401k Plan data: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN plan

HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 401k Plan overview

Plan Name	HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN
Plan identification number	101

HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) 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

HERITAGE FAMILY FUNERAL SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: HERITAGE FAMILY FUNERAL SERVICES, INC.

Employer identification number (EIN): 620910684

NAIC Classification: 812210
NAIC Description: Funeral Homes and Funeral Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
101 2017-01-01 RENEE LOCKHART
101 2016-01-01 RENEE LOCKHART
101 2015-01-01 RENEE LOCKHART
101 2014-01-01 RENEE LOCKHART
101 2013-01-01 RENEE LOCKHART
101 2012-01-01 PHIL TISUE

Plan id#	Filing Submission Date	Name of Administrator
101	2017-01-01	RENEE LOCKHART
101	2016-01-01	RENEE LOCKHART
101	2015-01-01	RENEE LOCKHART
101	2014-01-01	RENEE LOCKHART
101	2013-01-01	RENEE LOCKHART
101	2012-01-01	PHIL TISUE

Plan Statistics for HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN

401k plan membership statisitcs for HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN

Measure Date Value
2017: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 219
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 192
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 16
Total of all active and inactive participants 2017-01-01 208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 208
Number of participants with account balances 2017-01-01 96
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 6
2016: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 213
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 210
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 8
Total of all active and inactive participants 2016-01-01 219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 219
Number of participants with account balances 2016-01-01 96
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 3
2015: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 198
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 201
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 2015-01-01 205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 205
Number of participants with account balances 2015-01-01 97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 2
2014: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 137
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 136
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 2014-01-01 141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 141
Number of participants with account balances 2014-01-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 2
2013: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 129
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 2
Total of all active and inactive participants 2013-01-01 132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 132
Number of participants with account balances 2013-01-01 111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 2
2012: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 147
Number of retired or separated participants receiving benefits 2012-01-01 3
Number of other retired or separated participants entitled to future benefits 2012-01-01 13
Total of all active and inactive participants 2012-01-01 163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 163
Number of participants with account balances 2012-01-01 106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 6

Measure	Date	Value
2017: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	219
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	192
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	16
Total of all active and inactive participants	2017-01-01	208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	208
Number of participants with account balances	2017-01-01	96
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	6
2016: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	213
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	210
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	8
Total of all active and inactive participants	2016-01-01	219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	219
Number of participants with account balances	2016-01-01	96
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	3
2015: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	198
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	201
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	205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	205
Number of participants with account balances	2015-01-01	97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	2
2014: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	137
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	136
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	141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	141
Number of participants with account balances	2014-01-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	2
2013: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	129
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	2
Total of all active and inactive participants	2013-01-01	132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	132
Number of participants with account balances	2013-01-01	111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	2
2012: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	147
Number of retired or separated participants receiving benefits	2012-01-01	3
Number of other retired or separated participants entitled to future benefits	2012-01-01	13
Total of all active and inactive participants	2012-01-01	163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	163
Number of participants with account balances	2012-01-01	106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	6

