401k Plan data: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN plan

LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 401k Plan overview

Plan Name	LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN
Plan identification number	001

LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

401k Sponsoring company profile

LIFE ACTION MINISTRIES has sponsored the creation of one or more 401k plans.

Company Name: LIFE ACTION MINISTRIES

Employer identification number (EIN): 382157686

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about LIFE ACTION MINISTRIES

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2009-01-10

Company Identification Number: 0801056333

Legal Registered Office Address: PO BOX 31 C/O CINDY WOOD

BUCHANAN
United States of America (USA)
49107

More information about LIFE ACTION MINISTRIES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01
001 2016-01-01 CHRISTOPHER BROWN
001 2015-01-01 BRENT PAULUS
001 2014-01-01 CHARLES ARCHER
001 2013-01-01 CHARLES ARCHER CHARLES ARCHER 2014-10-16
001 2012-01-01 CHARLES ARCHER CHARLES ARCHER 2013-10-14
001 2011-01-01 CHARLES ARCHER
001 2010-01-01 CHARLES ARCHER
001 2009-01-01 CHARLES ARCHER ALLEN MAZELIN 2010-09-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01
001	2016-01-01	CHRISTOPHER BROWN
001	2015-01-01	BRENT PAULUS
001	2014-01-01	CHARLES ARCHER
001	2013-01-01	CHARLES ARCHER	CHARLES ARCHER	2014-10-16
001	2012-01-01	CHARLES ARCHER	CHARLES ARCHER	2013-10-14
001	2011-01-01	CHARLES ARCHER
001	2010-01-01	CHARLES ARCHER
001	2009-01-01	CHARLES ARCHER	ALLEN MAZELIN	2010-09-14

Plan Statistics for LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN

401k plan membership statisitcs for LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN

Measure Date Value
2016: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 141
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 140
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 1
Total of all active and inactive participants 2016-01-01 142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 142
Number of participants with account balances 2016-01-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 141
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 133
Number of retired or separated participants receiving benefits 2015-01-01 1
Number of other retired or separated participants entitled to future benefits 2015-01-01 2
Total of all active and inactive participants 2015-01-01 136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 136
Number of participants with account balances 2015-01-01 94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 1
2014: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 144
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 132
Number of retired or separated participants receiving benefits 2014-01-01 1
Number of other retired or separated participants entitled to future benefits 2014-01-01 2
Total of all active and inactive participants 2014-01-01 135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 135
Number of participants with account balances 2014-01-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 2
2013: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 116
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 111
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 1
Total of all active and inactive participants 2013-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 112
Number of participants with account balances 2013-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 115
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 5
Total of all active and inactive participants 2012-01-01 120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 120
Number of participants with account balances 2012-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 110
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 110
Number of participants with account balances 2011-01-01 81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 107
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 107
Number of participants with account balances 2010-01-01 82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 97
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 104
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 5
Total of all active and inactive participants 2009-01-01 109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 109
Number of participants with account balances 2009-01-01 76
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2016: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	141
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	140
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	1
Total of all active and inactive participants	2016-01-01	142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	142
Number of participants with account balances	2016-01-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	141
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	133
Number of retired or separated participants receiving benefits	2015-01-01	1
Number of other retired or separated participants entitled to future benefits	2015-01-01	2
Total of all active and inactive participants	2015-01-01	136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	136
Number of participants with account balances	2015-01-01	94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	1
2014: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	132
Number of retired or separated participants receiving benefits	2014-01-01	1
Number of other retired or separated participants entitled to future benefits	2014-01-01	2
Total of all active and inactive participants	2014-01-01	135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	135
Number of participants with account balances	2014-01-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	2
2013: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	116
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	111
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	1
Total of all active and inactive participants	2013-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	112
Number of participants with account balances	2013-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	115
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	5
Total of all active and inactive participants	2012-01-01	120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	120
Number of participants with account balances	2012-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	110
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	110
Number of participants with account balances	2011-01-01	81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	107
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	107
Number of participants with account balances	2010-01-01	82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	97
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	104
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	5
Total of all active and inactive participants	2009-01-01	109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	109
Number of participants with account balances	2009-01-01	76
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN

Measure	Date	Value
2016 : LIFE ACTION MINISTRIES 401(K) RETIREMENT 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	$356,546
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$83,952
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$81,567
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$233,841
Value of total assets at end of year	2016-12-31	$2,108,128
Value of total assets at beginning of year	2016-12-31	$1,835,534
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$2,385
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$172,339
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$155,275
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	$272,594
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,108,128
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,835,534
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	$1,986,515
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,697,409
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$43,047
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$25,978
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$122,705
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	$78,566
Employer contributions (assets) at end of year	2016-12-31	$78,566
Employer contributions (assets) at beginning of year	2016-12-31	$112,147
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$81,567
Contract administrator fees	2016-12-31	$2,385
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2016-12-31	381357951
2015 : LIFE ACTION MINISTRIES 401(K) RETIREMENT 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	$230,261
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$80,520
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$77,910
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$264,760
Value of total assets at end of year	2015-12-31	$1,835,534
Value of total assets at beginning of year	2015-12-31	$1,685,793
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$2,610
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$185,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$152,613
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	$149,741
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,835,534
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,685,793
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	$1,697,409
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,556,308
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$25,978
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$17,272
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-34,499
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	$112,147
Employer contributions (assets) at end of year	2015-12-31	$112,147
Employer contributions (assets) at beginning of year	2015-12-31	$112,213
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$77,910
Contract administrator fees	2015-12-31	$2,610
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	PLANTE AND MORAN
Accountancy firm EIN	2015-12-31	381357951
2014 : LIFE ACTION MINISTRIES 401(K) RETIREMENT 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	$434,003
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$77,817
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$75,287
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$356,243
Value of total assets at end of year	2014-12-31	$1,685,793
Value of total assets at beginning of year	2014-12-31	$1,329,607
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$2,530
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$150,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$145,967
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$98,063
Other income not declared elsewhere	2014-12-31	$79
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	$356,186
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,685,793
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,329,607
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	$1,556,308
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,329,607
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$17,272
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$77,681
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	$112,213
Employer contributions (assets) at end of year	2014-12-31	$112,213
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$75,287
Contract administrator fees	2014-12-31	$2,530
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	PLANTE AND MORAN, PLLC
Accountancy firm EIN	2014-12-31	381357951
2013 : LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$446,120
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$40,720
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$37,639
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$176,761
Value of total assets at end of year	2013-12-31	$1,329,607
Value of total assets at beginning of year	2013-12-31	$924,207
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$3,081
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$100,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Funding deficiency by the employer to the plan for this plan year	2013-12-31	$0
Minimum employer required contribution for this plan year	2013-12-31	$0
Amount contributed by the employer to the plan for this plan year	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$124,115
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$5,788
Administrative expenses (other) incurred	2013-12-31	$3,081
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$405,400
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,329,607
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$924,207
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$1,329,607
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$924,207
Net investment gain/loss from pooled separate accounts	2013-12-31	$269,359
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$46,858
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$37,639
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	PLANTE & MORAN, PLLC
Accountancy firm EIN	2013-12-31	381357951
2012 : LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$0
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets to this plan	2012-12-31	$0
Total transfer of assets from this plan	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$292,261
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$63,408
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$60,386
Expenses. Certain deemed distributions of participant loans	2012-12-31	$0
Value of total corrective distributions	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$187,414
Value of total assets at end of year	2012-12-31	$924,207
Value of total assets at beginning of year	2012-12-31	$695,354
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$3,022
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$100,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$112,069
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$0
Other income not declared elsewhere	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$3,022
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$228,853
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$924,207
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$695,354
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$924,207
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$695,354
Value of interest in pooled separate accounts at end of year	2012-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$0
Interest on participant loans	2012-12-31	$0
Interest earned on other investments	2012-12-31	$0
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Value of interest in common/collective trusts at beginning of year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$0
Net investment gain/loss from pooled separate accounts	2012-12-31	$104,847
Net investment gain or loss from common/collective trusts	2012-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Assets. Invements in employer securities at end of year	2012-12-31	$0
Assets. Invements in employer securities at beginning of year	2012-12-31	$0
Contributions received in cash from employer	2012-12-31	$75,345
Income. Dividends from common stock	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$60,386
Asset. Corporate debt instrument debt (other) at end of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2012-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2012-12-31	$0
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	PLANTE & MORAN, PLLC
Accountancy firm EIN	2012-12-31	381357951
2011 : LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$114,577
Expenses. Total of all expenses incurred	2011-12-31	$7,644
Benefits paid (including direct rollovers)	2011-12-31	$4,518
Total plan assets at end of year	2011-12-31	$695,354
Total plan assets at beginning of year	2011-12-31	$588,421
Value of fidelity bond covering the plan	2011-12-31	$70,000
Total contributions received or receivable from participants	2011-12-31	$98,842
Expenses. Other expenses not covered elsewhere	2011-12-31	$3,126
Other income received	2011-12-31	$-32,863
Net income (gross income less expenses)	2011-12-31	$106,933
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$695,354
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$588,421
Total contributions received or receivable from employer(s)	2011-12-31	$48,598
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0
2010 : LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$214,637
Expenses. Total of all expenses incurred	2010-12-31	$26,800
Benefits paid (including direct rollovers)	2010-12-31	$23,722
Total plan assets at end of year	2010-12-31	$588,421
Total plan assets at beginning of year	2010-12-31	$400,584
Value of fidelity bond covering the plan	2010-12-31	$70,000
Total contributions received or receivable from participants	2010-12-31	$88,152
Expenses. Other expenses not covered elsewhere	2010-12-31	$3,078
Contributions received from other sources (not participants or employers)	2010-12-31	$617
Other income received	2010-12-31	$58,865
Net income (gross income less expenses)	2010-12-31	$187,837
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$588,421
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$400,584
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2010-12-31	$201
Total contributions received or receivable from employer(s)	2010-12-31	$67,003
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$0
Amount contributed by the employer to the plan for this plan year	2010-12-31	$0
2009 : LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year	2009-12-31	$0
Minimum employer required contribution for this plan year	2009-12-31	$0
Amount contributed by the employer to the plan for this plan year	2009-12-31	$0

