401k Plan data: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN plan

EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 401k Plan overview

Plan Name	EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN
Plan identification number	002

EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

EVERGREEN CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: EVERGREEN CENTER, INC.

Employer identification number (EIN): 042753469

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2021-07-01 ROBERT F. LITTLETON, JR. 2023-03-29
002 2020-07-01 ROBERT F. LITTLETON, JR. 2022-04-13
002 2019-07-01
002 2018-07-01
002 2017-07-01
002 2016-07-01 ROBERT F. LITTLETON, JR.
002 2015-07-01 ROBERT F. LITTLETON, JR.
002 2014-07-01 ROBERT F. LITTLETON, JR.
002 2013-07-01 ROBERT F. LITTLETON, JR.
002 2012-07-01 ROBERT F. LITTLETON, JR.
002 2011-07-01 ROBERT F. LITTLETON, JR.
002 2009-07-01 ROBERT F. LITTLETON, JR ROBERT F. LITTLETON, JR. 2011-04-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2021-07-01	ROBERT F. LITTLETON, JR.	2023-03-29
002	2020-07-01	ROBERT F. LITTLETON, JR.	2022-04-13
002	2019-07-01
002	2018-07-01
002	2017-07-01
002	2016-07-01	ROBERT F. LITTLETON, JR.
002	2015-07-01	ROBERT F. LITTLETON, JR.
002	2014-07-01	ROBERT F. LITTLETON, JR.
002	2013-07-01	ROBERT F. LITTLETON, JR.
002	2012-07-01	ROBERT F. LITTLETON, JR.
002	2011-07-01	ROBERT F. LITTLETON, JR.
002	2009-07-01	ROBERT F. LITTLETON, JR		ROBERT F. LITTLETON, JR.	2011-04-12

Plan Statistics for EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN

401k plan membership statisitcs for EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN

Measure Date Value
2021: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-07-01 525
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 265
Number of retired or separated participants receiving benefits 2021-07-01 0
Number of other retired or separated participants entitled to future benefits 2021-07-01 113
Total of all active and inactive participants 2021-07-01 378
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-07-01 1
Total participants 2021-07-01 379
Number of participants with account balances 2021-07-01 212
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-07-01 0
2020: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 432
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 430
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 95
Total of all active and inactive participants 2020-07-01 525
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-07-01 0
Total participants 2020-07-01 525
Number of participants with account balances 2020-07-01 211
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-07-01 0
2019: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 446
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 328
Number of retired or separated participants receiving benefits 2019-07-01 0
Number of other retired or separated participants entitled to future benefits 2019-07-01 104
Total of all active and inactive participants 2019-07-01 432
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-07-01 0
Total participants 2019-07-01 432
Number of participants with account balances 2019-07-01 205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-07-01 0
2018: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 435
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 345
Number of retired or separated participants receiving benefits 2018-07-01 0
Number of other retired or separated participants entitled to future benefits 2018-07-01 101
Total of all active and inactive participants 2018-07-01 446
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-07-01 0
Total participants 2018-07-01 446
Number of participants with account balances 2018-07-01 194
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-07-01 0
2017: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 407
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 342
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 93
Total of all active and inactive participants 2017-07-01 435
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-07-01 0
Total participants 2017-07-01 435
Number of participants with account balances 2017-07-01 194
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-07-01 0
2016: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 418
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 315
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 92
Total of all active and inactive participants 2016-07-01 407
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 0
Total participants 2016-07-01 407
Number of participants with account balances 2016-07-01 177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 0
2015: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 419
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 326
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 92
Total of all active and inactive participants 2015-07-01 418
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 0
Total participants 2015-07-01 418
Number of participants with account balances 2015-07-01 168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 0
2014: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 414
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 340
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 78
Total of all active and inactive participants 2014-07-01 418
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 1
Total participants 2014-07-01 419
Number of participants with account balances 2014-07-01 166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 397
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 342
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 72
Total of all active and inactive participants 2013-07-01 414
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 414
Number of participants with account balances 2013-07-01 157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 0
2012: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 388
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 337
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 59
Total of all active and inactive participants 2012-07-01 396
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 396
Number of participants with account balances 2012-07-01 137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 0
2011: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 367
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 342
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 46
Total of all active and inactive participants 2011-07-01 388
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 388
Number of participants with account balances 2011-07-01 118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0
2009: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 334
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 302
Number of retired or separated participants receiving benefits 2009-07-01 0
Number of other retired or separated participants entitled to future benefits 2009-07-01 41
Total of all active and inactive participants 2009-07-01 343
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 343
Number of participants with account balances 2009-07-01 101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 0

