401k Plan data: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN plan

THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	001

THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) 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.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

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

Company Name: THE LAKES COUNTRY CLUB ASSOCIATION, INC.

Employer identification number (EIN): 953792265

NAIC Classification: 713900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-07-01 TODD CHALOUX 2023-04-11 TODD CHALOUX 2023-04-11
001 2020-07-01
001 2019-07-01
001 2018-07-01
001 2017-07-01
001 2016-07-01 NICHOLE FESTA
001 2015-07-01 NICHOLE FESTA
001 2014-07-01 NICHOLE FESTA
001 2013-07-01 RENE BUNSE
001 2012-07-01 RENE BUNSE
001 2012-01-01 NICHOLE FESTA 2013-03-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2021-07-01	TODD CHALOUX	2023-04-11	TODD CHALOUX	2023-04-11
001	2020-07-01
001	2019-07-01
001	2018-07-01
001	2017-07-01
001	2016-07-01	NICHOLE FESTA
001	2015-07-01	NICHOLE FESTA
001	2014-07-01	NICHOLE FESTA
001	2013-07-01	RENE BUNSE
001	2012-07-01	RENE BUNSE
001	2012-01-01	NICHOLE FESTA	2013-03-13

Plan Statistics for THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2021: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-07-01 136
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 122
Number of retired or separated participants receiving benefits 2021-07-01 0
Number of other retired or separated participants entitled to future benefits 2021-07-01 23
Total of all active and inactive participants 2021-07-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-07-01 0
Total participants 2021-07-01 145
Number of participants with account balances 2021-07-01 105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-07-01 0
2020: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 135
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 112
Number of retired or separated participants receiving benefits 2020-07-01 0
Number of other retired or separated participants entitled to future benefits 2020-07-01 24
Total of all active and inactive participants 2020-07-01 136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-07-01 0
Total participants 2020-07-01 136
Number of participants with account balances 2020-07-01 98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-07-01 0
2019: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 141
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 117
Number of retired or separated participants receiving benefits 2019-07-01 0
Number of other retired or separated participants entitled to future benefits 2019-07-01 18
Total of all active and inactive participants 2019-07-01 135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-07-01 0
Total participants 2019-07-01 135
Number of participants with account balances 2019-07-01 100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-07-01 0
2018: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 137
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 127
Number of retired or separated participants receiving benefits 2018-07-01 0
Number of other retired or separated participants entitled to future benefits 2018-07-01 14
Total of all active and inactive participants 2018-07-01 141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-07-01 0
Total participants 2018-07-01 141
Number of participants with account balances 2018-07-01 97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-07-01 0
2017: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 145
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 125
Number of retired or separated participants receiving benefits 2017-07-01 0
Number of other retired or separated participants entitled to future benefits 2017-07-01 12
Total of all active and inactive participants 2017-07-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-07-01 0
Total participants 2017-07-01 137
Number of participants with account balances 2017-07-01 94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-07-01 0
2016: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 131
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 130
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 15
Total of all active and inactive participants 2016-07-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 0
Total participants 2016-07-01 145
Number of participants with account balances 2016-07-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 0
2015: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 127
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 83
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 48
Total of all active and inactive participants 2015-07-01 131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 0
Total participants 2015-07-01 131
Number of participants with account balances 2015-07-01 102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 0
2014: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 108
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 74
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 53
Total of all active and inactive participants 2014-07-01 127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 127
Number of participants with account balances 2014-07-01 100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 114
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 51
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 57
Total of all active and inactive participants 2013-07-01 108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 108
Number of participants with account balances 2013-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 0
2012: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 82
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 63
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 51
Total of all active and inactive participants 2012-07-01 114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 114
Number of participants with account balances 2012-07-01 112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 0

