401k Plan data: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN plan

THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 401k Plan overview

Plan Name	THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN
Plan identification number	001

THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING 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

SHELTI OPCO, LLC has sponsored the creation of one or more 401k plans.

Company Name: SHELTI OPCO, LLC

Employer identification number (EIN): 800903202

NAIC Classification: 713200
NAIC Description: Gambling Industries

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 CARLTON GEER CARLTON GEER 2018-08-27
001 2016-01-01 CARLTON GEER CARLTON GEER 2017-07-19
001 2015-01-01 CARLTON GEER CARLTON GEER 2016-07-12
001 2014-10-01 KATHY PICOLLO KATHY PICOLLO 2015-07-15
001 2013-10-01 KATHY PICOLLO KATHY PICOLLO 2015-02-06

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2019-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	CARLTON GEER	CARLTON GEER	2018-08-27
001	2016-01-01	CARLTON GEER	CARLTON GEER	2017-07-19
001	2015-01-01	CARLTON GEER	CARLTON GEER	2016-07-12
001	2014-10-01	KATHY PICOLLO	KATHY PICOLLO	2015-07-15
001	2013-10-01	KATHY PICOLLO	KATHY PICOLLO	2015-02-06

Plan Statistics for THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN

401k plan membership statisitcs for THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN

Measure Date Value
2019: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 594
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 0
Number of participants with account balances 2019-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 635
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 3
Number of retired or separated participants receiving benefits 2018-01-01 31
Number of other retired or separated participants entitled to future benefits 2018-01-01 556
Total of all active and inactive participants 2018-01-01 590
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 590
Number of participants with account balances 2018-01-01 590
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 787
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 76
Number of retired or separated participants receiving benefits 2017-01-01 27
Number of other retired or separated participants entitled to future benefits 2017-01-01 604
Total of all active and inactive participants 2017-01-01 707
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 707
Number of participants with account balances 2017-01-01 635
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,299
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 90
Number of retired or separated participants receiving benefits 2016-01-01 34
Number of other retired or separated participants entitled to future benefits 2016-01-01 669
Total of all active and inactive participants 2016-01-01 793
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 793
Number of participants with account balances 2016-01-01 715
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,236
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 954
Number of retired or separated participants receiving benefits 2015-01-01 25
Number of other retired or separated participants entitled to future benefits 2015-01-01 302
Total of all active and inactive participants 2015-01-01 1,281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 1,281
Number of participants with account balances 2015-01-01 970
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 3
2014: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 1,178
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 970
Number of retired or separated participants receiving benefits 2014-10-01 17
Number of other retired or separated participants entitled to future benefits 2014-10-01 207
Total of all active and inactive participants 2014-10-01 1,194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-10-01 0
Total participants 2014-10-01 1,194
Number of participants with account balances 2014-10-01 845
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-10-01 9
2013: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 1,167
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 848
Number of retired or separated participants receiving benefits 2013-10-01 16
Number of other retired or separated participants entitled to future benefits 2013-10-01 190
Total of all active and inactive participants 2013-10-01 1,054
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-10-01 0
Total participants 2013-10-01 1,054
Number of participants with account balances 2013-10-01 728
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-10-01 5

Measure	Date	Value
2019: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	594
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	0
Number of participants with account balances	2019-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	635
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	3
Number of retired or separated participants receiving benefits	2018-01-01	31
Number of other retired or separated participants entitled to future benefits	2018-01-01	556
Total of all active and inactive participants	2018-01-01	590
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	590
Number of participants with account balances	2018-01-01	590
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	787
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	76
Number of retired or separated participants receiving benefits	2017-01-01	27
Number of other retired or separated participants entitled to future benefits	2017-01-01	604
Total of all active and inactive participants	2017-01-01	707
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	707
Number of participants with account balances	2017-01-01	635
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,299
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	90
Number of retired or separated participants receiving benefits	2016-01-01	34
Number of other retired or separated participants entitled to future benefits	2016-01-01	669
Total of all active and inactive participants	2016-01-01	793
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	793
Number of participants with account balances	2016-01-01	715
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,236
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	954
Number of retired or separated participants receiving benefits	2015-01-01	25
Number of other retired or separated participants entitled to future benefits	2015-01-01	302
Total of all active and inactive participants	2015-01-01	1,281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	1,281
Number of participants with account balances	2015-01-01	970
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	3
2014: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	1,178
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	970
Number of retired or separated participants receiving benefits	2014-10-01	17
Number of other retired or separated participants entitled to future benefits	2014-10-01	207
Total of all active and inactive participants	2014-10-01	1,194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-10-01	0
Total participants	2014-10-01	1,194
Number of participants with account balances	2014-10-01	845
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-10-01	9
2013: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	1,167
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	848
Number of retired or separated participants receiving benefits	2013-10-01	16
Number of other retired or separated participants entitled to future benefits	2013-10-01	190
Total of all active and inactive participants	2013-10-01	1,054
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-10-01	0
Total participants	2013-10-01	1,054
Number of participants with account balances	2013-10-01	728
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-10-01	5

