401k Plan data: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN plan

WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 401k Plan overview

Plan Name	WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN
Plan identification number	002

WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.

401k Sponsoring company profile

WESTMINSTER VILLAGE WEST LAFAYETTE INCORPORATED has sponsored the creation of one or more 401k plans.

Company Name: WESTMINSTER VILLAGE WEST LAFAYETTE INCORPORATED

Employer identification number (EIN): 311002846

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2015-07-01 TODD PAYNE
002 2014-07-01 TODD PAYNE
002 2013-07-01 TODD PAYNE
002 2012-07-01 TODD PAYNE
002 2011-07-01 DEANN DALTON
002 2010-07-01 DEANN DALTON DEANN DALTON 2012-02-16
002 2009-07-01 DEANN DALTON
002 2007-07-01 DEANN DALTON
002 2006-07-01 DEANN DALTON
002 2005-07-01 DEANN DALTON
002 2004-01-17 DEANN DALTON
002 2003-07-01 DEANN DALTON

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2015-07-01	TODD PAYNE
002	2014-07-01	TODD PAYNE
002	2013-07-01	TODD PAYNE
002	2012-07-01	TODD PAYNE
002	2011-07-01	DEANN DALTON
002	2010-07-01	DEANN DALTON	DEANN DALTON	2012-02-16
002	2009-07-01	DEANN DALTON
002	2007-07-01	DEANN DALTON
002	2006-07-01	DEANN DALTON
002	2005-07-01	DEANN DALTON
002	2004-01-17	DEANN DALTON
002	2003-07-01	DEANN DALTON

Plan Statistics for WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN

401k plan membership statisitcs for WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN

Measure Date Value
2015: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 190
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 0
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 0
Total participants 2015-07-01 0
2014: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 214
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 183
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 7
Total of all active and inactive participants 2014-07-01 190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 190
Number of participants with account balances 2014-07-01 25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 178
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 206
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 8
Total of all active and inactive participants 2013-07-01 214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 214
Number of participants with account balances 2013-07-01 27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 0
2012: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 180
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 168
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 10
Total of all active and inactive participants 2012-07-01 178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 178
Number of participants with account balances 2012-07-01 29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 0
2011: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 174
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 172
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 8
Total of all active and inactive participants 2011-07-01 180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 180
Number of participants with account balances 2011-07-01 28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0
2010: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-07-01 149
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 168
Number of retired or separated participants receiving benefits 2010-07-01 0
Number of other retired or separated participants entitled to future benefits 2010-07-01 6
Total of all active and inactive participants 2010-07-01 174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-07-01 0
Total participants 2010-07-01 174
Number of participants with account balances 2010-07-01 30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-07-01 0
2009: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 149
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 144
Number of retired or separated participants receiving benefits 2009-07-01 0
Number of other retired or separated participants entitled to future benefits 2009-07-01 5
Total of all active and inactive participants 2009-07-01 149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 149
Number of participants with account balances 2009-07-01 33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 0

Measure	Date	Value
2015: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	190
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	0
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	0
Total participants	2015-07-01	0
2014: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	214
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	183
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	7
Total of all active and inactive participants	2014-07-01	190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	190
Number of participants with account balances	2014-07-01	25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	178
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	206
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	8
Total of all active and inactive participants	2013-07-01	214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	214
Number of participants with account balances	2013-07-01	27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	0
2012: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	180
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	168
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	10
Total of all active and inactive participants	2012-07-01	178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	178
Number of participants with account balances	2012-07-01	29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	0
2011: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	174
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	172
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	8
Total of all active and inactive participants	2011-07-01	180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	180
Number of participants with account balances	2011-07-01	28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
2010: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-07-01	149
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	168
Number of retired or separated participants receiving benefits	2010-07-01	0
Number of other retired or separated participants entitled to future benefits	2010-07-01	6
Total of all active and inactive participants	2010-07-01	174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-07-01	0
Total participants	2010-07-01	174
Number of participants with account balances	2010-07-01	30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-07-01	0
2009: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	149
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	144
Number of retired or separated participants receiving benefits	2009-07-01	0
Number of other retired or separated participants entitled to future benefits	2009-07-01	5
Total of all active and inactive participants	2009-07-01	149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	149
Number of participants with account balances	2009-07-01	33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	0

