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SHORT ENTERPRISES 401(K) SAVINGS PLAN 401k Plan overview

Plan NameSHORT ENTERPRISES 401(K) SAVINGS PLAN
Plan identification number 001

SHORT ENTERPRISES 401(K) SAVINGS PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

SHORT ENTERPRISES has sponsored the creation of one or more 401k plans.

Company Name:SHORT ENTERPRISES
Employer identification number (EIN):371106518
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHORT ENTERPRISES 401(K) SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012013-11-01NINA MCDANIEL2014-11-26 NINA MCDANIEL2014-11-26
0012012-11-01L.DEAN SHORT L.DEAN SHORT2014-08-07
0012011-11-01NINA MCDANIEL NINA MCDANIEL2013-08-14
0012010-11-01KATHERN DILLOW KATHERN DILLOW2012-05-09
0012009-11-01KATHERN DILLOW KATHERN DILLOW2011-04-20

Financial Data on SHORT ENTERPRISES 401(K) SAVINGS PLAN

Measure Date Value
2013 : SHORT ENTERPRISES 401(K) SAVINGS PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets2013-10-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2013-10-31$0
Total unrealized appreciation/depreciation of assets2013-10-31$0
Total transfer of assets to this plan2013-10-31$0
Total transfer of assets from this plan2013-10-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-10-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-10-31$0
Total income from all sources (including contributions)2013-10-31$62,688
Total loss/gain on sale of assets2013-10-31$0
Total of all expenses incurred2013-10-31$149,101
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-10-31$148,636
Expenses. Certain deemed distributions of participant loans2013-10-31$0
Value of total corrective distributions2013-10-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-10-31$27,963
Value of total assets at end of year2013-10-31$237,569
Value of total assets at beginning of year2013-10-31$323,982
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-10-31$465
Total income from rents2013-10-31$0
Total interest from all sources2013-10-31$1,158
Total dividends received (eg from common stock, registered investment company shares)2013-10-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-10-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-10-31$0
Administrative expenses professional fees incurred2013-10-31$0
Was this plan covered by a fidelity bond2013-10-31Yes
Value of fidelity bond cover2013-10-31$25,000
If this is an individual account plan, was there a blackout period2013-10-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-10-31$0
Were there any nonexempt tranactions with any party-in-interest2013-10-31No
Amount of non-exempt transactions with any party-in-interest2013-10-31$0
Contributions received from participants2013-10-31$25,495
Participant contributions at end of year2013-10-31$26,464
Participant contributions at beginning of year2013-10-31$26,525
Participant contributions at end of year2013-10-31$0
Participant contributions at beginning of year2013-10-31$0
Income. Received or receivable in cash from other sources (including rollovers)2013-10-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-10-31$299
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-10-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-10-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-10-31$0
Other income not declared elsewhere2013-10-31$-47
Administrative expenses (other) incurred2013-10-31$0
Liabilities. Value of operating payables at beginning of year2013-10-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-10-31No
Value of net income/loss2013-10-31$-86,413
Value of net assets at end of year (total assets less liabilities)2013-10-31$237,569
Value of net assets at beginning of year (total assets less liabilities)2013-10-31$323,982
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-10-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2013-10-31$0
Were any leases to which the plan was party in default or uncollectible2013-10-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2013-10-31$0
Investment advisory and management fees2013-10-31$0
Value of interest in pooled separate accounts at end of year2013-10-31$189,017
Value of interest in pooled separate accounts at beginning of year2013-10-31$263,419
Interest on participant loans2013-10-31$1,071
Income. Interest from loans (other than to participants)2013-10-31$0
Interest earned on other investments2013-10-31$87
Income. Interest from US Government securities2013-10-31$0
Income. Interest from corporate debt instruments2013-10-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-10-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-10-31$22,088
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-10-31$34,038
Expenses. Payments to insurance carriers foe the provision of benefits2013-10-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-10-31$0
Net investment gain/loss from pooled separate accounts2013-10-31$33,614
Net investment gain or loss from common/collective trusts2013-10-31$0
Net gain/loss from 103.12 investment entities2013-10-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-10-31No
Was there a failure to transmit to the plan any participant contributions2013-10-31No
Has the plan failed to provide any benefit when due under the plan2013-10-31No
Contributions received in cash from employer2013-10-31$2,468
Employer contributions (assets) at end of year2013-10-31$0
Employer contributions (assets) at beginning of year2013-10-31$0
Income. Dividends from preferred stock2013-10-31$0
Income. Dividends from common stock2013-10-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-10-31$148,337
Contract administrator fees2013-10-31$465
