401k Plan data: CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN plan

CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN 401k Plan overview

Plan Name	CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN
Plan identification number	502

CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

CHICKASAW NATION INDUSTRIES, INC. has sponsored the creation of one or more 401k plans.

Company Name: CHICKASAW NATION INDUSTRIES, INC.

Employer identification number (EIN): 731543162

NAIC Classification: 238900

Additional information about CHICKASAW NATION INDUSTRIES, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2007-04-03

Company Identification Number: 0800796812

Legal Registered Office Address: 2600 JOHN SAXON BLVD STE 100

NORMAN
United States of America (USA)
73071

More information about CHICKASAW NATION INDUSTRIES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2012-01-01 KATHY PETITO
502 2011-01-01 KATHY PETITO
502 2009-01-01 KATHY PETITO

Plan id#	Filing Submission Date	Name of Administrator
502	2012-01-01	KATHY PETITO
502	2011-01-01	KATHY PETITO
502	2009-01-01	KATHY PETITO

Plan Statistics for CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN

401k plan membership statisitcs for CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN

Measure Date Value
2012: CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,019
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
Total of all active and inactive participants 2012-01-01 0
2011: CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,800
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,316
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 0
Total of all active and inactive participants 2011-01-01 1,316
2009: CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,813
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,852
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 1,852

Measure	Date	Value
2012: CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,019
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
Total of all active and inactive participants	2012-01-01	0
2011: CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,800
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,316
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	0
Total of all active and inactive participants	2011-01-01	1,316
2009: CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,813
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,852
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	1,852

Form 5500 Responses for CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN

2012: CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
2012-01-01	This submission is the final filing	Yes
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 benefit arrangement – Insurance	Yes
2011: CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE 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 – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: CHICKASAW NATION INDUSTRIES, INC. EMPLOYEE LIFE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	CHICKASAW NATION INDUSTRIES, INC.
Employer identification number (EIN):	731543162
NAIC Classification:	238900

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2007-04-03
Company Identification Number:	0800796812
Legal Registered Office Address:	2600 JOHN SAXON BLVD STE 100 NORMAN United States of America (USA) 73071