401k Plan data: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN plan

FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 401k Plan overview

Plan Name	FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN
Plan identification number	553

FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Prepaid legal Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

FORMED FIBER TECHNOLOGIES has sponsored the creation of one or more 401k plans.

Company Name: FORMED FIBER TECHNOLOGIES

Employer identification number (EIN): 010396065

NAIC Classification: 336300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
553 2015-01-01 JESSICA PALLADINO JESSICA PALLADINO 2016-10-07
553 2012-01-01 JESSICA L PALLADINO
553 2011-01-01 FREDERICK FROHARDT
553 2010-01-01 FREDERICK FROHARDT
553 2009-01-01 FREDERICK FROHARDT

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
553	2015-01-01	JESSICA PALLADINO	JESSICA PALLADINO	2016-10-07
553	2012-01-01	JESSICA L PALLADINO
553	2011-01-01	FREDERICK FROHARDT
553	2010-01-01	FREDERICK FROHARDT
553	2009-01-01	FREDERICK FROHARDT

Plan Statistics for FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN

401k plan membership statisitcs for FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN

Measure Date Value
2015: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 55
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 68
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 68
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 68
Number of participants with account balances 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
Number of employers contributing to the scheme 2015-01-01 0
2012: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 53
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 82
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 82
2011: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 48
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 53
Total of all active and inactive participants 2011-01-01 53
Total participants 2011-01-01 53
2010: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 45
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 48
Total of all active and inactive participants 2010-01-01 48
Total participants 2010-01-01 48
2009: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 80
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 45
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 45
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 45

Measure	Date	Value
2015: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	55
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	68
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	68
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	68
Number of participants with account balances	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
Number of employers contributing to the scheme	2015-01-01	0
2012: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	53
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	82
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	82
2011: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	48
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	53
Total of all active and inactive participants	2011-01-01	53
Total participants	2011-01-01	53
2010: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	45
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	48
Total of all active and inactive participants	2010-01-01	48
Total participants	2010-01-01	48
2009: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	80
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	45
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	45
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	45

Form 5500 Responses for FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN

2015: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2012: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: FORMED FIBER TECHNOLOGIES, INC. LEGAL SERVICES PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	FORMED FIBER TECHNOLOGIES
Employer identification number (EIN):	010396065
NAIC Classification:	336300