Measure	Date	Value
2021: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-07-01	136
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	122
Number of retired or separated participants receiving benefits	2021-07-01	0
Number of other retired or separated participants entitled to future benefits	2021-07-01	23
Total of all active and inactive participants	2021-07-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-07-01	0
Total participants	2021-07-01	145
Number of participants with account balances	2021-07-01	105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-07-01	0
2020: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	135
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	112
Number of retired or separated participants receiving benefits	2020-07-01	0
Number of other retired or separated participants entitled to future benefits	2020-07-01	24
Total of all active and inactive participants	2020-07-01	136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-07-01	0
Total participants	2020-07-01	136
Number of participants with account balances	2020-07-01	98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-07-01	0
2019: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	141
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	117
Number of retired or separated participants receiving benefits	2019-07-01	0
Number of other retired or separated participants entitled to future benefits	2019-07-01	18
Total of all active and inactive participants	2019-07-01	135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-07-01	0
Total participants	2019-07-01	135
Number of participants with account balances	2019-07-01	100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-07-01	0
2018: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	137
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	127
Number of retired or separated participants receiving benefits	2018-07-01	0
Number of other retired or separated participants entitled to future benefits	2018-07-01	14
Total of all active and inactive participants	2018-07-01	141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-07-01	0
Total participants	2018-07-01	141
Number of participants with account balances	2018-07-01	97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-07-01	0
2017: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	145
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	125
Number of retired or separated participants receiving benefits	2017-07-01	0
Number of other retired or separated participants entitled to future benefits	2017-07-01	12
Total of all active and inactive participants	2017-07-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-07-01	0
Total participants	2017-07-01	137
Number of participants with account balances	2017-07-01	94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-07-01	0
2016: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	131
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	130
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	15
Total of all active and inactive participants	2016-07-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	0
Total participants	2016-07-01	145
Number of participants with account balances	2016-07-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	0
2015: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	127
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	83
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	48
Total of all active and inactive participants	2015-07-01	131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	0
Total participants	2015-07-01	131
Number of participants with account balances	2015-07-01	102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
2014: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	108
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	74
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	53
Total of all active and inactive participants	2014-07-01	127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	127
Number of participants with account balances	2014-07-01	100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	114
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	51
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	57
Total of all active and inactive participants	2013-07-01	108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	108
Number of participants with account balances	2013-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	0
2012: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	82
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	63
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	51
Total of all active and inactive participants	2012-07-01	114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	114
Number of participants with account balances	2012-07-01	112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	0

Financial Data on THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2022 : THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total income from all sources (including contributions)	2022-06-30	$-333,501
Total loss/gain on sale of assets	2022-06-30	$0
Total of all expenses incurred	2022-06-30	$339,647
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-06-30	$337,447
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-06-30	$377,397
Value of total assets at end of year	2022-06-30	$3,899,473
Value of total assets at beginning of year	2022-06-30	$4,572,621
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-06-30	$2,200
Total interest from all sources	2022-06-30	$484,934
Total dividends received (eg from common stock, registered investment company shares)	2022-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-06-30	No
Administrative expenses professional fees incurred	2022-06-30	$2,200
Was this plan covered by a fidelity bond	2022-06-30	Yes
Value of fidelity bond cover	2022-06-30	$500,000
If this is an individual account plan, was there a blackout period	2022-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2022-06-30	No
Contributions received from participants	2022-06-30	$232,502
Participant contributions at end of year	2022-06-30	$167,419
Participant contributions at beginning of year	2022-06-30	$236,721
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Value of net income/loss	2022-06-30	$-673,148
Value of net assets at end of year (total assets less liabilities)	2022-06-30	$3,899,473
Value of net assets at beginning of year (total assets less liabilities)	2022-06-30	$4,572,621
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-06-30	No
Were any leases to which the plan was party in default or uncollectible	2022-06-30	No
Value of interest in pooled separate accounts at end of year	2022-06-30	$3,429,267
Value of interest in pooled separate accounts at beginning of year	2022-06-30	$3,748,046
Interest on participant loans	2022-06-30	$8,614
Value of interest in common/collective trusts at end of year	2022-06-30	$0
Value of interest in common/collective trusts at beginning of year	2022-06-30	$286,535
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-06-30	$476,320
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-06-30	$302,787
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-06-30	$295,905
Net investment gain/loss from pooled separate accounts	2022-06-30	$-1,195,832
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-06-30	No
Was there a failure to transmit to the plan any participant contributions	2022-06-30	No
Has the plan failed to provide any benefit when due under the plan	2022-06-30	No
Contributions received in cash from employer	2022-06-30	$144,895
Employer contributions (assets) at end of year	2022-06-30	$0
Employer contributions (assets) at beginning of year	2022-06-30	$5,414
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-06-30	$337,447
Did the plan have assets held for investment	2022-06-30	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	2022-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-06-30	No
Opinion of an independent qualified public accountant for this plan	2022-06-30	Disclaimer
Accountancy firm name	2022-06-30	COACHELLA VALLEY ACCOUNTING & AUDIT
Accountancy firm EIN	2022-06-30	872516350
2021 : THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$0
Total income from all sources (including contributions)	2021-06-30	$1,246,355
Total loss/gain on sale of assets	2021-06-30	$0
Total of all expenses incurred	2021-06-30	$113,009
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-06-30	$110,993
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-06-30	$353,191
Value of total assets at end of year	2021-06-30	$4,572,621
Value of total assets at beginning of year	2021-06-30	$3,439,275
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-06-30	$2,016
Total interest from all sources	2021-06-30	$196,908
Total dividends received (eg from common stock, registered investment company shares)	2021-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-06-30	No
Administrative expenses professional fees incurred	2021-06-30	$2,016
Was this plan covered by a fidelity bond	2021-06-30	Yes
Value of fidelity bond cover	2021-06-30	$500,000
If this is an individual account plan, was there a blackout period	2021-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2021-06-30	No
Contributions received from participants	2021-06-30	$207,943
Participant contributions at end of year	2021-06-30	$236,721
Participant contributions at beginning of year	2021-06-30	$273,626
Income. Received or receivable in cash from other sources (including rollovers)	2021-06-30	$8,131
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Value of net income/loss	2021-06-30	$1,133,346
Value of net assets at end of year (total assets less liabilities)	2021-06-30	$4,572,621
Value of net assets at beginning of year (total assets less liabilities)	2021-06-30	$3,439,275
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-06-30	No
Were any leases to which the plan was party in default or uncollectible	2021-06-30	No
Value of interest in pooled separate accounts at end of year	2021-06-30	$3,748,046
Value of interest in pooled separate accounts at beginning of year	2021-06-30	$2,667,287
Interest on participant loans	2021-06-30	$10,991
Value of interest in common/collective trusts at end of year	2021-06-30	$286,535
Value of interest in common/collective trusts at beginning of year	2021-06-30	$202,659
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-06-30	$185,917
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-06-30	$295,905
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-06-30	$295,703