Financial Data on THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN

Measure	Date	Value
2019 : THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-08-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-08-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-08-31	$0
Total income from all sources (including contributions)	2019-08-31	$760,779
Total loss/gain on sale of assets	2019-08-31	$0
Total of all expenses incurred	2019-08-31	$7,520,666
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-08-31	$7,463,473
Expenses. Certain deemed distributions of participant loans	2019-08-31	$9,998
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-08-31	$0
Value of total assets at end of year	2019-08-31	$0
Value of total assets at beginning of year	2019-08-31	$6,759,887
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-08-31	$47,195
Total interest from all sources	2019-08-31	$2,650
Total dividends received (eg from common stock, registered investment company shares)	2019-08-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-08-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2019-08-31	$11,460
Administrative expenses professional fees incurred	2019-08-31	$12,141
Was this plan covered by a fidelity bond	2019-08-31	Yes
Value of fidelity bond cover	2019-08-31	$500,000
If this is an individual account plan, was there a blackout period	2019-08-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-08-31	No
Participant contributions at end of year	2019-08-31	$0
Participant contributions at beginning of year	2019-08-31	$116,094
Income. Received or receivable in cash from other sources (including rollovers)	2019-08-31	$0
Other income not declared elsewhere	2019-08-31	$9,898
Administrative expenses (other) incurred	2019-08-31	$23,408
Total non interest bearing cash at end of year	2019-08-31	$0
Total non interest bearing cash at beginning of year	2019-08-31	$34,233
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-08-31	No
Value of net income/loss	2019-08-31	$-6,759,887
Value of net assets at end of year (total assets less liabilities)	2019-08-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2019-08-31	$6,759,887
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-08-31	No
Were any leases to which the plan was party in default or uncollectible	2019-08-31	No
Investment advisory and management fees	2019-08-31	$10,711
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-08-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-08-31	$6,609,560
Interest on participant loans	2019-08-31	$2,650
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-08-31	$748,231
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-08-31	No
Was there a failure to transmit to the plan any participant contributions	2019-08-31	No
Has the plan failed to provide any benefit when due under the plan	2019-08-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-08-31	$7,463,473
Contract administrator fees	2019-08-31	$935
Did the plan have assets held for investment	2019-08-31	No
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	2019-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-08-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-08-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-08-31	Disclaimer
Accountancy firm name	2019-08-31	TRAVELLER AND COMPANY, LLC
Accountancy firm EIN	2019-08-31	870668060
2018 : THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$-444,877
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$1,482,959
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,366,818
Expenses. Certain deemed distributions of participant loans	2018-12-31	$78,274
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$0
Value of total assets at end of year	2018-12-31	$6,759,887
Value of total assets at beginning of year	2018-12-31	$8,687,723
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$37,867
Total interest from all sources	2018-12-31	$6,866
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Participant contributions at end of year	2018-12-31	$116,094
Participant contributions at beginning of year	2018-12-31	$277,459
Administrative expenses (other) incurred	2018-12-31	$37,867
Total non interest bearing cash at end of year	2018-12-31	$34,233
Total non interest bearing cash at beginning of year	2018-12-31	$42,023
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-1,927,836
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$6,759,887
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$8,687,723
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$6,609,560
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$8,368,241
Interest on participant loans	2018-12-31	$6,866
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-451,743
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,366,818
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	TRAVELLER AND COMPANY, LLC
Accountancy firm EIN	2018-12-31	870668060
2017 : THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$1,277,690
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$2,716,689
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$2,681,603
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$0
Value of total assets at end of year	2017-12-31	$8,687,723
Value of total assets at beginning of year	2017-12-31	$10,126,722
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$35,086
Total interest from all sources	2017-12-31	$14,273
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	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$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
Participant contributions at end of year	2017-12-31	$277,459
Participant contributions at beginning of year	2017-12-31	$405,057
Total non interest bearing cash at end of year	2017-12-31	$42,023
Total non interest bearing cash at beginning of year	2017-12-31	$42,023
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	$-1,438,999
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$8,687,723
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$10,126,722
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
Investment advisory and management fees	2017-12-31	$26,826
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$8,368,241
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$9,679,642
Interest on participant loans	2017-12-31	$14,273
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$1,263,417
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$2,681,603
Contract administrator fees	2017-12-31	$8,260
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	TRAVELLER AND COMPANY, LLC
Accountancy firm EIN	2017-12-31	870668060
2016 : THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,326,218
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$9,980,340
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$9,922,001
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$399,277
Value of total assets at end of year	2016-12-31	$10,126,722
Value of total assets at beginning of year	2016-12-31	$18,780,844
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$58,339
Total interest from all sources	2016-12-31	$26,840
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	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Administrative expenses professional fees incurred	2016-12-31	$34,067
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$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	$399,277
Participant contributions at end of year	2016-12-31	$405,057
Participant contributions at beginning of year	2016-12-31	$892,300
Total non interest bearing cash at end of year	2016-12-31	$42,023
Total non interest bearing cash at beginning of year	2016-12-31	$51,940
