| Plan Name | 401(K) RETIREMENT PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | JANSEN INSURANCE AGENCY INC |
| Employer identification number (EIN): | 411914473 |
| NAIC Classification: | 524210 |
| NAIC Description: | Insurance Agencies and Brokerages |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2015-01-01 | RUTH JANSEN | 2015-07-15 | ||
| 001 | 2014-01-01 | RUTH JANSEN | 2015-07-15 |