Financial Data on WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN

Measure	Date	Value
2015 : WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-08-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-08-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-08-31	$0
Total income from all sources (including contributions)	2015-08-31	$-4,145
Total loss/gain on sale of assets	2015-08-31	$0
Total of all expenses incurred	2015-08-31	$379,334
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-08-31	$378,757
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-08-31	$4,159
Value of total assets at end of year	2015-08-31	$0
Value of total assets at beginning of year	2015-08-31	$383,479
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-08-31	$577
Total interest from all sources	2015-08-31	$548
Total dividends received (eg from common stock, registered investment company shares)	2015-08-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-08-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-08-31	$0
Administrative expenses professional fees incurred	2015-08-31	$577
Was this plan covered by a fidelity bond	2015-08-31	Yes
Value of fidelity bond cover	2015-08-31	$500,000
If this is an individual account plan, was there a blackout period	2015-08-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-08-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-08-31	No
Contributions received from participants	2015-08-31	$4,159
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-08-31	No
Value of net income/loss	2015-08-31	$-383,479
Value of net assets at end of year (total assets less liabilities)	2015-08-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2015-08-31	$383,479
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-08-31	No
Were any leases to which the plan was party in default or uncollectible	2015-08-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-08-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-08-31	$259,378
Value of interest in pooled separate accounts at end of year	2015-08-31	$0
Value of interest in pooled separate accounts at beginning of year	2015-08-31	$17,610
Interest earned on other investments	2015-08-31	$548
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-08-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-08-31	$106,491
Expenses. Payments to insurance carriers foe the provision of benefits	2015-08-31	$344,180
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-08-31	$-9,094
Net investment gain/loss from pooled separate accounts	2015-08-31	$242
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-08-31	No
Was there a failure to transmit to the plan any participant contributions	2015-08-31	No
Has the plan failed to provide any benefit when due under the plan	2015-08-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-08-31	$34,577
Did the plan have assets held for investment	2015-08-31	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	2015-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-08-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-08-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-08-31	Disclaimer
Accountancy firm name	2015-08-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2015-08-31	410746749
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total income from all sources (including contributions)	2015-06-30	$36,775
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$4,593
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$4,593
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$22,810
Value of total assets at end of year	2015-06-30	$383,479
Value of total assets at beginning of year	2015-06-30	$351,297
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$0
Total interest from all sources	2015-06-30	$3,085
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-06-30	$0
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$500,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$22,810
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Value of net income/loss	2015-06-30	$32,182
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$383,479
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$351,297
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-06-30	$259,378
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-30	$238,219
Value of interest in pooled separate accounts at end of year	2015-06-30	$17,610
Value of interest in pooled separate accounts at beginning of year	2015-06-30	$15,641
Interest earned on other investments	2015-06-30	$3,085
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$106,491
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$97,437
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-06-30	$9,271
Net investment gain/loss from pooled separate accounts	2015-06-30	$1,609
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	No
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$4,593
Did the plan have assets held for investment	2015-06-30	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	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-06-30	Disclaimer
Accountancy firm name	2015-06-30	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2015-06-30	410746749
2014 : WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total income from all sources (including contributions)	2014-06-30	$81,549
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$63,946
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$63,946
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$43,826
Value of total assets at end of year	2014-06-30	$351,297
Value of total assets at beginning of year	2014-06-30	$333,694
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$0
Total interest from all sources	2014-06-30	$3,149
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$500,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$40,302
Income. Received or receivable in cash from other sources (including rollovers)	2014-06-30	$3,524
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Value of net income/loss	2014-06-30	$17,603
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$351,297
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$333,694
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-06-30	$238,219
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-06-30	$219,109
Value of interest in pooled separate accounts at end of year	2014-06-30	$15,641
Value of interest in pooled separate accounts at beginning of year	2014-06-30	$17,418
Interest earned on other investments	2014-06-30	$3,149
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$97,437
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$97,167
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-06-30	$32,723
Net investment gain/loss from pooled separate accounts	2014-06-30	$1,851
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$63,946
Did the plan have assets held for investment	2014-06-30	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	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2014-06-30	410746749
2013 : WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total income from all sources (including contributions)	2013-06-30	$83,834
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$11,037
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$11,037
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$59,889
Value of total assets at end of year	2013-06-30	$333,694
Value of total assets at beginning of year	2013-06-30	$260,897
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$0
Total interest from all sources	2013-06-30	$2,842
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$125,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$58,663
Income. Received or receivable in cash from other sources (including rollovers)	2013-06-30	$1,226
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$72,797
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$333,694
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$260,897
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-06-30	$219,109
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-06-30	$168,100
Value of interest in pooled separate accounts at end of year	2013-06-30	$17,418
Value of interest in pooled separate accounts at beginning of year	2013-06-30	$11,304
Interest earned on other investments	2013-06-30	$2,842
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$97,167
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$81,493
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-06-30	$19,861
Net investment gain/loss from pooled separate accounts	2013-06-30	$1,242
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	No
Was there a failure to transmit to the plan any participant contributions	2013-06-30	No
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$11,037
Did the plan have assets held for investment	2013-06-30	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	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2013-06-30	410746749
2012 : WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total income from all sources (including contributions)	2012-06-30	$36,066
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$52,075
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$52,075
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$31,868
Value of total assets at end of year	2012-06-30	$260,897
Value of total assets at beginning of year	2012-06-30	$276,906
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$0
Total interest from all sources	2012-06-30	$2,621
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$125,000
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	$29,162
Income. Received or receivable in cash from other sources (including rollovers)	2012-06-30	$2,706
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	$-16,009
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$260,897
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$276,906
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	$168,100
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-06-30	$180,646
Value of interest in pooled separate accounts at end of year	2012-06-30	$11,304
Value of interest in pooled separate accounts at beginning of year	2012-06-30	$18,922
Interest earned on other investments	2012-06-30	$2,621
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$81,493
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$77,338
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-06-30	$209
Net investment gain/loss from pooled separate accounts	2012-06-30	$1,368
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$52,075
Did the plan have assets held for investment	2012-06-30	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	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	No
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	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2012-06-30	410746749
2011 : WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total income from all sources (including contributions)	2011-06-30	$59,619
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$26,545
Value of total assets at end of year	2011-06-30	$276,906
Value of total assets at beginning of year	2011-06-30	$217,287
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$0
Total interest from all sources	2011-06-30	$2,425
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$125,000
If this is an individual account plan, was there a blackout period	2011-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Contributions received from participants	2011-06-30	$26,545
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Value of net income/loss	2011-06-30	$59,619
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$276,906
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$217,287
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-06-30	$180,646
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-06-30	$129,467
Value of interest in pooled separate accounts at end of year	2011-06-30	$18,922
Value of interest in pooled separate accounts at beginning of year	2011-06-30	$15,314
Interest earned on other investments	2011-06-30	$2,425
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$77,338
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$72,506
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-06-30	$27,667
Net investment gain/loss from pooled separate accounts	2011-06-30	$2,982
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	No
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Did the plan have assets held for investment	2011-06-30	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	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2011-06-30	410746749
2010 : WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0