Measure	Date	Value
2021: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-07-01	525
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	265
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	113
Total of all active and inactive participants	2021-07-01	378
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-07-01	1
Total participants	2021-07-01	379
Number of participants with account balances	2021-07-01	212
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-07-01	0
2020: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	432
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	430
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	95
Total of all active and inactive participants	2020-07-01	525
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-07-01	0
Total participants	2020-07-01	525
Number of participants with account balances	2020-07-01	211
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-07-01	0
2019: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	446
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	328
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	104
Total of all active and inactive participants	2019-07-01	432
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-07-01	0
Total participants	2019-07-01	432
Number of participants with account balances	2019-07-01	205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-07-01	0
2018: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	435
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	345
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	101
Total of all active and inactive participants	2018-07-01	446
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-07-01	0
Total participants	2018-07-01	446
Number of participants with account balances	2018-07-01	194
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-07-01	0
2017: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	407
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	342
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	93
Total of all active and inactive participants	2017-07-01	435
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-07-01	0
Total participants	2017-07-01	435
Number of participants with account balances	2017-07-01	194
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-07-01	0
2016: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	418
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	315
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	92
Total of all active and inactive participants	2016-07-01	407
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	0
Total participants	2016-07-01	407
Number of participants with account balances	2016-07-01	177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	0
2015: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	419
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	326
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	92
Total of all active and inactive participants	2015-07-01	418
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	0
Total participants	2015-07-01	418
Number of participants with account balances	2015-07-01	168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
2014: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	414
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	340
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	78
Total of all active and inactive participants	2014-07-01	418
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	1
Total participants	2014-07-01	419
Number of participants with account balances	2014-07-01	166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	397
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	342
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	72
Total of all active and inactive participants	2013-07-01	414
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	414
Number of participants with account balances	2013-07-01	157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	0
2012: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	388
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	337
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	59
Total of all active and inactive participants	2012-07-01	396
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	396
Number of participants with account balances	2012-07-01	137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	0
2011: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	367
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	342
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	46
Total of all active and inactive participants	2011-07-01	388
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	388
Number of participants with account balances	2011-07-01	118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
2009: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	334
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	302
Number of retired or separated participants receiving benefits	2009-07-01	0
Number of other retired or separated participants entitled to future benefits	2009-07-01	41
Total of all active and inactive participants	2009-07-01	343
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	343
Number of participants with account balances	2009-07-01	101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	0

