses)	2010-12-31	$531,895
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$3,103,754
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,571,859
Assets. Value of participant loans	2010-12-31	$84,777
Total contributions received or receivable from employer(s)	2010-12-31	$43,045
Value of certain deemed distributions of participant loans	2010-12-31	$2,074
Value of corrective distributions	2010-12-31	$3,397

Form 5500 Responses for SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK

2012: SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 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	Yes
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: SBERA 401(K) PLAN AS ADOPTED BY SOUTH ADAMS SAVINGS BANK 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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	ADAMS COMMUNITY BANK
Employer identification number (EIN):	041851620
NAIC Classification:	522120
NAIC Description:	Savings Institutions