401k Plan data: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN plan

DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	DON SERVICES, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	001

DON SERVICES, INC. 401(K) PROFIT SHARING 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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

DON SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: DON SERVICES, INC.

Employer identification number (EIN): 331120614

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DON SERVICES, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 STEPHEN CARDELLA 2024-10-11
001 2022-01-01 STEPHEN CARDELLA 2023-10-13
001 2021-01-01 COURT HOWER 2022-10-14
001 2021-01-01 COURT HOWER 2023-03-28
001 2020-01-01 CHRIS LLOYD 2021-09-21
001 2019-01-01 CHRIS LLOYD 2020-10-06
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 CHRISTOPHER LLOYD

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2023-01-01	STEPHEN CARDELLA	2024-10-11
001	2022-01-01	STEPHEN CARDELLA	2023-10-13
001	2021-01-01	COURT HOWER	2022-10-14
001	2021-01-01	COURT HOWER	2023-03-28
001	2020-01-01	CHRIS LLOYD	2021-09-21
001	2019-01-01	CHRIS LLOYD	2020-10-06
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	CHRISTOPHER LLOYD

Plan Statistics for DON SERVICES, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for DON SERVICES, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2023: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 536
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 446
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 33
Total of all active and inactive participants 2023-01-01 479
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 0
Total participants 2023-01-01 479
Number of participants with account balances 2023-01-01 157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 1
2022: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 615
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 431
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 72
Total of all active and inactive participants 2022-01-01 503
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 503
Number of participants with account balances 2022-01-01 196
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 1
2021: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 662
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 540
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 58
Total of all active and inactive participants 2021-01-01 598
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 598
Number of participants with account balances 2021-01-01 234
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 3
2020: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 632
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 564
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 54
Total of all active and inactive participants 2020-01-01 618
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 618
Number of participants with account balances 2020-01-01 252
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 5
2019: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 591
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 558
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 39
Total of all active and inactive participants 2019-01-01 597
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 597
Number of participants with account balances 2019-01-01 245
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 22
2017: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 448
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 435
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 68
Total of all active and inactive participants 2017-01-01 503
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 503
Number of participants with account balances 2017-01-01 300
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 47
2016: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 378
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 387
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 34
Total of all active and inactive participants 2016-01-01 421
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 421
Number of participants with account balances 2016-01-01 307
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 55
2015: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 304
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 331
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 12
Total of all active and inactive participants 2015-01-01 343
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 343
Number of participants with account balances 2015-01-01 322
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 10
2014: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 246
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 244
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 5
Total of all active and inactive participants 2014-01-01 249
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 249
Number of participants with account balances 2014-01-01 228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0

Measure	Date	Value
2023: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	536
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	446
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	33
Total of all active and inactive participants	2023-01-01	479
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	0
Total participants	2023-01-01	479
Number of participants with account balances	2023-01-01	157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	1
2022: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	615
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	431
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	72
Total of all active and inactive participants	2022-01-01	503
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	503
Number of participants with account balances	2022-01-01	196
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	1
2021: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	662
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	540
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	58
Total of all active and inactive participants	2021-01-01	598
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	598
Number of participants with account balances	2021-01-01	234
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	3
2020: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	632
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	564
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	54
Total of all active and inactive participants	2020-01-01	618
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	618
Number of participants with account balances	2020-01-01	252
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	5
2019: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	591
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	558
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	39
Total of all active and inactive participants	2019-01-01	597
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	597
Number of participants with account balances	2019-01-01	245
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	22
2017: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	448
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	435
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	68
Total of all active and inactive participants	2017-01-01	503
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	503
Number of participants with account balances	2017-01-01	300
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	47
2016: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	378
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	387
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	34
Total of all active and inactive participants	2016-01-01	421
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	421
Number of participants with account balances	2016-01-01	307
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	55
2015: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	304
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	331
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	12
Total of all active and inactive participants	2015-01-01	343
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	343
Number of participants with account balances	2015-01-01	322
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	10
2014: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	246
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	244
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	5
Total of all active and inactive participants	2014-01-01	249
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	249
Number of participants with account balances	2014-01-01	228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0

