401k Plan data: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN plan

FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 401k Plan overview

Plan Name	FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN
Plan identification number	001

FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP 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.
Stock bonus
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.
ESOP other than a leveraged ESOP - A completed Schedule E must be attached to a Form 5500 filed for an Employee Stock Ownership Plan (ESOP).
Leveraged ESOP - An ESOP that acquires employer securities with borrowed money or other debt-financing techniques. A completed Schedule E must be attached to a Form 5500 filed for an ESOP.
The employer maintaining this ESOP is an S Corporation
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.
Plan requiring that all or part of employer contributions be invested and held, at least for a limited period, in employer securities.

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): 450134685

NAIC Classification: 522120
NAIC Description: Savings Institutions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01 STEVE SWARTZ
001 2017-01-01 STEVE SWARTZ
001 2016-01-01 STEVE SWARTZ
001 2015-01-01 STEVE SWARTZ
001 2014-01-01 STEVE SWARTZ
001 2013-01-01 STEVE SWARTZ 2014-04-09
001 2012-01-01 STEVE SWARTZ 2013-01-31
001 2011-01-01 STEVE SWARTZ 2012-03-06
001 2010-01-01 STEVE SWARTZ
001 2009-01-01 STEVE SWARTZ

Plan Statistics for FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN

401k plan membership statisitcs for FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN

Measure Date Value
2022: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 49
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 48
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 1
Total of all active and inactive participants 2022-01-01 49
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 49
Number of participants with account balances 2022-01-01 44
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 43
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 44
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 44
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 44
Number of participants with account balances 2021-01-01 41
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) EMPLOYEE STOCK OWNERSHIP PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 37
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 38
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 38
Number of participants with account balances 2020-01-01 37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 32
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 43
Number of retired or separated participants receiving benefits 2019-01-01 1
Number of other retired or separated participants entitled to future benefits 2019-01-01 2
Total of all active and inactive participants 2019-01-01 46
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 46
Number of participants with account balances 2019-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 33
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 29
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 3
Total of all active and inactive participants 2018-01-01 32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 32
Number of participants with account balances 2018-01-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 35
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 29
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 4
Total of all active and inactive participants 2017-01-01 33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 33
Number of participants with account balances 2017-01-01 32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 35
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 30
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 5
Total of all active and inactive participants 2016-01-01 35
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 35
Number of participants with account balances 2016-01-01 35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 36
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 31
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 4
Total of all active and inactive participants 2015-01-01 35
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 35
Number of participants with account balances 2015-01-01 35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 40
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 31
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 5
Total of all active and inactive participants 2014-01-01 36
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 36
Number of participants with account balances 2014-01-01 36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2010: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 36
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 32
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 7
Total of all active and inactive participants 2010-01-01 39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 39
Number of participants with account balances 2010-01-01 38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 32
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 33
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 3
Total of all active and inactive participants 2009-01-01 36
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 36
Number of participants with account balances 2009-01-01 34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2022: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	49
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	48
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	1
Total of all active and inactive participants	2022-01-01	49
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	49
Number of participants with account balances	2022-01-01	44
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	43
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	44
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	44
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	44
Number of participants with account balances	2021-01-01	41
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) EMPLOYEE STOCK OWNERSHIP PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	37
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	38
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	38
Number of participants with account balances	2020-01-01	37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	32
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	43
Number of retired or separated participants receiving benefits	2019-01-01	1
Number of other retired or separated participants entitled to future benefits	2019-01-01	2
Total of all active and inactive participants	2019-01-01	46
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	46
Number of participants with account balances	2019-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	33
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	29
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	3
Total of all active and inactive participants	2018-01-01	32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	32
Number of participants with account balances	2018-01-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	35
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	29
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	4
Total of all active and inactive participants	2017-01-01	33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	33
Number of participants with account balances	2017-01-01	32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	35
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	30
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	5
Total of all active and inactive participants	2016-01-01	35
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	35
Number of participants with account balances	2016-01-01	35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	36
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	31
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	4
Total of all active and inactive participants	2015-01-01	35
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	35
Number of participants with account balances	2015-01-01	35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	40
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	31
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	5
Total of all active and inactive participants	2014-01-01	36
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	36
Number of participants with account balances	2014-01-01	36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2010: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	36
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	32
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	7
Total of all active and inactive participants	2010-01-01	39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	39
Number of participants with account balances	2010-01-01	38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	32
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	33
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	3
Total of all active and inactive participants	2009-01-01	36
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	36
Number of participants with account balances	2009-01-01	34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN

