401k Plan data: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN plan

CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 401k Plan overview

Plan Name	CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN
Plan identification number	002

CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

CITIZENS BANK & TRUST COMPANY DC has sponsored the creation of one or more 401k plans.

Company Name: CITIZENS BANK & TRUST COMPANY DC

Employer identification number (EIN): 720152830

NAIC Classification: 522110
NAIC Description: Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 KRISTEN SPEDALE 2023-07-21
002 2021-01-01 JOYCELYN LAMOTHE 2022-05-24 JOYCELYN LAMOTHE 2022-05-24
002 2020-01-01 JOYCELYN F. LAMOTHE 2021-06-17 JOYCELYN F. LAMOTHE 2021-06-17
002 2019-01-01 JOYCELYN F. LAMOTHE 2020-06-01 JOYCELYN F. LAMOTHE 2020-06-01
002 2018-01-01 JOYCELYN LAMOTHE 2019-06-24
002 2017-01-01 JOYCELYN F. LAMOTHE 2018-06-13
002 2016-01-01 JOYCELYN F. LAMOTHE 2017-06-15
002 2015-01-01 JOYCELYN LAMOTHE 2016-06-17
002 2014-01-01 JOYCELYN F. LAMOTHE
002 2013-01-01 JOYCELYN LAMOTHE
002 2012-01-01 JOYCELYN LAMOTHE
002 2011-01-01 JOYCELYN LAMOTHE
002 2010-01-01 JOYCELYN LAMOTHE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01	KRISTEN SPEDALE	2023-07-21
002	2021-01-01	JOYCELYN LAMOTHE	2022-05-24	JOYCELYN LAMOTHE	2022-05-24
002	2020-01-01	JOYCELYN F. LAMOTHE	2021-06-17	JOYCELYN F. LAMOTHE	2021-06-17
002	2019-01-01	JOYCELYN F. LAMOTHE	2020-06-01	JOYCELYN F. LAMOTHE	2020-06-01
002	2018-01-01	JOYCELYN LAMOTHE	2019-06-24
002	2017-01-01	JOYCELYN F. LAMOTHE	2018-06-13
002	2016-01-01	JOYCELYN F. LAMOTHE	2017-06-15
002	2015-01-01	JOYCELYN LAMOTHE	2016-06-17
002	2014-01-01	JOYCELYN F. LAMOTHE
002	2013-01-01	JOYCELYN LAMOTHE
002	2012-01-01	JOYCELYN LAMOTHE
002	2011-01-01	JOYCELYN LAMOTHE
002	2010-01-01	JOYCELYN LAMOTHE

Plan Statistics for CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN

401k plan membership statisitcs for CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN

Measure Date Value
2014: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 62
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 55
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 9
Total of all active and inactive participants 2014-01-01 64
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 64
Number of participants with account balances 2014-01-01 61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 61
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 52
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 9
Total of all active and inactive participants 2013-01-01 61
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 61
Number of participants with account balances 2013-01-01 57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 61
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 54
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 11
Total of all active and inactive participants 2012-01-01 65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 65
Number of participants with account balances 2012-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 64
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 57
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 2
Total of all active and inactive participants 2011-01-01 59
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 59
Number of participants with account balances 2011-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 61
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 57
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 1
Total of all active and inactive participants 2010-01-01 58
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 58
Number of participants with account balances 2010-01-01 58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0

Measure	Date	Value
2014: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	62
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	55
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	9
Total of all active and inactive participants	2014-01-01	64
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	64
Number of participants with account balances	2014-01-01	61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	61
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	52
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	9
Total of all active and inactive participants	2013-01-01	61
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	61
Number of participants with account balances	2013-01-01	57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	61
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	54
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	11
Total of all active and inactive participants	2012-01-01	65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	65
Number of participants with account balances	2012-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	64
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	57
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	2
Total of all active and inactive participants	2011-01-01	59
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	59
Number of participants with account balances	2011-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	61
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	57
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	1
Total of all active and inactive participants	2010-01-01	58
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	58
Number of participants with account balances	2010-01-01	58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0

