401k Plan data: THE MEADOWS COUNTRY CLUB 401(K) SAVINGS plan

THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 401k Plan overview

Plan Name	THE MEADOWS COUNTRY CLUB 401(K) SAVINGS
Plan identification number	003

THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 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

THE MEADOWS COUNTRY CLUB, INC. has sponsored the creation of one or more 401k plans.

Company Name: THE MEADOWS COUNTRY CLUB, INC.

Employer identification number (EIN): 650065871

NAIC Classification: 713900

Additional information about THE MEADOWS COUNTRY CLUB, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 1988-07-13

Company Identification Number: N27413

Legal Registered Office Address: Icon Management Services, Inc.

Bradenton

34208

More information about THE MEADOWS COUNTRY CLUB, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE MEADOWS COUNTRY CLUB 401(K) SAVINGS

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2020-01-01 JOHN A. STARR 2021-07-22
003 2019-01-01 JOHN A. STARR 2020-09-29
003 2017-01-01 JOHN A. STARR 2019-10-31
003 2015-01-01 JOHN A. STARR
003 2014-01-01 JOHN A. STARR DOUG DOMINO 2015-10-15
003 2013-01-01 DOUG DOMINO
003 2012-01-01 DOUG DOMINO

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
003	2020-01-01	JOHN A. STARR	2021-07-22
003	2019-01-01	JOHN A. STARR	2020-09-29
003	2017-01-01	JOHN A. STARR	2019-10-31
003	2015-01-01	JOHN A. STARR
003	2014-01-01	JOHN A. STARR		DOUG DOMINO	2015-10-15
003	2013-01-01	DOUG DOMINO
003	2012-01-01	DOUG DOMINO

Plan Statistics for THE MEADOWS COUNTRY CLUB 401(K) SAVINGS

401k plan membership statisitcs for THE MEADOWS COUNTRY CLUB 401(K) SAVINGS

Measure Date Value
2015: THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 2015 401k membership
Total participants, beginning-of-year 2015-01-01 162
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 96
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 51
Total of all active and inactive participants 2015-01-01 147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 147
Number of participants with account balances 2015-01-01 92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 2014 401k membership
Total participants, beginning-of-year 2014-01-01 170
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 109
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 43
Total of all active and inactive participants 2014-01-01 152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 152
Number of participants with account balances 2014-01-01 98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 2013 401k membership
Total participants, beginning-of-year 2013-01-01 176
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 171
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 8
Total of all active and inactive participants 2013-01-01 179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 179
Number of participants with account balances 2013-01-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 2012 401k membership
Total participants, beginning-of-year 2012-01-01 165
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 163
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 10
Total of all active and inactive participants 2012-01-01 173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 173
Number of participants with account balances 2012-01-01 133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 7

Measure	Date	Value
2015: THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 2015 401k membership
Total participants, beginning-of-year	2015-01-01	162
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	96
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	51
Total of all active and inactive participants	2015-01-01	147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	147
Number of participants with account balances	2015-01-01	92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 2014 401k membership
Total participants, beginning-of-year	2014-01-01	170
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	109
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	43
Total of all active and inactive participants	2014-01-01	152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	152
Number of participants with account balances	2014-01-01	98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 2013 401k membership
Total participants, beginning-of-year	2013-01-01	176
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	171
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	8
Total of all active and inactive participants	2013-01-01	179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	179
Number of participants with account balances	2013-01-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 2012 401k membership
Total participants, beginning-of-year	2012-01-01	165
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	163
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	10
Total of all active and inactive participants	2012-01-01	173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	173
Number of participants with account balances	2012-01-01	133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	7