Form 5500 Responses for WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN

2015: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	Yes
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2011: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2010: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	Submission has been amended	No
2010-07-01	This submission is the final filing	No
2010-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-07-01	Plan is a collectively bargained plan	No
2010-07-01	Plan funding arrangement – Insurance	Yes
2010-07-01	Plan funding arrangement – Trust	Yes
2010-07-01	Plan benefit arrangement – Insurance	Yes
2010-07-01	Plan benefit arrangement - Trust	Yes
2009: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes
2007: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2007 form 5500 responses
2007-07-01	Type of plan entity	Single employer plan
2007-07-01	Submission has been amended	Yes
2007-07-01	This submission is the final filing	No
2007-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-07-01	Plan is a collectively bargained plan	No
2006: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2006 form 5500 responses
2006-07-01	Type of plan entity	Single employer plan
2006-07-01	Submission has been amended	Yes
2006-07-01	This submission is the final filing	No
2006-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2006-07-01	Plan is a collectively bargained plan	No
2005: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2005 form 5500 responses
2005-07-01	Type of plan entity	Single employer plan
2005-07-01	Submission has been amended	Yes
2005-07-01	This submission is the final filing	No
2005-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2005-07-01	Plan is a collectively bargained plan	No
2004: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2004 form 5500 responses
2004-01-17	Type of plan entity	Single employer plan
2004-01-17	Submission has been amended	Yes
2004-01-17	This submission is the final filing	No
2004-01-17	This return/report is a short plan year return/report (less than 12 months)	No
2004-01-17	Plan is a collectively bargained plan	No
2003: WESTMINSTER VILLAGE TAX DEFERRED ANNUITY RETIREMENT PLAN 2003 form 5500 responses
2003-07-01	Type of plan entity	Single employer plan
2003-07-01	Submission has been amended	Yes
2003-07-01	This submission is the final filing	No
2003-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2003-07-01	Plan is a collectively bargained plan	No

Insurance Providers Used on plan

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

388485

Policy instance

Insurance contract or identification number	388485
Number of Individuals Covered	0
Insurance policy start date	2015-07-01
Insurance policy end date	2015-08-31
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G70423

Policy instance

Insurance contract or identification number	G70423
Number of Individuals Covered	0
Insurance policy start date	2015-07-01
Insurance policy end date	2015-08-31
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

388485

Policy instance

Insurance contract or identification number	388485
Number of Individuals Covered	25
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G70423

Policy instance

Insurance contract or identification number	G70423
Number of Individuals Covered	3
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

388485

Policy instance

Insurance contract or identification number	388485
Number of Individuals Covered	27
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G70423

Policy instance

Insurance contract or identification number	G70423
Number of Individuals Covered	3
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

388485

Policy instance

Insurance contract or identification number	388485
Number of Individuals Covered	29
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G70423

Policy instance

Insurance contract or identification number	G70423
Number of Individuals Covered	3
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G70423

Policy instance

Insurance contract or identification number	G70423
Number of Individuals Covered	3
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $9
Total amount of fees paid to insurance company	USD $0
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

388485

Policy instance

Insurance contract or identification number	388485
Number of Individuals Covered	25
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G70423

Policy instance

Insurance contract or identification number	G70423
Number of Individuals Covered	3
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $16
Total amount of fees paid to insurance company	USD $0
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

388485

Policy instance

Insurance contract or identification number	388485
Number of Individuals Covered	30
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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:	WESTMINSTER VILLAGE WEST LAFAYETTE INCORPORATED
Employer identification number (EIN):	311002846
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities