401k Plan data: SALARIED EMPLOYEES HEALTH BENEFITS PLAN plan

SALARIED EMPLOYEES HEALTH BENEFITS PLAN 401k Plan overview

Plan Name	SALARIED EMPLOYEES HEALTH BENEFITS PLAN
Plan identification number	501

SALARIED EMPLOYEES HEALTH BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

CLINTONS DITCH COOPERATIVE COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name: CLINTONS DITCH COOPERATIVE COMPANY, INC.

Employer identification number (EIN): 160926423

NAIC Classification: 312110
NAIC Description: Soft Drink and Ice Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SALARIED EMPLOYEES HEALTH BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2012-01-01 JOHN LENGYEL 2013-07-19
501 2011-01-01 JOHN LENGYEL 2012-07-19
501 2010-01-01 JOHN W. LENGYEL 2011-07-27
501 2009-01-01 JOHN LENGYEL
501 2008-01-01 JOHN LENGYEL
501 2007-01-01 JOHN LENGYEL
501 2006-01-01 JOHN LENGYEL
501 2005-01-01 JOHN LENGYEL
501 2004-01-01 JOHN LENGYEL
501 2003-01-01 JOHN LENGYEL

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2012-01-01	JOHN LENGYEL	2013-07-19
501	2011-01-01	JOHN LENGYEL	2012-07-19
501	2010-01-01	JOHN W. LENGYEL	2011-07-27
501	2009-01-01	JOHN LENGYEL
501	2008-01-01	JOHN LENGYEL
501	2007-01-01	JOHN LENGYEL
501	2006-01-01	JOHN LENGYEL
501	2005-01-01	JOHN LENGYEL
501	2004-01-01	JOHN LENGYEL
501	2003-01-01	JOHN LENGYEL

Plan Statistics for SALARIED EMPLOYEES HEALTH BENEFITS PLAN

401k plan membership statisitcs for SALARIED EMPLOYEES HEALTH BENEFITS PLAN

Measure Date Value
2009: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 23
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 0
Total of all active and inactive participants 2009-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 23
Number of participants with account balances 2009-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0
2008: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2008 401k membership
Total participants, beginning-of-year 2008-01-01 27
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 25
Number of retired or separated participants receiving benefits 2008-01-01 0
Number of other retired or separated participants entitled to future benefits 2008-01-01 0
Total of all active and inactive participants 2008-01-01 25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-01-01 0
Total participants 2008-01-01 25
Number of participants with account balances 2008-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-01-01 0
2007: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2007 401k membership
Total participants, beginning-of-year 2007-01-01 27
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 27
Number of retired or separated participants receiving benefits 2007-01-01 0
Number of other retired or separated participants entitled to future benefits 2007-01-01 0
Total of all active and inactive participants 2007-01-01 25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2007-01-01 0
Total participants 2007-01-01 25
Number of participants with account balances 2007-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2007-01-01 0
2006: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2006 401k membership
Total participants, beginning-of-year 2006-01-01 26
Total number of active participants reported on line 7a of the Form 5500 2006-01-01 27
Number of retired or separated participants receiving benefits 2006-01-01 0
Number of other retired or separated participants entitled to future benefits 2006-01-01 0
Total of all active and inactive participants 2006-01-01 27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2006-01-01 0
Total participants 2006-01-01 27
Number of participants with account balances 2006-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2006-01-01 0
2005: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2005 401k membership
Total participants, beginning-of-year 2005-01-01 27
Total number of active participants reported on line 7a of the Form 5500 2005-01-01 26
Number of retired or separated participants receiving benefits 2005-01-01 0
Number of other retired or separated participants entitled to future benefits 2005-01-01 0
Total of all active and inactive participants 2005-01-01 27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2005-01-01 0
Total participants 2005-01-01 27
Number of participants with account balances 2005-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2005-01-01 0
2004: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2004 401k membership
Total participants, beginning-of-year 2004-01-01 29
Total number of active participants reported on line 7a of the Form 5500 2004-01-01 27
Number of retired or separated participants receiving benefits 2004-01-01 0
Number of other retired or separated participants entitled to future benefits 2004-01-01 0
Total of all active and inactive participants 2004-01-01 27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2004-01-01 0
Total participants 2004-01-01 27
Number of participants with account balances 2004-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2004-01-01 0
2003: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2003 401k membership
Total participants, beginning-of-year 2003-01-01 29
Total number of active participants reported on line 7a of the Form 5500 2003-01-01 29
Number of retired or separated participants receiving benefits 2003-01-01 0
Number of other retired or separated participants entitled to future benefits 2003-01-01 0
Total of all active and inactive participants 2003-01-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2003-01-01 0
Total participants 2003-01-01 26
Number of participants with account balances 2003-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2003-01-01 0