Financial Data on EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN

Measure	Date	Value
2022 : EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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	$-247
Total loss/gain on sale of assets	2022-06-30	$0
Total of all expenses incurred	2022-06-30	$185,177
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-06-30	$184,927
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-06-30	$380,921
Value of total assets at end of year	2022-06-30	$3,321,982
Value of total assets at beginning of year	2022-06-30	$3,507,406
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-06-30	$250
Total interest from all sources	2022-06-30	$21,544
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
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	$380,921
Participant contributions at end of year	2022-06-30	$0
Participant contributions at beginning of year	2022-06-30	$0
Assets. Loans (other than to participants) at end of year	2022-06-30	$54,106
Assets. Loans (other than to participants) at beginning of year	2022-06-30	$11,030
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	$-185,424
Value of net assets at end of year (total assets less liabilities)	2022-06-30	$3,321,982
Value of net assets at beginning of year (total assets less liabilities)	2022-06-30	$3,507,406
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 registered invesment companies (eg mutual funds) at end of year	2022-06-30	$2,464,518
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-06-30	$2,703,304
Value of interest in pooled separate accounts at end of year	2022-06-30	$171,543
Value of interest in pooled separate accounts at beginning of year	2022-06-30	$144,472
Interest on participant loans	2022-06-30	$715
Interest earned on other investments	2022-06-30	$20,829
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-06-30	$631,815
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-06-30	$648,600
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-06-30	$-434,811
Net investment gain/loss from pooled separate accounts	2022-06-30	$32,099
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-06-30	$184,927
Contract administrator fees	2022-06-30	$250
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	Unqualified
Accountancy firm name	2022-06-30	LEONARD MULHERIN & GREENE P.C.
Accountancy firm EIN	2022-06-30	043108635
2021 : EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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	$939,749
Total loss/gain on sale of assets	2021-06-30	$0
Total of all expenses incurred	2021-06-30	$397,009
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-06-30	$397,009
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-06-30	$333,683
Value of total assets at end of year	2021-06-30	$3,507,406
Value of total assets at beginning of year	2021-06-30	$2,964,666
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-06-30	$0
Total interest from all sources	2021-06-30	$23,807
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
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	$333,559
Participant contributions at end of year	2021-06-30	$11,030
Participant contributions at beginning of year	2021-06-30	$0
Participant contributions at end of year	2021-06-30	$0
Participant contributions at beginning of year	2021-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-06-30	$124
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	$542,740
Value of net assets at end of year (total assets less liabilities)	2021-06-30	$3,507,406
Value of net assets at beginning of year (total assets less liabilities)	2021-06-30	$2,964,666
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 registered invesment companies (eg mutual funds) at end of year	2021-06-30	$2,703,304
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-06-30	$2,065,239
Value of interest in pooled separate accounts at end of year	2021-06-30	$144,472
Value of interest in pooled separate accounts at beginning of year	2021-06-30	$143,898
Interest on participant loans	2021-06-30	$24
Interest earned on other investments	2021-06-30	$23,783
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-06-30	$648,600
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-06-30	$755,529
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-06-30	$573,184
Net investment gain/loss from pooled separate accounts	2021-06-30	$9,075
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-06-30	$397,009
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	LEONARD MULHERIN & GREENE P.C.
Accountancy firm EIN	2021-06-30	043108635
2020 : EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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	$425,536
Total loss/gain on sale of assets	2020-06-30	$0
Total of all expenses incurred	2020-06-30	$87,453
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-06-30	$87,453
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-06-30	$315,919
Value of total assets at end of year	2020-06-30	$2,964,666
Value of total assets at beginning of year	2020-06-30	$2,626,583
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-06-30	$0
Total interest from all sources	2020-06-30	$23,214
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
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	$283,505
Participant contributions at end of year	2020-06-30	$0
Participant contributions at beginning of year	2020-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-06-30	$32,414
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	$338,083
Value of net assets at end of year (total assets less liabilities)	2020-06-30	$2,964,666
Value of net assets at beginning of year (total assets less liabilities)	2020-06-30	$2,626,583
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 registered invesment companies (eg mutual funds) at end of year	2020-06-30	$2,065,239
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-06-30	$1,848,019
Value of interest in pooled separate accounts at end of year	2020-06-30	$143,898
Value of interest in pooled separate accounts at beginning of year	2020-06-30	$137,825
Interest on participant loans	2020-06-30	$2
Interest earned on other investments	2020-06-30	$23,212
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-06-30	$755,529
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-06-30	$640,739
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-06-30	$85,004