Financial Data on DON SERVICES, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2023 : DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets	2023-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total income from all sources (including contributions)	2023-12-31	$822,693
Total loss/gain on sale of assets	2023-12-31	$0
Total of all expenses incurred	2023-12-31	$728,020
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-12-31	$683,367
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-12-31	$412,323
Value of total assets at end of year	2023-12-31	$2,501,248
Value of total assets at beginning of year	2023-12-31	$2,406,575
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-12-31	$44,653
Total interest from all sources	2023-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2023-12-31	$60,549
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2023-12-31	$60,549
Was this plan covered by a fidelity bond	2023-12-31	Yes
Value of fidelity bond cover	2023-12-31	$250,000
If this is an individual account plan, was there a blackout period	2023-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2023-12-31	No
Contributions received from participants	2023-12-31	$258,092
Income. Received or receivable in cash from other sources (including rollovers)	2023-12-31	$4,336
Administrative expenses (other) incurred	2023-12-31	$13,088
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-12-31	No
Value of net income/loss	2023-12-31	$94,673
Value of net assets at end of year (total assets less liabilities)	2023-12-31	$2,501,248
Value of net assets at beginning of year (total assets less liabilities)	2023-12-31	$2,406,575
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-12-31	No
Were any leases to which the plan was party in default or uncollectible	2023-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-12-31	$2,465,878
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-12-31	$0
Value of interest in pooled separate accounts at end of year	2023-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2023-12-31	$2,352,538
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2023-12-31	$35,370
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2023-12-31	$54,037
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2023-12-31	$349,821
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-12-31	No
Was there a failure to transmit to the plan any participant contributions	2023-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2023-12-31	No
Contributions received in cash from employer	2023-12-31	$149,895
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-12-31	$683,367
Did the plan have assets held for investment	2023-12-31	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	2023-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-12-31	No
Opinion of an independent qualified public accountant for this plan	2023-12-31	Unqualified
Accountancy firm name	2023-12-31	MCGILL, POWER, BELL & ASSOCIATES
Accountancy firm EIN	2023-12-31	251031405
Total unrealized appreciation/depreciation of assets	2023-01-01	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-01-01	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-01-01	$0
Total income from all sources (including contributions)	2023-01-01	$822,693
Total loss/gain on sale of assets	2023-01-01	$0
Total of all expenses incurred	2023-01-01	$728,020
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-01-01	$683,367
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-01-01	$412,323
Value of total assets at end of year	2023-01-01	$2,501,248
Value of total assets at beginning of year	2023-01-01	$2,406,575
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-01-01	$44,653
Total interest from all sources	2023-01-01	$0
Total dividends received (eg from common stock, registered investment company shares)	2023-01-01	$60,549
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-01-01	No
Total dividends received from registered investment company shares (eg mutual funds)	2023-01-01	$60,549
Was this plan covered by a fidelity bond	2023-01-01	Yes
Value of fidelity bond cover	2023-01-01	$250,000
If this is an individual account plan, was there a blackout period	2023-01-01	No
Were there any nonexempt tranactions with any party-in-interest	2023-01-01	No
Contributions received from participants	2023-01-01	$258,092
Income. Received or receivable in cash from other sources (including rollovers)	2023-01-01	$4,336
Administrative expenses (other) incurred	2023-01-01	$13,088
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-01-01	No
Value of net income/loss	2023-01-01	$94,673
Value of net assets at end of year (total assets less liabilities)	2023-01-01	$2,501,248
Value of net assets at beginning of year (total assets less liabilities)	2023-01-01	$2,406,575
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-01-01	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-01-01	No
Were any leases to which the plan was party in default or uncollectible	2023-01-01	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-01-01	$2,465,878
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-01-01	$0
Value of interest in pooled separate accounts at end of year	2023-01-01	$0
Value of interest in pooled separate accounts at beginning of year	2023-01-01	$2,352,538
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2023-01-01	$35,370
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2023-01-01	$54,037
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2023-01-01	$349,821
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-01-01	No
Was there a failure to transmit to the plan any participant contributions	2023-01-01	Yes
Has the plan failed to provide any benefit when due under the plan	2023-01-01	No
Contributions received in cash from employer	2023-01-01	$149,895
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-01-01	$683,367
Did the plan have assets held for investment	2023-01-01	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	2023-01-01	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-01-01	No
Opinion of an independent qualified public accountant for this plan	2023-01-01	1
Accountancy firm name	2023-01-01	MCGILL, POWER, BELL & ASSOCIATES
Accountancy firm EIN	2023-01-01	251031405
2022 : DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-33,887
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$513,893
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$505,718
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$430,611
Value of total assets at end of year	2022-12-31	$2,406,575
Value of total assets at beginning of year	2022-12-31	$2,954,355
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$8,175
Total interest from all sources	2022-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$117,947
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$117,947
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$250,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$259,003
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$3,929
Administrative expenses (other) incurred	2022-12-31	$8,175
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-547,780
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$2,406,575
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$2,954,355
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$2,910,846
Value of interest in pooled separate accounts at end of year	2022-12-31	$2,352,538
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$54,037
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$43,509
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-582,445
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$167,679
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$505,718
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	MCGILL, POWER, BELL & ASSOCIATES
Accountancy firm EIN	2022-12-31	251031405
Total unrealized appreciation/depreciation of assets	2022-01-01	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-01-01	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-01-01	$0
Total income from all sources (including contributions)	2022-01-01	$-33,887
Total loss/gain on sale of assets	2022-01-01	$0
Total of all expenses incurred	2022-01-01	$513,893
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-01-01	$505,718
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-01-01	$430,611
Value of total assets at end of year	2022-01-01	$2,406,575
Value of total assets at beginning of year	2022-01-01	$2,954,355
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-01-01	$8,175
Total interest from all sources	2022-01-01	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-01-01	$117,947
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-01-01	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-01-01	$117,947
Was this plan covered by a fidelity bond	2022-01-01	Yes
Value of fidelity bond cover	2022-01-01	$250,000