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	$-8,654,122
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$10,126,722
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$18,780,844
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 registered invesment companies (eg mutual funds) at end of year	2016-12-31	$9,679,642
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$17,836,604
Interest on participant loans	2016-12-31	$26,840
Net investment gain/loss from pooled separate accounts	2016-12-31	$900,101
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$9,922,001
Contract administrator fees	2016-12-31	$24,272
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	TRAVELLER AND COMPANY, LLC
Accountancy firm EIN	2016-12-31	870668060
2015 : THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING 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	$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	$1,054,840
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$3,169,845
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$2,995,135
Expenses. Certain deemed distributions of participant loans	2015-12-31	$100,165
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,248,059
Value of total assets at end of year	2015-12-31	$18,780,844
Value of total assets at beginning of year	2015-12-31	$20,895,849
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$74,545
Total interest from all sources	2015-12-31	$41,137
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
Administrative expenses professional fees incurred	2015-12-31	$15,487
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
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$1,064,126
Participant contributions at end of year	2015-12-31	$892,300
Participant contributions at beginning of year	2015-12-31	$1,078,588
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$183,933
Total non interest bearing cash at end of year	2015-12-31	$51,940
Total non interest bearing cash at beginning of year	2015-12-31	$72,327
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	$-2,115,005
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$18,780,844
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$20,895,849
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 registered invesment companies (eg mutual funds) at end of year	2015-12-31	$17,836,604
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$19,744,934
Interest on participant loans	2015-12-31	$41,137
Net investment gain/loss from pooled separate accounts	2015-12-31	$-234,356
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$2,995,135
Contract administrator fees	2015-12-31	$59,058
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	TRAVELLER AND COMPANY, LLC
Accountancy firm EIN	2015-12-31	870668060
2014 : THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 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	$504,852
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,092,172
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,070,977
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$272,626
Value of total assets at end of year	2014-12-31	$20,895,849
Value of total assets at beginning of year	2014-12-31	$21,483,169
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$21,195
Total interest from all sources	2014-12-31	$11,444
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
Administrative expenses professional fees incurred	2014-12-31	$16,406
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	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$248,668
Participant contributions at end of year	2014-12-31	$1,078,588
Participant contributions at beginning of year	2014-12-31	$1,101,507
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$23,958
Total non interest bearing cash at end of year	2014-12-31	$72,327
Total non interest bearing cash at beginning of year	2014-12-31	$90,322
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	$-587,320
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$20,895,849
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$21,483,169
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 registered invesment companies (eg mutual funds) at end of year	2014-12-31	$19,744,934
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$20,291,340
Interest on participant loans	2014-12-31	$11,444
Net investment gain/loss from pooled separate accounts	2014-12-31	$220,782
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	$1,070,977
Contract administrator fees	2014-12-31	$4,789
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	TRAVELLER AND COMPANY, LLC
Accountancy firm EIN	2014-12-31	870668060
Total unrealized appreciation/depreciation of assets	2014-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-09-30	$29
Total income from all sources (including contributions)	2014-09-30	$3,040,765
Total loss/gain on sale of assets	2014-09-30	$0
Total of all expenses incurred	2014-09-30	$4,575,171
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-09-30	$4,495,664
Value of total corrective distributions	2014-09-30	$2,702
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-09-30	$1,121,596
Value of total assets at end of year	2014-09-30	$21,483,169
Value of total assets at beginning of year	2014-09-30	$23,017,604
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-09-30	$76,805
Total interest from all sources	2014-09-30	$48,405
Total dividends received (eg from common stock, registered investment company shares)	2014-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-09-30	No
Administrative expenses professional fees incurred	2014-09-30	$7,139
Was this plan covered by a fidelity bond	2014-09-30	Yes
Value of fidelity bond cover	2014-09-30	$500,000
If this is an individual account plan, was there a blackout period	2014-09-30	No
Were there any nonexempt tranactions with any party-in-interest	2014-09-30	No
Contributions received from participants	2014-09-30	$1,031,102
Participant contributions at end of year	2014-09-30	$1,101,507
Participant contributions at beginning of year	2014-09-30	$1,187,410
Income. Received or receivable in cash from other sources (including rollovers)	2014-09-30	$90,494
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-09-30	$29
Total non interest bearing cash at end of year	2014-09-30	$90,322
Total non interest bearing cash at beginning of year	2014-09-30	$97,025
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-09-30	No
Value of net income/loss	2014-09-30	$-1,534,406
Value of net assets at end of year (total assets less liabilities)	2014-09-30	$21,483,169
Value of net assets at beginning of year (total assets less liabilities)	2014-09-30	$23,017,575
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-09-30	No
Were any leases to which the plan was party in default or uncollectible	2014-09-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-09-30	$20,291,340
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-09-30	$21,733,169
Interest on participant loans	2014-09-30	$48,405
Net investment gain/loss from pooled separate accounts	2014-09-30	$1,870,764
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-09-30	No
Was there a failure to transmit to the plan any participant contributions	2014-09-30	No
Has the plan failed to provide any benefit when due under the plan	2014-09-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-09-30	$4,495,664
Contract administrator fees	2014-09-30	$69,666
Did the plan have assets held for investment	2014-09-30	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	2014-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-09-30	Disclaimer
Accountancy firm name	2014-09-30	TRAVELLER AND COMPANY, LLC
Accountancy firm EIN	2014-09-30	870668060