Net investment gain/loss from pooled separate accounts	2020-06-30	$1,399
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-06-30	$87,453
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	LEONARD MULHERIN & GREENE P.C.
Accountancy firm EIN	2020-06-30	043108635
2019 : EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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	$384,160
Total loss/gain on sale of assets	2019-06-30	$0
Total of all expenses incurred	2019-06-30	$300,431
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-06-30	$300,431
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-06-30	$266,370
Value of total assets at end of year	2019-06-30	$2,626,583
Value of total assets at beginning of year	2019-06-30	$2,542,854
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-06-30	$0
Total interest from all sources	2019-06-30	$20,448
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
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	$262,659
Participant contributions at end of year	2019-06-30	$0
Participant contributions at beginning of year	2019-06-30	$11,079
Income. Received or receivable in cash from other sources (including rollovers)	2019-06-30	$3,711
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	$83,729
Value of net assets at end of year (total assets less liabilities)	2019-06-30	$2,626,583
Value of net assets at beginning of year (total assets less liabilities)	2019-06-30	$2,542,854
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 registered invesment companies (eg mutual funds) at end of year	2019-06-30	$1,848,019
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-06-30	$1,666,277
Value of interest in pooled separate accounts at end of year	2019-06-30	$137,825
Value of interest in pooled separate accounts at beginning of year	2019-06-30	$214,850
Interest on participant loans	2019-06-30	$3
Interest earned on other investments	2019-06-30	$20,445
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-06-30	$640,739
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-06-30	$650,648
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-06-30	$88,866
Net investment gain/loss from pooled separate accounts	2019-06-30	$8,476
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-06-30	$300,431
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	LEONARD MULHERIN & GREENE P.C.
Accountancy firm EIN	2019-06-30	043108635
2018 : EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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	$444,059
Total loss/gain on sale of assets	2018-06-30	$0
Total of all expenses incurred	2018-06-30	$376,520
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-06-30	$376,520
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-06-30	$255,808
Value of total assets at end of year	2018-06-30	$2,542,854
Value of total assets at beginning of year	2018-06-30	$2,475,315
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-06-30	$0
Total interest from all sources	2018-06-30	$21,178
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
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	$255,808
Participant contributions at end of year	2018-06-30	$11,079
Participant contributions at beginning of year	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
Value of net income/loss	2018-06-30	$67,539
Value of net assets at end of year (total assets less liabilities)	2018-06-30	$2,542,854
Value of net assets at beginning of year (total assets less liabilities)	2018-06-30	$2,475,315
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 registered invesment companies (eg mutual funds) at end of year	2018-06-30	$1,666,277
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-06-30	$1,628,530
Value of interest in pooled separate accounts at end of year	2018-06-30	$214,850
Value of interest in pooled separate accounts at beginning of year	2018-06-30	$196,675
Interest on participant loans	2018-06-30	$2
Interest earned on other investments	2018-06-30	$21,176
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-06-30	$650,648
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-06-30	$650,110
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-06-30	$156,952
Net investment gain/loss from pooled separate accounts	2018-06-30	$10,121
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-06-30	$376,520
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	LEONARD MULHERIN & GREENE P.C.
Accountancy firm EIN	2018-06-30	043108635
2017 : EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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	$460,089
Total loss/gain on sale of assets	2017-06-30	$0
Total of all expenses incurred	2017-06-30	$99,785
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$99,785
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$272,784
Value of total assets at end of year	2017-06-30	$2,475,315
Value of total assets at beginning of year	2017-06-30	$2,115,011
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$0
Total interest from all sources	2017-06-30	$22,328
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
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	$246,318
Participant contributions at end of year	2017-06-30	$0
Participant contributions at beginning of year	2017-06-30	$8,945
Income. Received or receivable in cash from other sources (including rollovers)	2017-06-30	$26,466
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
Value of net income/loss	2017-06-30	$360,304
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$2,475,315
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$2,115,011
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 registered invesment companies (eg mutual funds) at end of year	2017-06-30	$1,628,530
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-06-30	$1,397,366
Value of interest in pooled separate accounts at end of year	2017-06-30	$196,675
Value of interest in pooled separate accounts at beginning of year	2017-06-30	$86,672
Interest earned on other investments	2017-06-30	$22,328
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-06-30	$650,110
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-06-30	$622,028
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-06-30	$158,230
Net investment gain/loss from pooled separate accounts	2017-06-30	$6,747
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$99,785