Net investment gain/loss from pooled separate accounts	2021-06-30	$696,256
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-06-30	No
Was there a failure to transmit to the plan any participant contributions	2021-06-30	No
Has the plan failed to provide any benefit when due under the plan	2021-06-30	No
Contributions received in cash from employer	2021-06-30	$137,117
Employer contributions (assets) at end of year	2021-06-30	$5,414
Employer contributions (assets) at beginning of year	2021-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-06-30	$110,993
Did the plan have assets held for investment	2021-06-30	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	2021-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-06-30	No
Opinion of an independent qualified public accountant for this plan	2021-06-30	Disclaimer
Accountancy firm name	2021-06-30	COACHELLA VALLEY ACCOUNTING & AUDIT
Accountancy firm EIN	2021-06-30	872516350
2020 : THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$0
Total income from all sources (including contributions)	2020-06-30	$459,107
Total loss/gain on sale of assets	2020-06-30	$0
Total of all expenses incurred	2020-06-30	$181,143
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-06-30	$176,669
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-06-30	$317,504
Value of total assets at end of year	2020-06-30	$3,439,275
Value of total assets at beginning of year	2020-06-30	$3,161,311
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-06-30	$4,474
Total interest from all sources	2020-06-30	$140,158
Total dividends received (eg from common stock, registered investment company shares)	2020-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-06-30	No
Administrative expenses professional fees incurred	2020-06-30	$4,474
Was this plan covered by a fidelity bond	2020-06-30	Yes
Value of fidelity bond cover	2020-06-30	$500,000
If this is an individual account plan, was there a blackout period	2020-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2020-06-30	No
Contributions received from participants	2020-06-30	$187,889
Participant contributions at end of year	2020-06-30	$273,626
Participant contributions at beginning of year	2020-06-30	$196,228
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Value of net income/loss	2020-06-30	$277,964
Value of net assets at end of year (total assets less liabilities)	2020-06-30	$3,439,275
Value of net assets at beginning of year (total assets less liabilities)	2020-06-30	$3,161,311
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-06-30	No
Were any leases to which the plan was party in default or uncollectible	2020-06-30	No
Value of interest in pooled separate accounts at end of year	2020-06-30	$2,667,287
Value of interest in pooled separate accounts at beginning of year	2020-06-30	$2,394,773
Interest on participant loans	2020-06-30	$8,957
Value of interest in common/collective trusts at end of year	2020-06-30	$202,659
Value of interest in common/collective trusts at beginning of year	2020-06-30	$191,593
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-06-30	$131,201
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-06-30	$295,703
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-06-30	$378,717
Net investment gain/loss from pooled separate accounts	2020-06-30	$1,445
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-06-30	No
Was there a failure to transmit to the plan any participant contributions	2020-06-30	No
Has the plan failed to provide any benefit when due under the plan	2020-06-30	No
Contributions received in cash from employer	2020-06-30	$129,615
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-06-30	$176,669
Did the plan have assets held for investment	2020-06-30	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	2020-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2020-06-30	Disclaimer
Accountancy firm name	2020-06-30	LUND & GUTTRY, LLP
Accountancy firm EIN	2020-06-30	952101327
2019 : THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$0
Total income from all sources (including contributions)	2019-06-30	$512,836
Total loss/gain on sale of assets	2019-06-30	$0
Total of all expenses incurred	2019-06-30	$211,026
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-06-30	$206,441
Expenses. Certain deemed distributions of participant loans	2019-06-30	$1,413
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-06-30	$351,482
Value of total assets at end of year	2019-06-30	$3,161,311
Value of total assets at beginning of year	2019-06-30	$2,859,501
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-06-30	$3,172
Total interest from all sources	2019-06-30	$157,679
Total dividends received (eg from common stock, registered investment company shares)	2019-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-06-30	No
Administrative expenses professional fees incurred	2019-06-30	$3,172
Was this plan covered by a fidelity bond	2019-06-30	Yes
Value of fidelity bond cover	2019-06-30	$500,000
If this is an individual account plan, was there a blackout period	2019-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2019-06-30	No
Contributions received from participants	2019-06-30	$211,701
Participant contributions at end of year	2019-06-30	$196,228
Participant contributions at beginning of year	2019-06-30	$195,089
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Value of net income/loss	2019-06-30	$301,810
Value of net assets at end of year (total assets less liabilities)	2019-06-30	$3,161,311
Value of net assets at beginning of year (total assets less liabilities)	2019-06-30	$2,859,501
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-06-30	No
Were any leases to which the plan was party in default or uncollectible	2019-06-30	No