Liabilities. Value of benefit claims payable at beginning of year2013-10-31$0
Did the plan have assets held for investment2013-10-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-10-31No
Aggregate proceeds on sale of assets2013-10-31$0
Aggregate carrying amount (costs) on sale of assets2013-10-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2013-10-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-10-31Yes
Opinion of an independent qualified public accountant for this plan2013-10-31Disclaimer
Accountancy firm name2013-10-31GRAY HUNTER STENN LLP
Accountancy firm EIN2013-10-31363077757
2012 : SHORT ENTERPRISES 401(K) SAVINGS PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets2012-10-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2012-10-31$0
Total unrealized appreciation/depreciation of assets2012-10-31$0
Total transfer of assets to this plan2012-10-31$0
Total transfer of assets from this plan2012-10-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-10-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-10-31$0
Total income from all sources (including contributions)2012-10-31$66,170
Total loss/gain on sale of assets2012-10-31$0
Total of all expenses incurred2012-10-31$60,180
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-10-31$60,014
Expenses. Certain deemed distributions of participant loans2012-10-31$0
Value of total corrective distributions2012-10-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-10-31$42,051
Value of total assets at end of year2012-10-31$323,982
Value of total assets at beginning of year2012-10-31$317,992
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-10-31$166
Total income from rents2012-10-31$0
Total interest from all sources2012-10-31$1,610
Total dividends received (eg from common stock, registered investment company shares)2012-10-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-10-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-10-31$0
Administrative expenses professional fees incurred2012-10-31$0
Was this plan covered by a fidelity bond2012-10-31Yes
Value of fidelity bond cover2012-10-31$25,000
If this is an individual account plan, was there a blackout period2012-10-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-10-31$0
Were there any nonexempt tranactions with any party-in-interest2012-10-31No
Amount of non-exempt transactions with any party-in-interest2012-10-31$0
Contributions received from participants2012-10-31$38,841
Participant contributions at end of year2012-10-31$26,525
Participant contributions at beginning of year2012-10-31$35,063
Participant contributions at end of year2012-10-31$0
Participant contributions at beginning of year2012-10-31$0
Income. Received or receivable in cash from other sources (including rollovers)2012-10-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-10-31$121
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-10-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-10-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-10-31$0
Other income not declared elsewhere2012-10-31$0
Administrative expenses (other) incurred2012-10-31$0
Liabilities. Value of operating payables at beginning of year2012-10-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-10-31No
Value of net income/loss2012-10-31$5,990
Value of net assets at end of year (total assets less liabilities)2012-10-31$323,982
Value of net assets at beginning of year (total assets less liabilities)2012-10-31$317,992
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-10-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2012-10-31$0
Were any leases to which the plan was party in default or uncollectible2012-10-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2012-10-31$0
Investment advisory and management fees2012-10-31$0
Value of interest in pooled separate accounts at end of year2012-10-31$263,419
Value of interest in pooled separate accounts at beginning of year2012-10-31$253,343
Interest on participant loans2012-10-31$1,350
Income. Interest from loans (other than to participants)2012-10-31$0
Interest earned on other investments2012-10-31$260
Income. Interest from US Government securities2012-10-31$0
Income. Interest from corporate debt instruments2012-10-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-10-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-10-31$34,038
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-10-31$29,586
Expenses. Payments to insurance carriers foe the provision of benefits2012-10-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-10-31$0
Net investment gain/loss from pooled separate accounts2012-10-31$22,509
Net investment gain or loss from common/collective trusts2012-10-31$0
Net gain/loss from 103.12 investment entities2012-10-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-10-31No
Was there a failure to transmit to the plan any participant contributions2012-10-31No
Has the plan failed to provide any benefit when due under the plan2012-10-31No
Contributions received in cash from employer2012-10-31$3,210
Employer contributions (assets) at end of year2012-10-31$0
Employer contributions (assets) at beginning of year2012-10-31$0
Income. Dividends from preferred stock2012-10-31$0
Income. Dividends from common stock2012-10-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-10-31$59,893
Contract administrator fees2012-10-31$166
Liabilities. Value of benefit claims payable at beginning of year2012-10-31$0
Did the plan have assets held for investment2012-10-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-10-31No
Aggregate proceeds on sale of assets2012-10-31$0
Aggregate carrying amount (costs) on sale of assets2012-10-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2012-10-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-10-31Yes