Financial Data on CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN

Measure	Date	Value
2014 : CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$1,245
Total income from all sources	2014-12-31	$545,628
Expenses. Total of all expenses incurred	2014-12-31	$121,839
Benefits paid (including direct rollovers)	2014-12-31	$117,212
Total plan assets at end of year	2014-12-31	$5,168,848
Total plan assets at beginning of year	2014-12-31	$4,743,814
Value of fidelity bond covering the plan	2014-12-31	$3,000,000
Total contributions received or receivable from participants	2014-12-31	$212,928
Expenses. Other expenses not covered elsewhere	2014-12-31	$175
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$265,707
Net income (gross income less expenses)	2014-12-31	$423,789
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$5,168,848
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$4,743,814
Assets. Value of participant loans	2014-12-31	$0
Total contributions received or receivable from employer(s)	2014-12-31	$66,993
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$4,452
Funding deficiency by the employer to the plan for this plan year	2014-12-31	$0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	2014-12-31	$0
2013 : CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$72
Total income from all sources	2013-12-31	$945,573
Expenses. Total of all expenses incurred	2013-12-31	$118,120
Benefits paid (including direct rollovers)	2013-12-31	$117,256
Total plan assets at end of year	2013-12-31	$4,743,814
Total plan assets at beginning of year	2013-12-31	$3,916,289
Value of fidelity bond covering the plan	2013-12-31	$3,000,000
Total contributions received or receivable from participants	2013-12-31	$213,158
Expenses. Other expenses not covered elsewhere	2013-12-31	$100
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$665,969
Net income (gross income less expenses)	2013-12-31	$827,453
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$4,743,814
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$3,916,289
Assets. Value of participant loans	2013-12-31	$0
Total contributions received or receivable from employer(s)	2013-12-31	$66,446
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$764
Funding deficiency by the employer to the plan for this plan year	2013-12-31	$0
Minimum employer required contribution for this plan year	2013-12-31	$0
Amount contributed by the employer to the plan for this plan year	2013-12-31	$0
2012 : CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$724,560
Expenses. Total of all expenses incurred	2012-12-31	$67,602
Benefits paid (including direct rollovers)	2012-12-31	$62,284
Total plan assets at end of year	2012-12-31	$3,916,289
Total plan assets at beginning of year	2012-12-31	$3,259,331
Value of fidelity bond covering the plan	2012-12-31	$3,000,000
Total contributions received or receivable from participants	2012-12-31	$209,030
Expenses. Other expenses not covered elsewhere	2012-12-31	$225
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$447,780
Net income (gross income less expenses)	2012-12-31	$656,958
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$3,916,289
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$3,259,331
Assets. Value of participant loans	2012-12-31	$0
Total contributions received or receivable from employer(s)	2012-12-31	$67,750
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$5,093
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
2011 : CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$24
Total income from all sources	2011-12-31	$198,384
Expenses. Total of all expenses incurred	2011-12-31	$28,104
Benefits paid (including direct rollovers)	2011-12-31	$28,079
Total plan assets at end of year	2011-12-31	$3,259,331
Total plan assets at beginning of year	2011-12-31	$3,089,027
Value of fidelity bond covering the plan	2011-12-31	$3,000,000
Total contributions received or receivable from participants	2011-12-31	$211,802
Expenses. Other expenses not covered elsewhere	2011-12-31	$25
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-77,956
Net income (gross income less expenses)	2011-12-31	$170,280
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$3,259,331
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$3,089,027
Assets. Value of participant loans	2011-12-31	$0
Total contributions received or receivable from employer(s)	2011-12-31	$64,538
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0
2010 : CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$618,220
Expenses. Total of all expenses incurred	2010-12-31	$168,122
Benefits paid (including direct rollovers)	2010-12-31	$168,097
Total plan assets at end of year	2010-12-31	$3,089,027
Total plan assets at beginning of year	2010-12-31	$2,638,929
Value of fidelity bond covering the plan	2010-12-31	$3,000,000
Total contributions received or receivable from participants	2010-12-31	$224,984
Expenses. Other expenses not covered elsewhere	2010-12-31	$25
Contributions received from other sources (not participants or employers)	2010-12-31	$1,028
Other income received	2010-12-31	$330,827
Net income (gross income less expenses)	2010-12-31	$450,098
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$3,089,027
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,638,929
Assets. Value of participant loans	2010-12-31	$0
Total contributions received or receivable from employer(s)	2010-12-31	$61,381
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$0
Amount contributed by the employer to the plan for this plan year	2010-12-31	$0

Form 5500 Responses for CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN

2014: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL 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
2013: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL 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
2012: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: CITIZENS BANK & TRUST COMPANY SALARY DEFERRAL PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

GA-821377

Policy instance

Insurance contract or identification number	GA-821377
Number of Individuals Covered	61
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $12,010
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?	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 $12,010
Insurance broker organization code?	3
Insurance broker name	SBHU LIFE AGENCY INC

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

Policy contract number

GA-821377

Policy instance

Insurance contract or identification number	GA-821377
Number of Individuals Covered	57
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $10,366
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?	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 $10,366
Insurance broker organization code?	3
Insurance broker name	SBHU LIFE AGCY INC

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

Policy contract number

GA-821377

Policy instance

Insurance contract or identification number	GA-821377
Number of Individuals Covered	59
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $7,963
Total amount of fees paid to insurance company	USD $101
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

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

Policy contract number

GA-821377

Policy instance

Insurance contract or identification number	GA-821377
Number of Individuals Covered	58
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,808
Total amount of fees paid to insurance company	USD $25
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 $2,808
Insurance broker organization code?	3
Amount paid for insurance broker fees	25
Additional information about fees paid to insurance broker	SALES/MARKETING
Insurance broker name	MORGANSTANLEY SMITHBARNEY LLC

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Company Name:	CITIZENS BANK & TRUST COMPANY DC
Employer identification number (EIN):	720152830
NAIC Classification:	522110
NAIC Description:	Commercial Banking