Measure	Date	Value
2022 : FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2022 401k financial data
Transfers to/from the plan	2022-12-31	$345,650
Total plan liabilities at end of year	2022-12-31	$0
Total plan liabilities at beginning of year	2022-12-31	$0
Total income from all sources	2022-12-31	$-489,686
Expenses. Total of all expenses incurred	2022-12-31	$463,179
Benefits paid (including direct rollovers)	2022-12-31	$462,979
Total plan assets at end of year	2022-12-31	$9,153,875
Total plan assets at beginning of year	2022-12-31	$9,761,090
Value of fidelity bond covering the plan	2022-12-31	$3,000,000
Total contributions received or receivable from participants	2022-12-31	$388,548
Expenses. Other expenses not covered elsewhere	2022-12-31	$0
Contributions received from other sources (not participants or employers)	2022-12-31	$127,939
Other income received	2022-12-31	$-1,185,449
Noncash contributions received	2022-12-31	$0
Net income (gross income less expenses)	2022-12-31	$-952,865
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$9,153,875
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$9,761,090
Value of loans by the plan or fixed income obligations due to the plan which were in default or classified as uncollectible at the close of the plan year	2022-12-31	$0
Value of leases to which the plan was a party in default or classified as uncollectible during the plan year	2022-12-31	$0
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	2022-12-31	$0
Assets. Value of employer securities	2022-12-31	$3,124,045
Total contributions received or receivable from employer(s)	2022-12-31	$179,276
Value of certain deemed distributions of participant loans	2022-12-31	$0
Value of corrective distributions	2022-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$200
2021 : FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2021 401k financial data
Transfers to/from the plan	2021-12-31	$2,275,624
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$421,543
Expenses. Total of all expenses incurred	2021-12-31	$7,409
Benefits paid (including direct rollovers)	2021-12-31	$7,309
Total plan assets at end of year	2021-12-31	$9,761,090
Total plan assets at beginning of year	2021-12-31	$7,071,332
Value of fidelity bond covering the plan	2021-12-31	$3,000,000
Total contributions received or receivable from participants	2021-12-31	$350,568
Expenses. Other expenses not covered elsewhere	2021-12-31	$0
Contributions received from other sources (not participants or employers)	2021-12-31	$879,306
Other income received	2021-12-31	$-966,409
Noncash contributions received	2021-12-31	$0
Net income (gross income less expenses)	2021-12-31	$414,134
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$9,761,090
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$7,071,332
Value of loans by the plan or fixed income obligations due to the plan which were in default or classified as uncollectible at the close of the plan year	2021-12-31	$0
Value of leases to which the plan was a party in default or classified as uncollectible during the plan year	2021-12-31	$0
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	2021-12-31	$0
Assets. Value of employer securities	2021-12-31	$2,519,440
Total contributions received or receivable from employer(s)	2021-12-31	$158,078
Value of certain deemed distributions of participant loans	2021-12-31	$0
Value of corrective distributions	2021-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$100
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2020 401k financial data
Transfers to/from the plan	2020-12-31	$0
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$1,881,398
Expenses. Total of all expenses incurred	2020-12-31	$535,124
Benefits paid (including direct rollovers)	2020-12-31	$535,124
Total plan assets at end of year	2020-12-31	$7,071,332
Total plan assets at beginning of year	2020-12-31	$5,725,058
Value of fidelity bond covering the plan	2020-12-31	$3,000,000
Total contributions received or receivable from participants	2020-12-31	$313,887
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$1,176,753
Other income received	2020-12-31	$241,959
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$1,346,274
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$7,071,332
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$5,725,058
Value of loans by the plan or fixed income obligations due to the plan which were in default or classified as uncollectible at the close of the plan year	2020-12-31	$0
Value of leases to which the plan was a party in default or classified as uncollectible during the plan year	2020-12-31	$0
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	2020-12-31	$0
Assets. Value of employer securities	2020-12-31	$0
Total contributions received or receivable from employer(s)	2020-12-31	$148,799
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2019 401k financial data
Transfers to/from the plan	2019-12-31	$0
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$1,371,356
Expenses. Total of all expenses incurred	2019-12-31	$101,466
Benefits paid (including direct rollovers)	2019-12-31	$101,391
Total plan assets at end of year	2019-12-31	$5,725,058
Total plan assets at beginning of year	2019-12-31	$4,455,168
Value of fidelity bond covering the plan	2019-12-31	$1,000,000
Total contributions received or receivable from participants	2019-12-31	$247,790
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$82,838
Other income received	2019-12-31	$921,141
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$1,269,890
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$5,725,058
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$4,455,168
Total contributions received or receivable from employer(s)	2019-12-31	$119,587
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$75
2018 : FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2018 401k financial data
Transfers to/from the plan	2018-12-31	$0
Total plan liabilities at end of year	2018-12-31	$0
Total plan liabilities at beginning of year	2018-12-31	$0
Total income from all sources	2018-12-31	$-12,646
Expenses. Total of all expenses incurred	2018-12-31	$473,695
Benefits paid (including direct rollovers)	2018-12-31	$473,620
Total plan assets at end of year	2018-12-31	$4,455,168
Total plan assets at beginning of year	2018-12-31	$4,941,509
Value of fidelity bond covering the plan	2018-12-31	$1,000,000
Total contributions received or receivable from participants	2018-12-31	$208,855
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$7,191
Other income received	2018-12-31	$-338,405
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$-486,341
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$4,455,168
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$4,941,509
Total contributions received or receivable from employer(s)	2018-12-31	$109,713
Value of certain deemed distributions of participant loans	2018-12-31	$0
Value of corrective distributions	2018-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$75
2017 : FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$961,015
Expenses. Total of all expenses incurred	2017-12-31	$143,362
Benefits paid (including direct rollovers)	2017-12-31	$143,312
Total plan assets at end of year	2017-12-31	$4,941,509
Total plan assets at beginning of year	2017-12-31	$4,123,856
Value of fidelity bond covering the plan	2017-12-31	$1,000,000
Assets. Value of tangible personal property	2017-12-31	$0
Total contributions received or receivable from participants	2017-12-31	$189,435
Assets. Value of loans (other than to participants)	2017-12-31	$0
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$663,733
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$817,653
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$4,941,509
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$4,123,856
Assets. Value of participant loans	2017-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2017-12-31	$0
Assets. Value of real-estate (other than employer real property)	2017-12-31	$0
Assets. Value of employer securities	2017-12-31	$0
Assets. Value of employer real property	2017-12-31	$0
Total contributions received or receivable from employer(s)	2017-12-31	$107,847
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$50
2016 : FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$505,364
Expenses. Total of all expenses incurred	2016-12-31	$60,345
Benefits paid (including direct rollovers)	2016-12-31	$60,245
Total plan assets at end of year	2016-12-31	$4,123,856
Total plan assets at beginning of year	2016-12-31	$3,678,837
Value of fidelity bond covering the plan	2016-12-31	$1,000,000
Total contributions received or receivable from participants	2016-12-31	$171,710
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$226,248
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$445,019
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$4,123,856
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$3,678,837
Total contributions received or receivable from employer(s)	2016-12-31	$107,406
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$100
2015 : FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$219,913
Expenses. Total of all expenses incurred	2015-12-31	$85,800
Benefits paid (including direct rollovers)	2015-12-31	$85,750
Total plan assets at end of year	2015-12-31	$3,678,837
Total plan assets at beginning of year	2015-12-31	$3,544,724
Value of fidelity bond covering the plan	2015-12-31	$1,000,000
Total contributions received or receivable from participants	2015-12-31	$164,398
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-47,144
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$134,113
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$3,678,837
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$3,544,724
Total contributions received or receivable from employer(s)	2015-12-31	$102,659
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$50
2014 : FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$418,854
Expenses. Total of all expenses incurred	2014-12-31	$873,533
Benefits paid (including direct rollovers)	2014-12-31	$872,708
Total plan assets at end of year	2014-12-31	$3,544,724
Total plan assets at beginning of year	2014-12-31	$3,999,403
Value of fidelity bond covering the plan	2014-12-31	$1,000,000
Total contributions received or receivable from participants	2014-12-31	$148,686
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$173,151
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$-454,679
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$3,544,724
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$3,999,403
Total contributions received or receivable from employer(s)	2014-12-31	$97,017
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$825
2010 : FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$538,901
Expenses. Total of all expenses incurred	2010-12-31	$341,013
Benefits paid (including direct rollovers)	2010-12-31	$341,013
Total plan assets at end of year	2010-12-31	$2,717,475
Total plan assets at beginning of year	2010-12-31	$2,519,587
Value of fidelity bond covering the plan	2010-12-31	$1,000,000
Total contributions received or receivable from participants	2010-12-31	$123,979
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$338,468
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$197,888
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$2,717,475
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,519,587
Total contributions received or receivable from employer(s)	2010-12-31	$76,454
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN

2022: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
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 – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
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 – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP 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	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP 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 – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP 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 – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP 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 – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2010: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP 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
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: FIRST STATE BANK 401(K) EMPLOYEE STOCK OWNERSHIP 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
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

535817

Policy instance

Insurance contract or identification number	535817
Number of Individuals Covered	48
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

467968

Policy instance

Insurance contract or identification number	467968
Number of Individuals Covered	48
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

535817

Policy instance

Insurance contract or identification number	535817
Number of Individuals Covered	43
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $393
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	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 $393
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

467968

Policy instance

Insurance contract or identification number	467968
Number of Individuals Covered	43
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

535817

Policy instance

Insurance contract or identification number	535817
Number of Individuals Covered	38
Insurance policy start date	2020-12-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

467968

Policy instance

Insurance contract or identification number	467968
Number of Individuals Covered	38
Insurance policy start date	2020-12-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

47421

Policy instance

Insurance contract or identification number	47421
Number of Individuals Covered	0
Insurance policy start date	2014-01-01
Insurance policy end date	2014-11-30
Total amount of commissions paid to insurance broker	USD $10,009
Total amount of fees paid to insurance company	USD $2,668
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?	No
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 $10,009
Amount paid for insurance broker fees	0
Insurance broker name	JULY BUSINESS SERVICES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

47421

Policy instance

Insurance contract or identification number	47421
Number of Individuals Covered	38
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $6,458
Total amount of fees paid to insurance company	USD $1,982
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?	Yes
Commission paid to Insurance Broker	USD $6,458
Insurance broker organization code?	4
Amount paid for insurance broker fees	1982
Additional information about fees paid to insurance broker	SALES/ADMINISTRATION
Insurance broker name	JULY BUSINESS SERVICES

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Company Name:	FIRST STATE BANK
Employer identification number (EIN):	450134685
NAIC Classification:	522120
NAIC Description:	Savings Institutions