Opinion of an independent qualified public accountant for this plan2012-10-31Disclaimer
Accountancy firm name2012-10-31GRAY HUNTER STENN LLP
Accountancy firm EIN2012-10-31363077757
2011 : SHORT ENTERPRISES 401(K) SAVINGS PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets2011-10-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2011-10-31$0
Total unrealized appreciation/depreciation of assets2011-10-31$0
Total transfer of assets to this plan2011-10-31$0
Total transfer of assets from this plan2011-10-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-10-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-10-31$0
Total income from all sources (including contributions)2011-10-31$63,140
Total loss/gain on sale of assets2011-10-31$0
Total of all expenses incurred2011-10-31$91,165
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-10-31$90,655
Expenses. Certain deemed distributions of participant loans2011-10-31$0
Value of total corrective distributions2011-10-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-10-31$50,589
Value of total assets at end of year2011-10-31$317,992
Value of total assets at beginning of year2011-10-31$346,017
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-10-31$510
Total income from rents2011-10-31$0
Total interest from all sources2011-10-31$2,125
Total dividends received (eg from common stock, registered investment company shares)2011-10-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-10-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-10-31$0
Administrative expenses professional fees incurred2011-10-31$0
Was this plan covered by a fidelity bond2011-10-31Yes
Value of fidelity bond cover2011-10-31$25,000
If this is an individual account plan, was there a blackout period2011-10-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-10-31$0
Were there any nonexempt tranactions with any party-in-interest2011-10-31No
Amount of non-exempt transactions with any party-in-interest2011-10-31$0
Contributions received from participants2011-10-31$47,132
Participant contributions at end of year2011-10-31$35,063
Participant contributions at beginning of year2011-10-31$36,457
Participant contributions at end of year2011-10-31$0
Participant contributions at beginning of year2011-10-31$0
Income. Received or receivable in cash from other sources (including rollovers)2011-10-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-10-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-10-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-10-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-10-31$0
Other income not declared elsewhere2011-10-31$2
Administrative expenses (other) incurred2011-10-31$0
Liabilities. Value of operating payables at beginning of year2011-10-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-10-31No
Value of net income/loss2011-10-31$-28,025
Value of net assets at end of year (total assets less liabilities)2011-10-31$317,992
Value of net assets at beginning of year (total assets less liabilities)2011-10-31$346,017
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-10-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2011-10-31$0
Were any leases to which the plan was party in default or uncollectible2011-10-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2011-10-31$0
Investment advisory and management fees2011-10-31$0
Value of interest in pooled separate accounts at end of year2011-10-31$253,343
Value of interest in pooled separate accounts at beginning of year2011-10-31$275,093
Interest on participant loans2011-10-31$1,630
Income. Interest from loans (other than to participants)2011-10-31$0
Interest earned on other investments2011-10-31$495
Income. Interest from US Government securities2011-10-31$0
Income. Interest from corporate debt instruments2011-10-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-10-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-10-31$29,586
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-10-31$34,467
Expenses. Payments to insurance carriers foe the provision of benefits2011-10-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-10-31$0
Net investment gain/loss from pooled separate accounts2011-10-31$10,424
Net investment gain or loss from common/collective trusts2011-10-31$0
Net gain/loss from 103.12 investment entities2011-10-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-10-31No
Was there a failure to transmit to the plan any participant contributions2011-10-31No
Has the plan failed to provide any benefit when due under the plan2011-10-31No
Contributions received in cash from employer2011-10-31$3,457
Employer contributions (assets) at end of year2011-10-31$0
Employer contributions (assets) at beginning of year2011-10-31$0
Income. Dividends from preferred stock2011-10-31$0
Income. Dividends from common stock2011-10-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-10-31$90,655
Contract administrator fees2011-10-31$510
Liabilities. Value of benefit claims payable at beginning of year2011-10-31$0
Did the plan have assets held for investment2011-10-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-10-31No
Aggregate proceeds on sale of assets2011-10-31$0
Aggregate carrying amount (costs) on sale of assets2011-10-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2011-10-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-10-31Yes
Opinion of an independent qualified public accountant for this plan2011-10-31Disclaimer
Accountancy firm name2011-10-31DAVID HAAS
Accountancy firm EIN2011-10-31363077757
2010 : SHORT ENTERPRISES 401(K) SAVINGS PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-10-31$0