If this is an individual account plan, was there a blackout period	2022-01-01	No
Were there any nonexempt tranactions with any party-in-interest	2022-01-01	No
Contributions received from participants	2022-01-01	$259,003
Income. Received or receivable in cash from other sources (including rollovers)	2022-01-01	$3,929
Administrative expenses (other) incurred	2022-01-01	$8,175
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-01-01	No
Value of net income/loss	2022-01-01	$-547,780
Value of net assets at end of year (total assets less liabilities)	2022-01-01	$2,406,575
Value of net assets at beginning of year (total assets less liabilities)	2022-01-01	$2,954,355
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-01-01	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-01-01	No
Were any leases to which the plan was party in default or uncollectible	2022-01-01	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-01-01	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-01-01	$2,910,846
Value of interest in pooled separate accounts at end of year	2022-01-01	$2,352,538
Value of interest in pooled separate accounts at beginning of year	2022-01-01	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-01-01	$54,037
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-01-01	$43,509
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-01-01	$-582,445
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-01-01	No
Was there a failure to transmit to the plan any participant contributions	2022-01-01	Yes
Has the plan failed to provide any benefit when due under the plan	2022-01-01	No
Contributions received in cash from employer	2022-01-01	$167,679
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-01-01	$505,718
Did the plan have assets held for investment	2022-01-01	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	2022-01-01	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-01-01	No
Opinion of an independent qualified public accountant for this plan	2022-01-01	1
Accountancy firm name	2022-01-01	MCGILL, POWER, BELL & ASSOCIATES
Accountancy firm EIN	2022-01-01	251031405
2021 : DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$811,008
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$258,957
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$243,923
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$462,891
Value of total assets at end of year	2021-12-31	$2,954,718
Value of total assets at beginning of year	2021-12-31	$2,402,667
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$15,034
Total interest from all sources	2021-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$147,362
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$147,362
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$250,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$276,524
Participant contributions at end of year	2021-12-31	$161
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$39
Administrative expenses (other) incurred	2021-12-31	$15,034
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$552,051
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,954,718
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,402,667
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$2,910,846
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$2,359,742
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$43,509
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$42,925
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$200,755
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$186,328
Employer contributions (assets) at end of year	2021-12-31	$202
Employer contributions (assets) at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$243,923
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	MCGILL, POWER, BELL & ASSOCIATES
Accountancy firm EIN	2021-12-31	251031405
2020 : DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$795,961
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$233,598
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$220,351
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$505,863
Value of total assets at end of year	2020-12-31	$2,402,667
Value of total assets at beginning of year	2020-12-31	$1,840,304
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$13,247
Total interest from all sources	2020-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$71,081
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$71,081
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$250,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$295,381
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$14,058
Administrative expenses (other) incurred	2020-12-31	$13,247
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$562,363
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,402,667
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,840,304
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$2,359,742
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$1,767,848
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$42,925
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$72,456
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$219,017
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$196,424
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$220,351
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2020-12-31	550486667
2019 : DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$733,083
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$251,502
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$226,509
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$448,306
Value of total assets at end of year	2019-12-31	$1,840,304
Value of total assets at beginning of year	2019-12-31	$1,358,723
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$24,993
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$63,531
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$63,531
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$150,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$259,709
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$28,188
Administrative expenses (other) incurred	2019-12-31	$15,980
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$481,581
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,840,304
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,358,723
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$1,767,848
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,303,715
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$72,456
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$55,008
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$221,246
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$160,409
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$226,509
Contract administrator fees	2019-12-31	$9,013
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2019-12-31	550486667
2018 : DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$2,237
Total income from all sources (including contributions)	2018-12-31	$293,294
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$127,402
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$119,223
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$372,108
Value of total assets at end of year	2018-12-31	$1,358,723
Value of total assets at beginning of year	2018-12-31	$1,195,068
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$8,179
Total interest from all sources	2018-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$56,650
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$56,650
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$50,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$228,599
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$165,892
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,358,723
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,192,831
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$1,303,715
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$1,175,601
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$55,008
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$19,467
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-135,464
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$143,509
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$119,223
Contract administrator fees	2018-12-31	$8,179
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	No
Liabilities. Value of benefit claims payable at end of year	2018-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$2,237
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2018-12-31	550486667
2017 : DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$2,237
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$538,938
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$105,723
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$93,259