Form 5500 Responses for LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN

2016: LIFE ACTION MINISTRIES 401(K) RETIREMENT 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 – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: LIFE ACTION MINISTRIES 401(K) RETIREMENT 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 – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: LIFE ACTION MINISTRIES 401(K) RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

IRK108110

Policy instance

Insurance contract or identification number	IRK108110
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $11,113
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,668
Insurance broker organization code?	3
Insurance broker name	DANIEL CRAIG/SUNU THOMAS

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

IRK108110

Policy instance

Insurance contract or identification number	IRK108110
Number of Individuals Covered	135
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $8,809
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $7,968
Insurance broker organization code?	3
Insurance broker name	DANIEL CRAIG/SUNU THOMAS

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

Policy contract number

GA-804109

Policy instance

Insurance contract or identification number	GA-804109
Number of Individuals Covered	79
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $4,906
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,906
Insurance broker organization code?	3
Insurance broker name	EDWARD D JONES & CO

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

Policy contract number

GA-804109

Policy instance

Insurance contract or identification number	GA-804109
Number of Individuals Covered	115
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,933
Total amount of fees paid to insurance company	USD $783
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,933
Insurance broker organization code?	3
Amount paid for insurance broker fees	783
Additional information about fees paid to insurance broker	SALES/MARKETING
Insurance broker name	EDWARD D JONES & CO

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

Policy contract number

GA-804109

Policy instance

Insurance contract or identification number	GA-804109
Number of Individuals Covered	81
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $3,186
Total amount of fees paid to insurance company	USD $647
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

GA-804109

Policy instance

Insurance contract or identification number	GA-804109
Number of Individuals Covered	82
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,438
Total amount of fees paid to insurance company	USD $403
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	LIFE ACTION MINISTRIES
Employer identification number (EIN):	382157686
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2009-01-10
Company Identification Number:	0801056333
Legal Registered Office Address:	PO BOX 31 C/O CINDY WOOD BUCHANAN United States of America (USA) 49107