Form 5500 Responses for SHORT ENTERPRISES 401(K) SAVINGS PLAN

2012: SHORT ENTERPRISES 401(K) SAVINGS PLAN 2012 form 5500 responses
2012-11-01Type of plan entitySingle employer plan
2012-11-01This submission is the final filingNo
2012-11-01This return/report is a short plan year return/report (less than 12 months)No
2012-11-01Plan is a collectively bargained planNo
2012-11-01Plan funding arrangement – InsuranceYes
2012-11-01Plan funding arrangement – TrustYes
2012-11-01Plan benefit arrangement – InsuranceYes
2012-11-01Plan benefit arrangement - TrustYes
2011: SHORT ENTERPRISES 401(K) SAVINGS PLAN 2011 form 5500 responses
2011-11-01Type of plan entitySingle employer plan
2011-11-01This submission is the final filingNo
2011-11-01This return/report is a short plan year return/report (less than 12 months)No
2011-11-01Plan is a collectively bargained planNo
2011-11-01Plan funding arrangement – InsuranceYes
2011-11-01Plan funding arrangement – TrustYes
2011-11-01Plan benefit arrangement – InsuranceYes
2011-11-01Plan benefit arrangement - TrustYes
2010: SHORT ENTERPRISES 401(K) SAVINGS PLAN 2010 form 5500 responses
2010-11-01Type of plan entitySingle employer plan
2010-11-01This submission is the final filingNo
2010-11-01This return/report is a short plan year return/report (less than 12 months)No
2010-11-01Plan is a collectively bargained planNo
2010-11-01Plan funding arrangement – InsuranceYes
2010-11-01Plan funding arrangement – TrustYes
2010-11-01Plan benefit arrangement – InsuranceYes
2010-11-01Plan benefit arrangement - TrustYes
2009: SHORT ENTERPRISES 401(K) SAVINGS PLAN 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01This submission is the final filingNo
2009-11-01This return/report is a short plan year return/report (less than 12 months)No
2009-11-01Plan is a collectively bargained planNo
2009-11-01Plan funding arrangement – InsuranceYes
2009-11-01Plan funding arrangement – TrustYes
2009-11-01Plan benefit arrangement – InsuranceYes
2009-11-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number434214
Policy instance 1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number434214
Policy instance 1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number434214
Policy instance 1

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