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	LEONARD MULHERIN & GREENE P.C.
Accountancy firm EIN	2017-06-30	043108635
2016 : EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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	$265,719
Total loss/gain on sale of assets	2016-06-30	$0
Total of all expenses incurred	2016-06-30	$190,659
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$190,659
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$254,080
Value of total assets at end of year	2016-06-30	$2,115,011
Value of total assets at beginning of year	2016-06-30	$2,039,951
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$0
Total interest from all sources	2016-06-30	$21,537
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
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	$240,098
Participant contributions at end of year	2016-06-30	$8,945
Participant contributions at beginning of year	2016-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-06-30	$13,982
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	$75,060
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$2,115,011
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$2,039,951
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 registered invesment companies (eg mutual funds) at end of year	2016-06-30	$1,397,366
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-06-30	$1,257,684
Value of interest in pooled separate accounts at end of year	2016-06-30	$86,672
Value of interest in pooled separate accounts at beginning of year	2016-06-30	$71,120
Interest earned on other investments	2016-06-30	$21,537
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-06-30	$622,028
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-06-30	$711,147
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-06-30	$-15,118
Net investment gain/loss from pooled separate accounts	2016-06-30	$5,220
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$190,659
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	LEONARD MULHERIN & GREENE P.C.
Accountancy firm EIN	2016-06-30	043108635
2015 : EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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	$354,988
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$345,064
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$345,064
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$271,476
Value of total assets at end of year	2015-06-30	$2,039,951
Value of total assets at beginning of year	2015-06-30	$2,030,027
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$0
Total interest from all sources	2015-06-30	$24,144
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
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$222,804
Income. Received or receivable in cash from other sources (including rollovers)	2015-06-30	$48,672
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
Value of net income/loss	2015-06-30	$9,924
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$2,039,951
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$2,030,027
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 registered invesment companies (eg mutual funds) at end of year	2015-06-30	$1,257,684
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-30	$1,285,358
Value of interest in pooled separate accounts at end of year	2015-06-30	$71,120
Value of interest in pooled separate accounts at beginning of year	2015-06-30	$96,394
Interest earned on other investments	2015-06-30	$24,144
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$711,147
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$648,275
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-06-30	$50,070
Net investment gain/loss from pooled separate accounts	2015-06-30	$9,298
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$345,064
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	LEONARD MULHERIN & GREENE P.C.
Accountancy firm EIN	2015-06-30	043108635
2014 : EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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	$435,695
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$249,205
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$249,205
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$234,992
Value of total assets at end of year	2014-06-30	$2,030,027
Value of total assets at beginning of year	2014-06-30	$1,843,537
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$0
Total interest from all sources	2014-06-30	$23,384
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	$217,575
Income. Received or receivable in cash from other sources (including rollovers)	2014-06-30	$17,417
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
Value of net income/loss	2014-06-30	$186,490
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$2,030,027
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$1,843,537
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 registered invesment companies (eg mutual funds) at end of year	2014-06-30	$1,285,358
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-06-30	$1,023,520
Value of interest in pooled separate accounts at end of year	2014-06-30	$96,394
Value of interest in pooled separate accounts at beginning of year	2014-06-30	$86,760
Interest earned on other investments	2014-06-30	$23,384
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$648,275
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$733,257
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-06-30	$167,815
Net investment gain/loss from pooled separate accounts	2014-06-30	$9,504
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$249,205
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	LEONARD MULHERIN & GREENE P.C.
Accountancy firm EIN	2014-06-30	043108635
2013 : EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
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	$333,331
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$69,546
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$69,546
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$205,018
Value of total assets at end of year	2013-06-30	$1,843,537
Value of total assets at beginning of year	2013-06-30	$1,579,752
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$0
Total interest from all sources	2013-06-30	$23,192
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$155,208