Financial Data on HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN

Measure	Date	Value
2017 : HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$9,709
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$28,112
Total income from all sources (including contributions)	2017-12-31	$1,122,471
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$204,643
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$202,433
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$375,942
Value of total assets at end of year	2017-12-31	$5,309,690
Value of total assets at beginning of year	2017-12-31	$4,410,265
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,210
Total interest from all sources	2017-12-31	$3,327
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$241,457
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$8,867
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$9,709
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$28,112
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$917,828
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$5,299,981
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$4,382,153
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in pooled separate accounts at end of year	2017-12-31	$4,959,394
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$4,091,511
Interest earned on other investments	2017-12-31	$3,327
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$350,296
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$318,754
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$743,202
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$125,618
Employer contributions (assets) at end of year	2017-12-31	$0
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$202,433
Contract administrator fees	2017-12-31	$2,210
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	COULTER & JUSTUS
Accountancy firm EIN	2017-12-31	621532536
2016 : HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) 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	$28,112
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$10,720
Total income from all sources (including contributions)	2016-12-31	$627,651
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$140,629
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$138,000
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$335,636
Value of total assets at end of year	2016-12-31	$4,410,265
Value of total assets at beginning of year	2016-12-31	$3,905,851
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$2,629
Total interest from all sources	2016-12-31	$3,299
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	$1,500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$189,320
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$35,750
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$28,112
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$10,720
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	$487,022
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$4,382,153
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$3,895,131
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 pooled separate accounts at end of year	2016-12-31	$4,091,511
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$3,613,865
Interest earned on other investments	2016-12-31	$3,299
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$318,754
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$291,986
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$288,716
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	$110,566
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$138,000
Contract administrator fees	2016-12-31	$2,629
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	COULTER & JUSTUS
Accountancy firm EIN	2016-12-31	621532536
2015 : HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) 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	$10,720
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$7,465
Total income from all sources (including contributions)	2015-12-31	$263,670
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$317,458
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$315,233
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$346,784
Value of total assets at end of year	2015-12-31	$3,905,851
Value of total assets at beginning of year	2015-12-31	$3,956,384
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$2,225
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	$1,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$207,576
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$4,931
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$16,653
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$10,720
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$7,465
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	$-53,788
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$3,895,131
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$3,948,919
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 pooled separate accounts at end of year	2015-12-31	$3,613,865
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$3,597,025
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$291,986
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$350,833
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-83,114
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	$122,555
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$3,595
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$315,233
Contract administrator fees	2015-12-31	$2,225
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	COULTER & JUSTUS
Accountancy firm EIN	2015-12-31	621532536
2014 : HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$0
Total transfer of assets from this plan	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$7,465
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$23,067
Total income from all sources (including contributions)	2014-12-31	$562,696
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$973,228
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$970,878
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$339,109
Value of total assets at end of year	2014-12-31	$3,956,384
Value of total assets at beginning of year	2014-12-31	$4,382,518
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$2,350
Total interest from all sources	2014-12-31	$3,475
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	$1,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$209,355
Participant contributions at end of year	2014-12-31	$4,931
Participant contributions at beginning of year	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$8,653
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$7,465
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$23,067
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	$-410,532
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$3,948,919
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$4,359,451
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 pooled separate accounts at end of year	2014-12-31	$3,597,025
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$4,038,471
Interest earned on other investments	2014-12-31	$3,475
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$350,833
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$335,394
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$220,112
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	$129,754
Employer contributions (assets) at end of year	2014-12-31	$3,595
Employer contributions (assets) at beginning of year	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$970,878
Contract administrator fees	2014-12-31	$2,350
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	COULTER & JUSTUS
Accountancy firm EIN	2014-12-31	621532536
2013 : HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) 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	$23,067
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$22,290
Total income from all sources (including contributions)	2013-12-31	$928,293
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$253,291
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$223,906
Value of total corrective distributions	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$337,876
Value of total assets at end of year	2013-12-31	$4,382,518
Value of total assets at beginning of year	2013-12-31	$3,706,739
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$29,385
Total interest from all sources	2013-12-31	$4,502
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	$1,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	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	$205,914
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$1,442
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$8,653
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$23,067
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$22,290
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	$675,002
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$4,359,451
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$3,684,449
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 pooled separate accounts at end of year	2013-12-31	$4,038,471
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$3,541,799
Interest earned on other investments	2013-12-31	$4,502
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$335,394
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$162,684
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$585,915
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	$131,962
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$814
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$223,906
Contract administrator fees	2013-12-31	$29,385
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	2013-12-31	Yes
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	COULTER & JUSTUS
Accountancy firm EIN	2013-12-31	621532536
2012 : HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets to this plan	2012-12-31	$3,960,403
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$22,290
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	$361,294
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$637,248
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$608,293
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$313,475
Value of total assets at end of year	2012-12-31	$3,706,739
Value of total assets at beginning of year	2012-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$28,955
Total interest from all sources	2012-12-31	$3,469
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	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	$188,699
Participant contributions at end of year	2012-12-31	$1,442
Participant contributions at beginning of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$22,290
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$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	2012-12-31	No
Value of net income/loss	2012-12-31	$-275,954
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$3,684,449
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$0
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 pooled separate accounts at end of year	2012-12-31	$3,541,799
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$0
Interest earned on other investments	2012-12-31	$3,469
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$162,684
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$0
Net investment gain/loss from pooled separate accounts	2012-12-31	$44,350
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
Contributions received in cash from employer	2012-12-31	$124,776
Employer contributions (assets) at end of year	2012-12-31	$814
Employer contributions (assets) at beginning of year	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$608,293
Contract administrator fees	2012-12-31	$28,955
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	COULTER & JUSTUS
Accountancy firm EIN	2012-12-31	621532536

Form 5500 Responses for HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN

2017: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) 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 – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) 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 – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) 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 – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) 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
2013: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) 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
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: HERITAGE FAMILY FUNERAL SERVICES, INC. 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
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
2012-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

810620

Policy instance

Insurance contract or identification number	810620
Number of Individuals Covered	96
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $19,204
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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 $19,204
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	3
Insurance broker name	WOODBURY FINANCIAL SERVICES INC

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

810620

Policy instance

Insurance contract or identification number	810620
Number of Individuals Covered	97
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $15,774
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?	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 $15,774
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	3
Insurance broker name	WOODBURY FINANCIAL SERVICES INC

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

810620

Policy instance

Insurance contract or identification number	810620
Number of Individuals Covered	109
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,617
Total amount of fees paid to insurance company	USD $2,000
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
Amount paid for insurance broker fees	2000
Additional information about fees paid to insurance broker	THIRD PARTY ADMINISTRATION FEES
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $1,617
Insurance broker name	WOODBURY FINANCIAL SERVICES INC

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

810620

Policy instance

Insurance contract or identification number	810620
Number of Individuals Covered	110
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $21,377
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?	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 $21,377
Insurance broker organization code?	3
Insurance broker name	WOODBURY FINANCIAL SERVICES INC

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

931061-199

Policy instance

Insurance contract or identification number	931061-199
Number of Individuals Covered	0
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $14,445
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?	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 $11,917
Insurance broker organization code?	3
Insurance broker name	PHIL E TISUE

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

931061-199

Policy instance

Insurance contract or identification number	931061-199
Number of Individuals Covered	163
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $15,710
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?	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 $13,257
Insurance broker organization code?	3
Insurance broker name	PHIL TISUE

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Company Name:	HERITAGE FAMILY FUNERAL SERVICES, INC.
Employer identification number (EIN):	620910684
NAIC Classification:	812210
NAIC Description:	Funeral Homes and Funeral Services