Value of interest in pooled separate accounts at end of year	2019-06-30	$2,394,773
Value of interest in pooled separate accounts at beginning of year	2019-06-30	$2,399,889
Income. Interest from loans (other than to participants)	2019-06-30	$7,093
Interest earned on other investments	2019-06-30	$1,298
Value of interest in common/collective trusts at end of year	2019-06-30	$191,593
Value of interest in common/collective trusts at beginning of year	2019-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-06-30	$149,288
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-06-30	$378,717
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-06-30	$264,523
Net investment gain/loss from pooled separate accounts	2019-06-30	$3,675
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-06-30	No
Was there a failure to transmit to the plan any participant contributions	2019-06-30	No
Has the plan failed to provide any benefit when due under the plan	2019-06-30	No
Contributions received in cash from employer	2019-06-30	$139,781
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-06-30	$206,441
Did the plan have assets held for investment	2019-06-30	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	2019-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2019-06-30	Disclaimer
Accountancy firm name	2019-06-30	LUND & GUTTRY, LLP
Accountancy firm EIN	2019-06-30	952101327
2018 : THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Total income from all sources (including contributions)	2018-06-30	$577,727
Total loss/gain on sale of assets	2018-06-30	$0
Total of all expenses incurred	2018-06-30	$221,063
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-06-30	$217,683
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-06-30	$337,567
Value of total assets at end of year	2018-06-30	$2,859,501
Value of total assets at beginning of year	2018-06-30	$2,502,837
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-06-30	$3,380
Total interest from all sources	2018-06-30	$124,603
Total dividends received (eg from common stock, registered investment company shares)	2018-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-06-30	No
Administrative expenses professional fees incurred	2018-06-30	$3,380
Was this plan covered by a fidelity bond	2018-06-30	Yes
Value of fidelity bond cover	2018-06-30	$500,000
If this is an individual account plan, was there a blackout period	2018-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2018-06-30	No
Contributions received from participants	2018-06-30	$202,135
Participant contributions at end of year	2018-06-30	$195,089
Participant contributions at beginning of year	2018-06-30	$169,127
Income. Received or receivable in cash from other sources (including rollovers)	2018-06-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Income. Non cash contributions	2018-06-30	$0
Value of net income/loss	2018-06-30	$356,664
Value of net assets at end of year (total assets less liabilities)	2018-06-30	$2,859,501
Value of net assets at beginning of year (total assets less liabilities)	2018-06-30	$2,502,837
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-06-30	No
Were any leases to which the plan was party in default or uncollectible	2018-06-30	No
Value of interest in pooled separate accounts at end of year	2018-06-30	$2,399,889
Value of interest in pooled separate accounts at beginning of year	2018-06-30	$2,066,035
Interest on participant loans	2018-06-30	$5,050
Interest earned on other investments	2018-06-30	$8,311
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-06-30	$111,242
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-06-30	$264,523
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-06-30	$267,675
Net investment gain/loss from pooled separate accounts	2018-06-30	$115,557
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-06-30	No
Was there a failure to transmit to the plan any participant contributions	2018-06-30	No
Has the plan failed to provide any benefit when due under the plan	2018-06-30	No
Contributions received in cash from employer	2018-06-30	$135,432
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-06-30	$217,683
Did the plan have assets held for investment	2018-06-30	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	2018-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2018-06-30	Disclaimer
Accountancy firm name	2018-06-30	LUND & GUTTRY, LLP
Accountancy firm EIN	2018-06-30	952101327
2017 : THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total income from all sources (including contributions)	2017-06-30	$581,257
Total loss/gain on sale of assets	2017-06-30	$0
Total of all expenses incurred	2017-06-30	$292,583
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$288,492
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$296,810
Value of total assets at end of year	2017-06-30	$2,502,837
Value of total assets at beginning of year	2017-06-30	$2,214,163
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$4,091
Total interest from all sources	2017-06-30	$90,812
Total dividends received (eg from common stock, registered investment company shares)	2017-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-06-30	No
Administrative expenses professional fees incurred	2017-06-30	$4,091
Was this plan covered by a fidelity bond	2017-06-30	Yes
Value of fidelity bond cover	2017-06-30	$500,000
If this is an individual account plan, was there a blackout period	2017-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2017-06-30	No
Contributions received from participants	2017-06-30	$171,397
Participant contributions at end of year	2017-06-30	$169,127
Participant contributions at beginning of year	2017-06-30	$143,826
Income. Received or receivable in cash from other sources (including rollovers)	2017-06-30	$3,018