Form 5500 Responses for THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN

2019: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	Yes
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING 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: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING 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: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING 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: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan funding arrangement – Trust	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement - Trust	Yes
2013: THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan funding arrangement – Trust	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

97216

Policy instance

Insurance contract or identification number	97216
Insurance policy start date	2019-01-01
Insurance policy end date	2019-08-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $40,104
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
Amount paid for insurance broker fees	40104
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

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

Policy contract number

97216

Policy instance

Insurance contract or identification number	97216
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $19,401
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
Amount paid for insurance broker fees	19401
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

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

Policy contract number

97216

Policy instance

Insurance contract or identification number	97216
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $7,915
Total amount of fees paid to insurance company	USD $13,704
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
Commission paid to Insurance Broker	USD $7,915
Insurance broker organization code?	3
Amount paid for insurance broker fees	13704
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	NATIONAL BENEFIT SERVICES, LLC

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

Policy contract number

97216

Policy instance

Insurance contract or identification number	97216
Number of Individuals Covered	890
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $18,561
Total amount of fees paid to insurance company	USD $23,543
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
Commission paid to Insurance Broker	USD $13,315
Insurance broker organization code?	3
Amount paid for insurance broker fees	23543
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	NATIONAL BENEFIT SERVICES, LLC

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

Policy contract number

97216

Policy instance

Insurance contract or identification number	97216
Number of Individuals Covered	890
Insurance policy start date	2014-10-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $18,561
Total amount of fees paid to insurance company	USD $23,543
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
Commission paid to Insurance Broker	USD $5,246
Amount paid for insurance broker fees	23543
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5
Insurance broker name	EDWARD D. JONES & COMPANY

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

Policy contract number

97216

Policy instance

Insurance contract or identification number	97216
Number of Individuals Covered	780
Insurance policy start date	2013-10-01
Insurance policy end date	2014-09-30
Total amount of commissions paid to insurance broker	USD $66,616
Total amount of fees paid to insurance company	USD $35,265
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
Commission paid to Insurance Broker	USD $56,198
Insurance broker organization code?	3
Amount paid for insurance broker fees	24547
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	GRANT THORNTON

Potentially related plans

THE SPARK'S NUGGET, INC. EMPLOYEES' PROFIT SHARING PLAN [EIN = 880087882]

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Company Name:	SHELTI OPCO, LLC
Employer identification number (EIN):	800903202
NAIC Classification:	713200
NAIC Description:	Gambling Industries