Financial Data on THE MEADOWS COUNTRY CLUB 401(K) SAVINGS

Measure	Date	Value
2015 : THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$-19,830
Total unrealized appreciation/depreciation of assets	2015-12-31	$-19,830
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$49,139
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$435,288
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$434,131
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$47,509
Value of total assets at end of year	2015-12-31	$623,867
Value of total assets at beginning of year	2015-12-31	$1,010,016
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,157
Total interest from all sources	2015-12-31	$670
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$20,740
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$20,740
Administrative expenses professional fees incurred	2015-12-31	$1,157
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
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	$47,509
Participant contributions at end of year	2015-12-31	$13,022
Participant contributions at beginning of year	2015-12-31	$19,552
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$0
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 income not declared elsewhere	2015-12-31	$50
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	$-386,149
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$623,867
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,010,016
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	$606,901
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$970,403
Interest on participant loans	2015-12-31	$670
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$3,944
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$20,061
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	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$434,131
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	T.M. HAYES CPA
Accountancy firm EIN	2015-12-31	474449040
2014 : THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$89,986
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$83,599
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$78,343
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$38,398
Value of total assets at end of year	2014-12-31	$1,010,016
Value of total assets at beginning of year	2014-12-31	$1,003,629
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$5,256
Total interest from all sources	2014-12-31	$725
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$35,581
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$35,581
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	Yes
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	$38,398
Participant contributions at end of year	2014-12-31	$19,552
Participant contributions at beginning of year	2014-12-31	$22,728
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$3,087
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	$612
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	$6,387
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,010,016
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,003,629
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	$970,403
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$958,494
Interest on participant loans	2014-12-31	$725
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$20,061
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$18,708
Net investment gain/loss from pooled separate accounts	2014-12-31	$15,282
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$78,343
Contract administrator fees	2014-12-31	$5,256
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	2014-12-31	Yes
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	T.M. HAYES CPA
Accountancy firm EIN	2014-12-31	474449040
2013 : THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$126,817
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$104,423
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$86,934
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$36,394
Value of total assets at end of year	2013-12-31	$1,003,629
Value of total assets at beginning of year	2013-12-31	$981,235
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$17,489
Total interest from all sources	2013-12-31	$549
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	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$36,394
Participant contributions at end of year	2013-12-31	$22,728
Participant contributions at beginning of year	2013-12-31	$22,806
Participant contributions at end of year	2013-12-31	$3,087
Participant contributions at beginning of year	2013-12-31	$1,512
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$612
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$329
Other income not declared elsewhere	2013-12-31	$168
Administrative expenses (other) incurred	2013-12-31	$2,533
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	$22,394
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,003,629
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$981,235
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	$958,494
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$919,930
Interest on participant loans	2013-12-31	$549
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$18,708
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$36,658
Net investment gain/loss from pooled separate accounts	2013-12-31	$89,706
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	Yes
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$86,934
Contract administrator fees	2013-12-31	$14,956
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	TM HAYES
Accountancy firm EIN	2013-12-31	222346417
2012 : THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets to this plan	2012-12-31	$933,766
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
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	$137,109
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$89,640
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$77,842
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$61,834
Value of total assets at end of year	2012-12-31	$981,235
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	$11,798
Total interest from all sources	2012-12-31	$839
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	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$61,834
Participant contributions at end of year	2012-12-31	$22,806
Participant contributions at end of year	2012-12-31	$1,512
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-12-31	$1,922
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$329
Other income not declared elsewhere	2012-12-31	$7
Administrative expenses (other) incurred	2012-12-31	$6,963
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	$47,469
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$981,235
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	$919,930
Interest on participant loans	2012-12-31	$839
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$36,658
Net investment gain/loss from pooled separate accounts	2012-12-31	$74,429
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	Yes
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$75,920
Contract administrator fees	2012-12-31	$4,835
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	TM HAYES
Accountancy firm EIN	2012-12-31	222346417

Form 5500 Responses for THE MEADOWS COUNTRY CLUB 401(K) SAVINGS

2015: THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 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: THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 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: THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 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: THE MEADOWS COUNTRY CLUB 401(K) SAVINGS 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

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

833804

Policy instance

Insurance contract or identification number	833804
Number of Individuals Covered	92
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,360
Total amount of fees paid to insurance company	USD $454
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?	No
Commission paid to Insurance Broker	USD $1,360
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Insurance broker name	FIRST PARTY ADMINISTRATORS

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

833804

Policy instance

Insurance contract or identification number	833804
Number of Individuals Covered	99
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $15,262
Total amount of fees paid to insurance company	USD $569
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?	No
Commission paid to Insurance Broker	USD $15,262
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Insurance broker name	FIRST PARTY ADMINISTRATOR

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

69847

Policy instance

Insurance contract or identification number	69847
Number of Individuals Covered	109
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,957
Total amount of fees paid to insurance company	USD $1,587
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
Commission paid to Insurance Broker	USD $1,957
Insurance broker organization code?	4
Amount paid for insurance broker fees	975
Additional information about fees paid to insurance broker	TPA SUBSIDY
Insurance broker name	PINNACLE FINANCIAL SERVICES, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

69847

Policy instance

Insurance contract or identification number	69847
Number of Individuals Covered	133
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $955
Total amount of fees paid to insurance company	USD $2,940
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
Amount paid for insurance broker fees	2332
Additional information about fees paid to insurance broker	TPA SUBSIDY
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $955
Insurance broker name	PINNACLE FINANCIAL SERVICES, INC.

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Company Name:	THE MEADOWS COUNTRY CLUB, INC.
Employer identification number (EIN):	650065871
NAIC Classification:	713900

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	1988-07-13
Company Identification Number:	N27413
Legal Registered Office Address:	Icon Management Services, Inc. Bradenton 34208