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Income. Non cash contributions	2017-06-30	$0
Value of net income/loss	2017-06-30	$288,674
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$2,502,837
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$2,214,163
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-06-30	No
Were any leases to which the plan was party in default or uncollectible	2017-06-30	No
Value of interest in pooled separate accounts at end of year	2017-06-30	$2,066,035
Value of interest in pooled separate accounts at beginning of year	2017-06-30	$1,850,908
Interest on participant loans	2017-06-30	$5,514
Interest earned on other investments	2017-06-30	$24,112
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-06-30	$61,186
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-06-30	$267,675
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-06-30	$219,429
Net investment gain/loss from pooled separate accounts	2017-06-30	$193,635
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-06-30	No
Was there a failure to transmit to the plan any participant contributions	2017-06-30	No
Has the plan failed to provide any benefit when due under the plan	2017-06-30	No
Contributions received in cash from employer	2017-06-30	$122,395
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$288,492
Did the plan have assets held for investment	2017-06-30	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	2017-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2017-06-30	Disclaimer
Accountancy firm name	2017-06-30	LUND & GUTTRY, LLP
Accountancy firm EIN	2017-06-30	952101327
2016 : THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total income from all sources (including contributions)	2016-06-30	$363,596
Total loss/gain on sale of assets	2016-06-30	$0
Total of all expenses incurred	2016-06-30	$327,316
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$317,644
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$353,441
Value of total assets at end of year	2016-06-30	$2,214,163
Value of total assets at beginning of year	2016-06-30	$2,177,883
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$9,672
Total interest from all sources	2016-06-30	$90,806
Total dividends received (eg from common stock, registered investment company shares)	2016-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Administrative expenses professional fees incurred	2016-06-30	$9,672
Was this plan covered by a fidelity bond	2016-06-30	Yes
Value of fidelity bond cover	2016-06-30	$500,000
If this is an individual account plan, was there a blackout period	2016-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2016-06-30	No
Contributions received from participants	2016-06-30	$180,377
Participant contributions at end of year	2016-06-30	$143,826
Participant contributions at beginning of year	2016-06-30	$185,720
Income. Received or receivable in cash from other sources (including rollovers)	2016-06-30	$59,310
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Value of net income/loss	2016-06-30	$36,280
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$2,214,163
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$2,177,883
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-06-30	No
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Value of interest in pooled separate accounts at end of year	2016-06-30	$1,850,908
Value of interest in pooled separate accounts at beginning of year	2016-06-30	$1,703,182
Interest on participant loans	2016-06-30	$5,687
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-06-30	$85,119
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-06-30	$219,429
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-06-30	$288,981
Net investment gain/loss from pooled separate accounts	2016-06-30	$-80,651
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-06-30	No
Was there a failure to transmit to the plan any participant contributions	2016-06-30	No
Has the plan failed to provide any benefit when due under the plan	2016-06-30	No
Contributions received in cash from employer	2016-06-30	$113,754
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$317,644
Did the plan have assets held for investment	2016-06-30	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	2016-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2016-06-30	Disclaimer
Accountancy firm name	2016-06-30	LUND & GUTTRY, LLP
Accountancy firm EIN	2016-06-30	952101327
2015 : THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total income from all sources (including contributions)	2015-06-30	$415,162
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$172,895
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$167,983
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$376,450
Value of total assets at end of year	2015-06-30	$2,177,883
Value of total assets at beginning of year	2015-06-30	$1,935,616
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$4,912
Total interest from all sources	2015-06-30	$101,227
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Administrative expenses professional fees incurred	2015-06-30	$4,912
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$500,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$163,198
Participant contributions at end of year	2015-06-30	$185,720
Participant contributions at beginning of year	2015-06-30	$124,482
Income. Received or receivable in cash from other sources (including rollovers)	2015-06-30	$109,567
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Income. Non cash contributions	2015-06-30	$0
Value of net income/loss	2015-06-30	$242,267
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$2,177,883
