401k Plan data: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN plan

401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 401k Plan overview

Plan Name	401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN
Plan identification number	002

401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 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.
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

ALFRED STEIN, INC. DBA KEYSTONE MOTORS has sponsored the creation of one or more 401k plans.

Company Name: ALFRED STEIN, INC. DBA KEYSTONE MOTORS

Employer identification number (EIN): 231655226

NAIC Classification: 441110
NAIC Description: New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2015-01-01 LEE LICHTENSTEIN
002 2014-01-01 LEE LICHTENSTEIN
002 2013-01-01 LEE LICHTENSTEIN
002 2012-01-01 NOAH SULLUM
002 2011-01-01 NOAH SULLUM
002 2010-01-01 NOAH SULLUM
002 2009-01-01 HERBERT CHUBIN HERBERT CHUBIN 2010-09-24
002 2009-01-01 HERBERT CHUBIN HERBERT CHUBIN 2010-09-27

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2015-01-01	LEE LICHTENSTEIN
002	2014-01-01	LEE LICHTENSTEIN
002	2013-01-01	LEE LICHTENSTEIN
002	2012-01-01	NOAH SULLUM
002	2011-01-01	NOAH SULLUM
002	2010-01-01	NOAH SULLUM
002	2009-01-01	HERBERT CHUBIN	HERBERT CHUBIN	2010-09-24
002	2009-01-01	HERBERT CHUBIN	HERBERT CHUBIN	2010-09-27

Plan Statistics for 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN

401k plan membership statisitcs for 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN

Measure Date Value
2015: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
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 0
Total of all active and inactive participants 2015-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 0
Number of participants with account balances 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 79
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 17
Total of all active and inactive participants 2014-01-01 96
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 96
Number of participants with account balances 2014-01-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 17
2013: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 142
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 110
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 23
Total of all active and inactive participants 2013-01-01 133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 133
Number of participants with account balances 2013-01-01 124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 7
2012: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 119
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: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 137
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 89
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 30
Total of all active and inactive participants 2011-01-01 119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 119
Number of participants with account balances 2011-01-01 119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 98
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 21
Total of all active and inactive participants 2010-01-01 119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 119
Number of participants with account balances 2010-01-01 119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 130
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 101
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 34
Total of all active and inactive participants 2009-01-01 135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 135
Number of participants with account balances 2009-01-01 122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2015: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
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	0
Total of all active and inactive participants	2015-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	0
Number of participants with account balances	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	79
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	17
Total of all active and inactive participants	2014-01-01	96
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	96
Number of participants with account balances	2014-01-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	17
2013: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	142
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	110
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	23
Total of all active and inactive participants	2013-01-01	133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	133
Number of participants with account balances	2013-01-01	124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	7
2012: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	119
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: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	137
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	89
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	30
Total of all active and inactive participants	2011-01-01	119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	119
Number of participants with account balances	2011-01-01	119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	98
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	21
Total of all active and inactive participants	2010-01-01	119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	119
Number of participants with account balances	2010-01-01	119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	130
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	101
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	34
Total of all active and inactive participants	2009-01-01	135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	135
Number of participants with account balances	2009-01-01	122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN

Measure	Date	Value
2015 : 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-10-08	$0
Total transfer of assets from this plan	2015-10-08	$5,711,363
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-10-08	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-10-08	$4,752
Total income from all sources (including contributions)	2015-10-08	$213,942
Total loss/gain on sale of assets	2015-10-08	$0
Total of all expenses incurred	2015-10-08	$94,004
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-10-08	$72,102
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-10-08	$116,952
Value of total assets at end of year	2015-10-08	$0
Value of total assets at beginning of year	2015-10-08	$5,596,177
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-10-08	$21,902
Total interest from all sources	2015-10-08	$960
Total dividends received (eg from common stock, registered investment company shares)	2015-10-08	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-10-08	No
Administrative expenses professional fees incurred	2015-10-08	$3,571
Was this plan covered by a fidelity bond	2015-10-08	Yes
Value of fidelity bond cover	2015-10-08	$500,000
If this is an individual account plan, was there a blackout period	2015-10-08	No
Were there any nonexempt tranactions with any party-in-interest	2015-10-08	No
Contributions received from participants	2015-10-08	$116,952
Participant contributions at end of year	2015-10-08	$0
Participant contributions at beginning of year	2015-10-08	$73,897
Participant contributions at end of year	2015-10-08	$0
Participant contributions at beginning of year	2015-10-08	$8,231
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-10-08	$74
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-10-08	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-10-08	$729
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-10-08	$4,752
Other income not declared elsewhere	2015-10-08	$137
Administrative expenses (other) incurred	2015-10-08	$4,821
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-10-08	No
Value of net income/loss	2015-10-08	$119,938
Value of net assets at end of year (total assets less liabilities)	2015-10-08	$0
Value of net assets at beginning of year (total assets less liabilities)	2015-10-08	$5,591,425
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-10-08	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-10-08	No
Were any leases to which the plan was party in default or uncollectible	2015-10-08	No
Value of interest in pooled separate accounts at end of year	2015-10-08	$0
Value of interest in pooled separate accounts at beginning of year	2015-10-08	$5,290,096
Interest on participant loans	2015-10-08	$960
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-10-08	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-10-08	$223,224
Net investment gain/loss from pooled separate accounts	2015-10-08	$95,893
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-10-08	No
Was there a failure to transmit to the plan any participant contributions	2015-10-08	No
Has the plan failed to provide any benefit when due under the plan	2015-10-08	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-10-08	$72,028
Contract administrator fees	2015-10-08	$13,510
Did the plan have assets held for investment	2015-10-08	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-10-08	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-10-08	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-10-08	Yes
Opinion of an independent qualified public accountant for this plan	2015-10-08	Disclaimer
Accountancy firm name	2015-10-08	LBMC, PC
Accountancy firm EIN	2015-10-08	621199757
2014 : 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$4,752
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$13,374
Total income from all sources (including contributions)	2014-12-31	$548,888
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$368,613
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$321,014
Value of total corrective distributions	2014-12-31	$4,752
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$411,632
Value of total assets at end of year	2014-12-31	$5,596,177
Value of total assets at beginning of year	2014-12-31	$5,424,524
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$42,847
Total interest from all sources	2014-12-31	$2,962
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Administrative expenses professional fees incurred	2014-12-31	$403
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$367,033
Participant contributions at end of year	2014-12-31	$73,897
Participant contributions at beginning of year	2014-12-31	$65,028
Participant contributions at end of year	2014-12-31	$8,231
Participant contributions at beginning of year	2014-12-31	$6,611
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$729
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$533
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$4,752
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$13,374
Administrative expenses (other) incurred	2014-12-31	$11,552
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Income. Non cash contributions	2014-12-31	$44,599
Value of net income/loss	2014-12-31	$180,275
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$5,591,425
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$5,411,150
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in pooled separate accounts at end of year	2014-12-31	$5,290,096
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$5,121,429
Interest on participant loans	2014-12-31	$2,962
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$223,224
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$212,840
Net investment gain/loss from pooled separate accounts	2014-12-31	$134,294
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Employer contributions (assets) at beginning of year	2014-12-31	$18,083
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$321,014
Contract administrator fees	2014-12-31	$30,892
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	LATTIMORE, BLACK, MORGAN & CAIN, PC
Accountancy firm EIN	2014-12-31	621199757
2013 : 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets to this plan	2013-12-31	$4,574,295
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$13,374
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$1,167,559
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$330,704
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$281,866
Value of total corrective distributions	2013-12-31	$13,374
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$395,115
Value of total assets at end of year	2013-12-31	$5,424,524
Value of total assets at beginning of year	2013-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$35,464
Total interest from all sources	2013-12-31	$2,022
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$541,115
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$376,692
Participant contributions at end of year	2013-12-31	$65,028
Participant contributions at end of year	2013-12-31	$6,611
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$533
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$13,374
Other income not declared elsewhere	2013-12-31	$3
Administrative expenses (other) incurred	2013-12-31	$9,732
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$836,855
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$5,411,150
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in pooled separate accounts at end of year	2013-12-31	$5,121,429
Interest on participant loans	2013-12-31	$2,022
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$212,840
Net investment gain/loss from pooled separate accounts	2013-12-31	$770,419
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$18,423
Employer contributions (assets) at end of year	2013-12-31	$18,083
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$281,866
Contract administrator fees	2013-12-31	$25,732
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	WARREN AVERETT, LLC
Accountancy firm EIN	2013-12-31	454084437
2012 : 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2012 401k financial data
Total transfer of assets from this plan	2012-06-30	$4,059,065
Total income from all sources (including contributions)	2012-06-30	$251,593
Total of all expenses incurred	2012-06-30	$135,364
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$133,312
Expenses. Certain deemed distributions of participant loans	2012-06-30	$0
Value of total corrective distributions	2012-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$126,351
Value of total assets at end of year	2012-06-30	$0
Value of total assets at beginning of year	2012-06-30	$3,951,216
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$2,052
Total interest from all sources	2012-06-30	$702
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$5,000,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$117,311
Participant contributions at end of year	2012-06-30	$0
Participant contributions at beginning of year	2012-06-30	$47,776
Income. Received or receivable in cash from other sources (including rollovers)	2012-06-30	$9,040
Other income not declared elsewhere	2012-06-30	$411
Administrative expenses (other) incurred	2012-06-30	$2,052
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$116,229
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$3,951,216
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-06-30	$3,895,471
Value of interest in pooled separate accounts at end of year	2012-06-30	$0
Value of interest in pooled separate accounts at beginning of year	2012-06-30	$0
Interest on participant loans	2012-06-30	$702
Interest earned on other investments	2012-06-30	$0
Value of interest in common/collective trusts at end of year	2012-06-30	$0
Value of interest in common/collective trusts at beginning of year	2012-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-06-30	$0
Net investment gain/loss from pooled separate accounts	2012-06-30	$124,129
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Contributions received in cash from employer	2012-06-30	$0
Employer contributions (assets) at end of year	2012-06-30	$0
Employer contributions (assets) at beginning of year	2012-06-30	$7,969
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$133,312
Did the plan have assets held for investment	2012-06-30	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	WARREN AVERETT, LLC
Accountancy firm EIN	2012-06-30	454084437
2011 : 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$0
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets to this plan	2011-12-31	$0
Total transfer of assets from this plan	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$8,380
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$7,611
Total income from all sources (including contributions)	2011-12-31	$300,235
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$593,373
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$580,825
Expenses. Certain deemed distributions of participant loans	2011-12-31	$0
Value of total corrective distributions	2011-12-31	$8,392
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$405,841
Value of total assets at end of year	2011-12-31	$3,951,216
Value of total assets at beginning of year	2011-12-31	$4,243,585
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$4,156
Total interest from all sources	2011-12-31	$1,887
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$380,112
Participant contributions at end of year	2011-12-31	$47,776
Participant contributions at beginning of year	2011-12-31	$65,121
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$8,380
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$7,611
Other income not declared elsewhere	2011-12-31	$-771
Administrative expenses (other) incurred	2011-12-31	$4,156
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-293,138
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$3,942,836
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,235,974
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$3,895,471
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$4,159,498
Value of interest in pooled separate accounts at end of year	2011-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$0
Interest on participant loans	2011-12-31	$1,887
Interest earned on other investments	2011-12-31	$0
Value of interest in common/collective trusts at end of year	2011-12-31	$0
Value of interest in common/collective trusts at beginning of year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$0
Net investment gain/loss from pooled separate accounts	2011-12-31	$-106,722
Net investment gain or loss from common/collective trusts	2011-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Assets. Invements in employer securities at end of year	2011-12-31	$0
Assets. Invements in employer securities at beginning of year	2011-12-31	$0
Contributions received in cash from employer	2011-12-31	$25,729
Employer contributions (assets) at end of year	2011-12-31	$7,969
Employer contributions (assets) at beginning of year	2011-12-31	$18,966
Income. Dividends from common stock	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$580,825
Asset. Corporate debt instrument debt (other) at end of year	2011-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$0
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
2010 : 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$0
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets to this plan	2010-12-31	$0
Total transfer of assets from this plan	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$7,611
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$849,723
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$151,961
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$140,028
Expenses. Certain deemed distributions of participant loans	2010-12-31	$7,611
Value of total corrective distributions	2010-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$413,879
Value of total assets at end of year	2010-12-31	$4,243,585
Value of total assets at beginning of year	2010-12-31	$3,538,212
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$4,322
Total interest from all sources	2010-12-31	$2,177
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$0
Amount contributed by the employer to the plan for this plan year	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$392,740
Participant contributions at end of year	2010-12-31	$65,121
Participant contributions at beginning of year	2010-12-31	$44,197
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$2,173
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$7,611
Other income not declared elsewhere	2010-12-31	$0
Administrative expenses (other) incurred	2010-12-31	$4,322
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$697,762
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,235,974
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,538,212
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$4,159,498
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$3,475,288
Value of interest in pooled separate accounts at end of year	2010-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$0
Interest on participant loans	2010-12-31	$2,177
Interest earned on other investments	2010-12-31	$0
Value of interest in common/collective trusts at end of year	2010-12-31	$0
Value of interest in common/collective trusts at beginning of year	2010-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$0
Net investment gain/loss from pooled separate accounts	2010-12-31	$433,667
Net investment gain or loss from common/collective trusts	2010-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Assets. Invements in employer securities at end of year	2010-12-31	$0
Assets. Invements in employer securities at beginning of year	2010-12-31	$0
Contributions received in cash from employer	2010-12-31	$18,966
Employer contributions (assets) at end of year	2010-12-31	$18,966
Employer contributions (assets) at beginning of year	2010-12-31	$18,727
Income. Dividends from common stock	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$140,028
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$0
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	EISNERAMPER LLP
Accountancy firm EIN	2010-12-31	131639826
2009 : 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year	2009-12-31	$0
Minimum employer required contribution for this plan year	2009-12-31	$0
Amount contributed by the employer to the plan for this plan year	2009-12-31	$0

Form 5500 Responses for 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN

2015: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) 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	Yes
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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 – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) 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 – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	First time form 5500 has been submitted	Yes
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 – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) 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	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 – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) 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 – Insurance	Yes
2010: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) 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 – Insurance	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

GP17961

Policy instance

Insurance contract or identification number	GP17961
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $6,945
Total amount of fees paid to insurance company	USD $4,726
Are there contracts with allocated funds for individual policies?	No
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 $6,945
Insurance broker organization code?	4
Amount paid for insurance broker fees	2778
Additional information about fees paid to insurance broker	TPA SUBSIDY
Insurance broker name	PINNACLE FINANCIAL SERVICES, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

GP17961

Policy instance

Insurance contract or identification number	GP17961
Number of Individuals Covered	99
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $13,669
Total amount of fees paid to insurance company	USD $8,717
Are there contracts with allocated funds for individual policies?	No
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 $13,669
Insurance broker organization code?	4
Amount paid for insurance broker fees	5468
Additional information about fees paid to insurance broker	TPA SUBSIDY
Insurance broker name	PINNACLE FINANCIAL SERVICES, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

GP17961

Policy instance

Insurance contract or identification number	GP17961
Number of Individuals Covered	124
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $6,658
Total amount of fees paid to insurance company	USD $7,850
Are there contracts with allocated funds for individual policies?	No
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 $6,658
Insurance broker organization code?	4
Amount paid for insurance broker fees	4739
Additional information about fees paid to insurance broker	TPA SUBSIDY
Insurance broker name	PINNACLE FINANCIAL SERVICES, INC.

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-712038

Policy instance

Insurance contract or identification number	GA-712038
Number of Individuals Covered	0
Insurance policy start date	2012-01-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $5,227
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,227
Insurance broker organization code?	3
Insurance broker name	SBHU LIFE AGCY INC.

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-712038

Policy instance

Insurance contract or identification number	GA-712038
Number of Individuals Covered	119
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $11,581
Total amount of fees paid to insurance company	USD $101
Are there contracts with allocated funds for individual policies?	No
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

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-712038

Policy instance

Insurance contract or identification number	GA-712038
Number of Individuals Covered	119
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $6,804
Total amount of fees paid to insurance company	USD $76
Are there contracts with allocated funds for individual policies?	No
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:	ALFRED STEIN, INC. DBA KEYSTONE MOTORS
Employer identification number (EIN):	231655226
NAIC Classification:	441110
NAIC Description:	New Car Dealers