Measure	Date	Value
2009: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	23
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	0
Total of all active and inactive participants	2009-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	23
Number of participants with account balances	2009-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0
2008: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	27
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	25
Number of retired or separated participants receiving benefits	2008-01-01	0
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-01-01	0
Total participants	2008-01-01	25
Number of participants with account balances	2008-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-01-01	0
2007: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2007 401k membership
Total participants, beginning-of-year	2007-01-01	27
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	27
Number of retired or separated participants receiving benefits	2007-01-01	0
Number of other retired or separated participants entitled to future benefits	2007-01-01	0
Total of all active and inactive participants	2007-01-01	25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2007-01-01	0
Total participants	2007-01-01	25
Number of participants with account balances	2007-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2007-01-01	0
2006: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2006 401k membership
Total participants, beginning-of-year	2006-01-01	26
Total number of active participants reported on line 7a of the Form 5500	2006-01-01	27
Number of retired or separated participants receiving benefits	2006-01-01	0
Number of other retired or separated participants entitled to future benefits	2006-01-01	0
Total of all active and inactive participants	2006-01-01	27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2006-01-01	0
Total participants	2006-01-01	27
Number of participants with account balances	2006-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2006-01-01	0
2005: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2005 401k membership
Total participants, beginning-of-year	2005-01-01	27
Total number of active participants reported on line 7a of the Form 5500	2005-01-01	26
Number of retired or separated participants receiving benefits	2005-01-01	0
Number of other retired or separated participants entitled to future benefits	2005-01-01	0
Total of all active and inactive participants	2005-01-01	27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2005-01-01	0
Total participants	2005-01-01	27
Number of participants with account balances	2005-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2005-01-01	0
2004: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2004 401k membership
Total participants, beginning-of-year	2004-01-01	29
Total number of active participants reported on line 7a of the Form 5500	2004-01-01	27
Number of retired or separated participants receiving benefits	2004-01-01	0
Number of other retired or separated participants entitled to future benefits	2004-01-01	0
Total of all active and inactive participants	2004-01-01	27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2004-01-01	0
Total participants	2004-01-01	27
Number of participants with account balances	2004-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2004-01-01	0
2003: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2003 401k membership
Total participants, beginning-of-year	2003-01-01	29
Total number of active participants reported on line 7a of the Form 5500	2003-01-01	29
Number of retired or separated participants receiving benefits	2003-01-01	0
Number of other retired or separated participants entitled to future benefits	2003-01-01	0
Total of all active and inactive participants	2003-01-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2003-01-01	0
Total participants	2003-01-01	26
Number of participants with account balances	2003-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2003-01-01	0

Form 5500 Responses for SALARIED EMPLOYEES HEALTH BENEFITS PLAN

2009: SALARIED EMPLOYEES HEALTH BENEFITS 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 – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2008: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2008-01-01	Plan benefit arrangement – Insurance	Yes
2008-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2007: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	No
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2007-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2007-01-01	Plan benefit arrangement – Insurance	Yes
2007-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2006: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2006 form 5500 responses
2006-01-01	Type of plan entity	Single employer plan
2006-01-01	Submission has been amended	No
2006-01-01	This submission is the final filing	No
2006-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2006-01-01	Plan is a collectively bargained plan	No
2006-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2006-01-01	Plan benefit arrangement – Insurance	Yes
2006-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2005: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2005 form 5500 responses
2005-01-01	Type of plan entity	Single employer plan
2005-01-01	Submission has been amended	No
2005-01-01	This submission is the final filing	No
2005-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2005-01-01	Plan is a collectively bargained plan	No
2005-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2005-01-01	Plan benefit arrangement – Insurance	Yes
2005-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2004: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2004 form 5500 responses
2004-01-01	Type of plan entity	Single employer plan
2004-01-01	Submission has been amended	No
2004-01-01	This submission is the final filing	No
2004-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2004-01-01	Plan is a collectively bargained plan	No
2004-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2004-01-01	Plan benefit arrangement – Insurance	Yes
2004-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2003: SALARIED EMPLOYEES HEALTH BENEFITS PLAN 2003 form 5500 responses
2003-01-01	Type of plan entity	Single employer plan
2003-01-01	Submission has been amended	No
2003-01-01	This submission is the final filing	No
2003-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2003-01-01	Plan is a collectively bargained plan	No
2003-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2003-01-01	Plan benefit arrangement – Insurance	Yes
2003-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	CLINTONS DITCH COOPERATIVE COMPANY, INC.
Employer identification number (EIN):	160926423
NAIC Classification:	312110
NAIC Description:	Soft Drink and Ice Manufacturing