Value of total corrective distributions	2017-12-31	$2,237
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$382,788
Value of total assets at end of year	2017-12-31	$1,195,068
Value of total assets at beginning of year	2017-12-31	$759,616
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$10,227
Total interest from all sources	2017-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$31,291
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$31,291
Administrative expenses professional fees incurred	2017-12-31	$6,680
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$50,000
If this is an individual account plan, was there a blackout period	2017-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$236,461
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$433,215
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,192,831
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$759,616
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$1,175,601
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$734,880
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$19,467
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$24,736
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$24,736
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$124,859
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$146,327
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$93,259
Contract administrator fees	2017-12-31	$3,547
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	Yes
Liabilities. Value of benefit claims payable at end of year	2017-12-31	$2,237
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$0
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2017-12-31	550486667
2016 : DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$336,295
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$37,467
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$34,016
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$294,960
Value of total assets at end of year	2016-12-31	$759,616
Value of total assets at beginning of year	2016-12-31	$460,788
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$3,451
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$21,357
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$21,357
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$50,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$173,128
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$122
Administrative expenses (other) incurred	2016-12-31	$3,451
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$298,828
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$759,616
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$460,788
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$734,880
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$409,508
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$24,736
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$1,067
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$1,067
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$19,978
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$121,832
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$50,091
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$34,016
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2016-12-31	550486667
2015 : DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$224,812
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$12,689
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$11,204
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$231,613
Value of total assets at end of year	2015-12-31	$460,788
Value of total assets at beginning of year	2015-12-31	$248,665
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,485
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$17,015
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$17,015
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$50,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$111,191
Participant contributions at end of year	2015-12-31	$122
Participant contributions at beginning of year	2015-12-31	$25
Administrative expenses (other) incurred	2015-12-31	$1,485
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$212,123
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$460,788
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$248,665
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$409,508
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$122,917
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$1,067
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-23,816
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$120,422
Employer contributions (assets) at end of year	2015-12-31	$50,091
Employer contributions (assets) at beginning of year	2015-12-31	$125,723
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$11,204
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2015-12-31	550486667
2014 : DON SERVICES, INC. 401(K) PROFIT SHARING 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$250,506
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,841
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,666
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$248,164
Value of total assets at end of year	2014-12-31	$248,665
Value of total assets at beginning of year	2014-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$175
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$4,212
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$4,212
Administrative expenses professional fees incurred	2014-12-31	$175
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$50,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$77,158
Participant contributions at end of year	2014-12-31	$25
Participant contributions at beginning of year	2014-12-31	$0
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
Value of net income/loss	2014-12-31	$248,665
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$248,665
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$0
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 registered invesment companies (eg mutual funds) at end of year	2014-12-31	$122,917
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-1,870
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
Contributions received in cash from employer	2014-12-31	$171,006
Employer contributions (assets) at end of year	2014-12-31	$125,723
Employer contributions (assets) at beginning of year	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,666
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	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2014-12-31	550486667

Form 5500 Responses for DON SERVICES, INC. 401(K) PROFIT SHARING PLAN

2023: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2017: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: DON SERVICES, INC. 401(K) PROFIT SHARING 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	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: DON SERVICES, INC. 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	First time form 5500 has been submitted	Yes
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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

758602-01

Policy instance

Insurance contract or identification number	758602-01
Number of Individuals Covered	10
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Are there contracts with allocated funds for individual policies?	0
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?	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

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

758602-01

Policy instance

Insurance contract or identification number	758602-01
Number of Individuals Covered	197
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,980
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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?	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

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

841853

Policy instance

Insurance contract or identification number	CI 961672
Number of Individuals Covered	153
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $335
Total amount of fees paid to insurance company	USD $112
Are there contracts with allocated funds for individual policies?	0
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?	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
Other welfare benefits provided	CRITICAL ILLNESS
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $2,236
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

841853

Policy instance

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

841853

Policy instance

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Company Name:	DON SERVICES, INC.
Employer identification number (EIN):	331120614
NAIC Classification:	624100
NAIC Description:	Individual and Family Services