A. J. BLOSENSKI, INC. LIFE INSURANCE PLAN 401k Plan overview

A. J. BLOSENSKI, INC. LIFE INSURANCE PLAN Benefits

401k Sponsoring company profile

Company Name:	A. J. BLOSENSKI, INC.
Employer identification number (EIN):	232785764
NAIC Classification:	562000

Form 5500 Filing Information

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2015-01-01	JAMES CLARK
501	2014-01-01	JAMES CLARK

Plan Statistics for A. J. BLOSENSKI, INC. LIFE INSURANCE PLAN

Measure	Date	Value
2015: A. J. BLOSENSKI, INC. LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	114
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	142
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	142
2014: A. J. BLOSENSKI, INC. LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	114
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	0
Total of all active and inactive participants	2014-01-01	114

Form 5500 Responses for A. J. BLOSENSKI, INC. LIFE INSURANCE PLAN

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