401k Plan data: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN plan

FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 401k Plan overview

Plan Name	FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN
Plan identification number	575

FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Other welfare benefit cover Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20. Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

FORKLIFTS OF MINNESOTA INC has sponsored the creation of one or more 401k plans.

Company Name: FORKLIFTS OF MINNESOTA INC

Employer identification number (EIN): 410734498

NAIC Classification: 423800

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
575 2017-01-01 CLAYTON SCHUBERT CLAYTON SCHUBERT 2018-07-31
575 2016-01-01 CLAYTON SCHUBERT
575 2015-01-01 CLAYTON SCHUBERT
575 2014-01-01 CLAYTON SCHUBERT
575 2013-01-01 CLAYTON SCHUBERT
575 2012-01-01 CLAYTON SCHUBERT
575 2010-01-01 CLAYTON SCHUBERT
575 2009-01-01 CLAYTON SCHUBERT

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
575	2017-01-01	CLAYTON SCHUBERT	CLAYTON SCHUBERT	2018-07-31
575	2016-01-01	CLAYTON SCHUBERT
575	2015-01-01	CLAYTON SCHUBERT
575	2014-01-01	CLAYTON SCHUBERT
575	2013-01-01	CLAYTON SCHUBERT
575	2012-01-01	CLAYTON SCHUBERT
575	2010-01-01	CLAYTON SCHUBERT
575	2009-01-01	CLAYTON SCHUBERT

Plan Statistics for FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN

401k plan membership statisitcs for FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN

Measure Date Value
2017: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 105
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 113
Total of all active and inactive participants 2017-01-01 113
Total participants 2017-01-01 113
2016: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 111
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 105
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 105
2015: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 111
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 111
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 111
2014: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 105
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 111
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 111
2013: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 99
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 104
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 105
2012: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 99
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 0
Total of all active and inactive participants 2012-01-01 99
2010: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 98
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 89
Number of retired or separated participants receiving benefits 2010-01-01 3
Number of other retired or separated participants entitled to future benefits 2010-01-01 1
Total of all active and inactive participants 2010-01-01 93
2009: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 116
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 95
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 0
Total of all active and inactive participants 2009-01-01 95

Measure	Date	Value
2017: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	105
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	113
Total of all active and inactive participants	2017-01-01	113
Total participants	2017-01-01	113
2016: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	111
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	105
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	105
2015: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	111
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	111
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	111
2014: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	105
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	111
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	111
2013: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	99
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	104
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	105
2012: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	99
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	0
Total of all active and inactive participants	2012-01-01	99
2010: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	98
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	89
Number of retired or separated participants receiving benefits	2010-01-01	3
Number of other retired or separated participants entitled to future benefits	2010-01-01	1
Total of all active and inactive participants	2010-01-01	93
2009: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	116
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	95
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	0
Total of all active and inactive participants	2009-01-01	95

Form 5500 Responses for FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN

2017: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT 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 – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT 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 – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT 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 – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT 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 – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT 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 – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT 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 – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: FORKLIFTS OF MINNESOTA, INC. FORKLIFTS OF MINNESOTA, INC. MEDICAL REIMBURSMENT 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 – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	FORKLIFTS OF MINNESOTA INC
Employer identification number (EIN):	410734498
NAIC Classification:	423800