401k Plan data: FIRST STATE BANK 401(K) SAVINGS PLAN plan

FIRST STATE BANK 401(K) SAVINGS PLAN 401k Plan overview

Plan Name	FIRST STATE BANK 401(K) SAVINGS PLAN
Plan identification number	002

FIRST STATE BANK 401(K) SAVINGS 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

FIRST STATE BANK has sponsored the creation of one or more 401k plans.

Company Name: FIRST STATE BANK

Employer identification number (EIN): 390281110

NAIC Classification: 522110
NAIC Description: Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST STATE BANK 401(K) SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2018-01-01 ROBERT VAN ASTEN 2019-06-12
002 2017-01-01 ROBERT VAN ASTEN 2018-06-22
002 2016-01-01 ROBERT VAN ASTEN 2017-06-06
002 2015-01-01 ROBERT VAN ASTEN 2016-08-15
002 2014-01-01 HARRY RADIX 2015-07-03
002 2013-01-01 MICHAEL SULLIVAN 2014-07-08
002 2012-01-01 HARRY RADIX 2013-07-02
002 2011-01-01 HARRY RADIX 2012-06-11
002 2010-01-01 HARRY RADIX 2011-06-06

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2018-01-01	ROBERT VAN ASTEN	2019-06-12
002	2017-01-01	ROBERT VAN ASTEN	2018-06-22
002	2016-01-01	ROBERT VAN ASTEN	2017-06-06
002	2015-01-01	ROBERT VAN ASTEN	2016-08-15
002	2014-01-01	HARRY RADIX	2015-07-03
002	2013-01-01	MICHAEL SULLIVAN	2014-07-08
002	2012-01-01	HARRY RADIX	2013-07-02
002	2011-01-01	HARRY RADIX	2012-06-11
002	2010-01-01	HARRY RADIX	2011-06-06

Plan Statistics for FIRST STATE BANK 401(K) SAVINGS PLAN

401k plan membership statisitcs for FIRST STATE BANK 401(K) SAVINGS PLAN

Measure Date Value
2022: FIRST STATE BANK 401(K) SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 101
Number of retired or separated participants receiving benefits 2022-01-01 2
Number of other retired or separated participants entitled to future benefits 2022-01-01 24
Total of all active and inactive participants 2022-01-01 127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 4
Total participants 2022-01-01 131
Number of participants with account balances 2022-01-01 130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 1
2021: FIRST STATE BANK 401(K) SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 98
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 31
Total of all active and inactive participants 2021-01-01 130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 130
Number of participants with account balances 2021-01-01 130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: FIRST STATE BANK 401(K) SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 122
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 100
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 30
Total of all active and inactive participants 2020-01-01 131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 131
Number of participants with account balances 2020-01-01 130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 2

Measure	Date	Value
2022: FIRST STATE BANK 401(K) SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	101
Number of retired or separated participants receiving benefits	2022-01-01	2
Number of other retired or separated participants entitled to future benefits	2022-01-01	24
Total of all active and inactive participants	2022-01-01	127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	4
Total participants	2022-01-01	131
Number of participants with account balances	2022-01-01	130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	1
2021: FIRST STATE BANK 401(K) SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	98
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	31
Total of all active and inactive participants	2021-01-01	130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	130
Number of participants with account balances	2021-01-01	130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: FIRST STATE BANK 401(K) SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	122
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	100
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	30
Total of all active and inactive participants	2020-01-01	131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	131
Number of participants with account balances	2020-01-01	130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	2