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$1,935,616
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Value of interest in pooled separate accounts at end of year	2015-06-30	$1,703,182
Value of interest in pooled separate accounts at beginning of year	2015-06-30	$1,403,447
Interest on participant loans	2015-06-30	$4,121
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-06-30	$97,106
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$288,981
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$407,687
Net investment gain/loss from pooled separate accounts	2015-06-30	$-62,515
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	No
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Contributions received in cash from employer	2015-06-30	$103,685
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$167,983
Did the plan have assets held for investment	2015-06-30	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	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-06-30	Disclaimer
Accountancy firm name	2015-06-30	LUND & GUTTRY, LLP
Accountancy firm EIN	2015-06-30	952101327
2014 : THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total income from all sources (including contributions)	2014-06-30	$453,354
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$136,931
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$135,147
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$245,727
Value of total assets at end of year	2014-06-30	$1,935,616
Value of total assets at beginning of year	2014-06-30	$1,619,193
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$1,784
Total interest from all sources	2014-06-30	$76,740
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$500,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$140,989
Participant contributions at end of year	2014-06-30	$124,482
Participant contributions at beginning of year	2014-06-30	$139,552
Income. Received or receivable in cash from other sources (including rollovers)	2014-06-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Income. Non cash contributions	2014-06-30	$0
Value of net income/loss	2014-06-30	$316,423
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$1,935,616
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$1,619,193
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of interest in pooled separate accounts at end of year	2014-06-30	$1,403,447
Value of interest in pooled separate accounts at beginning of year	2014-06-30	$1,157,002
Interest on participant loans	2014-06-30	$4,044
Interest earned on other investments	2014-06-30	$72,421
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-06-30	$275
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$407,687
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$322,639
Net investment gain/loss from pooled separate accounts	2014-06-30	$130,887
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Contributions received in cash from employer	2014-06-30	$104,738
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$135,147
Contract administrator fees	2014-06-30	$1,784
Did the plan have assets held for investment	2014-06-30	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	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	LUND & GUTTRY, LLP
Accountancy firm EIN	2014-06-30	952101327
2013 : THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2013-06-30	$0
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total transfer of assets to this plan	2013-06-30	$1,246,732
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total income from all sources (including contributions)	2013-06-30	$350,715
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$146,908
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$141,971
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$264,345
Value of total assets at end of year	2013-06-30	$1,619,193
Value of total assets at beginning of year	2013-06-30	$168,654
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$4,937
Total interest from all sources	2013-06-30	$54,428
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$500,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$152,755
Participant contributions at end of year	2013-06-30	$139,552
Participant contributions at beginning of year	2013-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-06-30	$6,620
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$203,807
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$1,619,193
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$168,654
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Value of interest in pooled separate accounts at end of year	2013-06-30	$1,157,002
Value of interest in pooled separate accounts at beginning of year	2013-06-30	$162,336
Income. Interest from loans (other than to participants)	2013-06-30	$4,604
Interest earned on other investments	2013-06-30	$49,098
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-06-30	$726
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$322,639
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$6,318
Net investment gain/loss from pooled separate accounts	2013-06-30	$31,942
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	No
Was there a failure to transmit to the plan any participant contributions	2013-06-30	No
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Contributions received in cash from employer	2013-06-30	$104,970
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$141,971
Contract administrator fees	2013-06-30	$4,937
Did the plan have assets held for investment	2013-06-30	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	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	LUND & GUTTRY, LLP
Accountancy firm EIN	2013-06-30	952101327