Financial Data on FIRST STATE BANK 401(K) SAVINGS PLAN

Measure	Date	Value
2022 : FIRST STATE BANK 401(K) SAVINGS PLAN 2022 401k financial data
Total income from all sources (including contributions)	2022-12-31	$-1,950,121
Total of all expenses incurred	2022-12-31	$1,149,717
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,105,368
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$891,211
Value of total assets at end of year	2022-12-31	$12,510,422
Value of total assets at beginning of year	2022-12-31	$15,610,260
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$44,349
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$228,060
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	$228,060
Administrative expenses professional fees incurred	2022-12-31	$8,750
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$542,188
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$2,076
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$29,054
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$84
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Other income not declared elsewhere	2022-12-31	$37
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$210
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	$-3,099,838
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$12,510,422
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$15,610,260
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
Investment advisory and management fees	2022-12-31	$35,599
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$11,933,628
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$14,662,378
Value of interest in common/collective trusts at end of year	2022-12-31	$568,412
Value of interest in common/collective trusts at beginning of year	2022-12-31	$945,596
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-3,069,547
Net investment gain or loss from common/collective trusts	2022-12-31	$118
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	$319,969
Employer contributions (assets) at end of year	2022-12-31	$8,298
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,105,368
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	2022-12-31	Yes
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	HAWKINS ASH CPAS, LLP
Accountancy firm EIN	2022-12-31	390912608
2021 : FIRST STATE BANK 401(K) SAVINGS 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	$2,516,417
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$816,645
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$767,364
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$815,166
Value of total assets at end of year	2021-12-31	$15,610,260
Value of total assets at beginning of year	2021-12-31	$13,910,488
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$49,281
Total interest from all sources	2021-12-31	$3,306
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$715,117
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	$715,117
Administrative expenses professional fees incurred	2021-12-31	$49,281
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	Yes
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	$502,480
Participant contributions at end of year	2021-12-31	$2,076
Participant contributions at beginning of year	2021-12-31	$6,714
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$21,783
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$479
Other income not declared elsewhere	2021-12-31	$5
Total non interest bearing cash at end of year	2021-12-31	$210
Total non interest bearing cash at beginning of year	2021-12-31	$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	2021-12-31	No
Value of net income/loss	2021-12-31	$1,699,772
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$15,610,260
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$13,910,488
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	$14,662,378
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$13,432,386
Interest on participant loans	2021-12-31	$3,306
Value of interest in common/collective trusts at end of year	2021-12-31	$945,596
Value of interest in common/collective trusts at beginning of year	2021-12-31	$470,909
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$974,537
Net investment gain or loss from common/collective trusts	2021-12-31	$8,286
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	$290,903
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$767,364
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	2021-12-31	Yes
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	HAWKINS ASH CPAS, LLP
Accountancy firm EIN	2021-12-31	390912608
2020 : FIRST STATE BANK 401(K) SAVINGS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total transfer of assets to this plan	2020-12-31	$2,657,489
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	$3,437,366
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,216,804
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,184,368
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$782,953
Value of total assets at end of year	2020-12-31	$13,910,488
Value of total assets at beginning of year	2020-12-31	$9,032,437
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$32,436
Total interest from all sources	2020-12-31	$639
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$155,361
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	$155,361
Administrative expenses professional fees incurred	2020-12-31	$32,436
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$3,000,000
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	$446,609
Participant contributions at end of year	2020-12-31	$6,714
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$39,860
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$479
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$682
Other income not declared elsewhere	2020-12-31	$31
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$7
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	$2,220,562
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$13,910,488
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$9,032,437
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	$13,432,386
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$8,755,788
Interest on participant loans	2020-12-31	$639
Value of interest in common/collective trusts at end of year	2020-12-31	$470,909
Value of interest in common/collective trusts at beginning of year	2020-12-31	$275,960
Net investment gain or loss from common/collective trusts	2020-12-31	$7,465
Net gain/loss from 103.12 investment entities	2020-12-31	$2,490,917
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	Yes
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	$296,484
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,184,368
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	Disclaimer
Accountancy firm name	2020-12-31	HAWKINS ASH CPAS, LLP
Accountancy firm EIN	2020-12-31	390912608

Form 5500 Responses for FIRST STATE BANK 401(K) SAVINGS PLAN

2022: FIRST STATE BANK 401(K) SAVINGS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: FIRST STATE BANK 401(K) SAVINGS 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 – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: FIRST STATE BANK 401(K) SAVINGS 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 – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	FIRST STATE BANK
Employer identification number (EIN):	390281110
NAIC Classification:	522110
NAIC Description:	Commercial Banking