Form 5500 Responses for THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN

2021: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-07-01	Type of plan entity	Single employer plan
2021-07-01	Submission has been amended	No
2021-07-01	This submission is the final filing	No
2021-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-07-01	Plan is a collectively bargained plan	No
2021-07-01	Plan funding arrangement – Insurance	Yes
2021-07-01	Plan funding arrangement – Trust	Yes
2021-07-01	Plan benefit arrangement – Insurance	Yes
2021-07-01	Plan benefit arrangement - Trust	Yes
2020: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	Submission has been amended	No
2020-07-01	This submission is the final filing	No
2020-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-07-01	Plan is a collectively bargained plan	No
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan funding arrangement – Trust	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement - Trust	Yes
2019: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
2019-07-01	Submission has been amended	No
2019-07-01	This submission is the final filing	No
2019-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-07-01	Plan is a collectively bargained plan	No
2019-07-01	Plan funding arrangement – Insurance	Yes
2019-07-01	Plan funding arrangement – Trust	Yes
2019-07-01	Plan benefit arrangement – Insurance	Yes
2019-07-01	Plan benefit arrangement - Trust	Yes
2018: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-07-01	Type of plan entity	Single employer plan
2018-07-01	Submission has been amended	No
2018-07-01	This submission is the final filing	No
2018-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-07-01	Plan is a collectively bargained plan	No
2018-07-01	Plan funding arrangement – Insurance	Yes
2018-07-01	Plan funding arrangement – Trust	Yes
2018-07-01	Plan benefit arrangement – Insurance	Yes
2018-07-01	Plan benefit arrangement - Trust	Yes
2017: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan funding arrangement – Trust	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement - Trust	Yes
2016: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan funding arrangement – Trust	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement - Trust	Yes
2015: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: THE LAKES COUNTRY CLUB ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

754335-01

Policy instance

Insurance contract or identification number	754335-01
Number of Individuals Covered	104
Insurance policy start date	2022-04-23
Insurance policy end date	2022-06-30
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

GA-830425

Policy instance

Insurance contract or identification number	GA-830425
Number of Individuals Covered	0
Insurance policy start date	2021-07-01
Insurance policy end date	2022-04-22
Total amount of commissions paid to insurance broker	USD $17,167
Total amount of fees paid to insurance company	USD $2,146
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?	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 $17,167
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	PLAN ADMIN
Insurance broker organization code?	3

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

Policy contract number

GA-830425

Policy instance

Insurance contract or identification number	GA-830425
Number of Individuals Covered	98
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $13,853
Total amount of fees paid to insurance company	USD $1,732
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,853
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	PLAN ADMIN
Insurance broker organization code?	3

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

Policy contract number

GA-830425

Policy instance

Insurance contract or identification number	GA-830425
Number of Individuals Covered	98
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $11,858
Total amount of fees paid to insurance company	USD $1,477
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,858
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	PLAN ADMIN
Insurance broker organization code?	3

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

Policy contract number

GA-830425

Policy instance

Insurance contract or identification number	GA-830425
Number of Individuals Covered	97
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $10,773
Total amount of fees paid to insurance company	USD $1,347
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,773
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	PLAN ADMIN
Insurance broker organization code?	3

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

Policy contract number

GA-830425

Policy instance

Insurance contract or identification number	GA-830425
Number of Individuals Covered	93
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $9,817
Total amount of fees paid to insurance company	USD $1,227
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

GA-830425

Policy instance

Insurance contract or identification number	GA-830425
Number of Individuals Covered	102
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $7,998
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,998
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SERVICES

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

Policy contract number

GA-830425

Policy instance

Insurance contract or identification number	GA-830425
Number of Individuals Covered	100
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $7,439
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,439
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SERVICES

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

Policy contract number

GA-830425

Policy instance

Insurance contract or identification number	GA-830425
Number of Individuals Covered	108
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $6,364
Total amount of fees paid to insurance company	USD $342
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,319
Insurance broker organization code?	3
Amount paid for insurance broker fees	342
Additional information about fees paid to insurance broker	SALES/ MARKETING
Insurance broker name	MERRILL LYNCH, PENNER, FENNER

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

Policy contract number

GA-830425

Policy instance

Insurance contract or identification number	GA-830425
Number of Individuals Covered	110
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $10,227
Total amount of fees paid to insurance company	USD $5,399
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 $10,227
Insurance broker organization code?	3
Amount paid for insurance broker fees	5000
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	MERRILL LYNCH LIFE AGENCY

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Company Name:	THE LAKES COUNTRY CLUB ASSOCIATION, INC.
Employer identification number (EIN):	953792265
NAIC Classification:	713900