Assets. Other investments not covered elsewhere at end of year	2013-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2013-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-06-30	$49,810
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	$263,785
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$1,843,537
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$1,579,752
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 registered invesment companies (eg mutual funds) at end of year	2013-06-30	$1,023,520
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-06-30	$861,572
Value of interest in pooled separate accounts at end of year	2013-06-30	$86,760
Value of interest in pooled separate accounts at beginning of year	2013-06-30	$78,664
Interest earned on other investments	2013-06-30	$23,192
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$733,257
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$639,516
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-06-30	$98,471
Net investment gain/loss from pooled separate accounts	2013-06-30	$6,650
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$69,546
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	LEONARD MULHERIN & GREENE P.C.
Accountancy firm EIN	2013-06-30	043108635
2012 : EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total income from all sources (including contributions)	2012-06-30	$296,425
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$125,862
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$125,862
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$162,969
Value of total assets at end of year	2012-06-30	$1,579,752
Value of total assets at beginning of year	2012-06-30	$1,409,189
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$0
Total interest from all sources	2012-06-30	$19,884
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$500,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$143,879
Assets. Other investments not covered elsewhere at end of year	2012-06-30	$105,019
Income. Received or receivable in cash from other sources (including rollovers)	2012-06-30	$19,090
Other income not declared elsewhere	2012-06-30	$102,377
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$170,563
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$1,579,752
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$1,409,189
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-06-30	$861,572
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-06-30	$792,275
Value of interest in pooled separate accounts at end of year	2012-06-30	$78,664
Value of interest in pooled separate accounts at beginning of year	2012-06-30	$70,660
Interest earned on other investments	2012-06-30	$19,884
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$534,497
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$546,254
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-06-30	$3,297
Net investment gain/loss from pooled separate accounts	2012-06-30	$7,898
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$125,862
Did the plan have assets held for investment	2012-06-30	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	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	LEONARD MULHERIN & GREENE P.C.
Accountancy firm EIN	2012-06-30	043108635
2011 : EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total income from all sources (including contributions)	2011-06-30	$327,097
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$96,346
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$96,346
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$171,261
Value of total assets at end of year	2011-06-30	$1,409,189
Value of total assets at beginning of year	2011-06-30	$1,178,438
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$0
Total interest from all sources	2011-06-30	$16,801
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$500,000
If this is an individual account plan, was there a blackout period	2011-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Contributions received from participants	2011-06-30	$154,138
Income. Received or receivable in cash from other sources (including rollovers)	2011-06-30	$17,123
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Income. Non cash contributions	2011-06-30	$0
Value of net income/loss	2011-06-30	$230,751
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$1,409,189
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$1,178,438
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-06-30	$792,275
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-06-30	$624,824
Value of interest in pooled separate accounts at end of year	2011-06-30	$70,660
Value of interest in pooled separate accounts at beginning of year	2011-06-30	$55,723
Interest earned on other investments	2011-06-30	$16,801
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$546,254
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$497,891
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-06-30	$128,012
Net investment gain/loss from pooled separate accounts	2011-06-30	$11,023
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	No
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Contributions received in cash from employer	2011-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$96,346
Did the plan have assets held for investment	2011-06-30	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	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	LEONARD MULHERIN & GREENE P.C.
Accountancy firm EIN	2011-06-30	043108635
2010 : EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0

Form 5500 Responses for EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN

2021: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) 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
2011: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2009: EVERGREEN CENTER, INC. TAX DEFERRED ANNUITY (TDA) PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

346549

Policy instance

Insurance contract or identification number	346549
Number of Individuals Covered	211
Insurance policy start date	2021-07-01
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?	Yes
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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

832945

Policy instance

Insurance contract or identification number	832945
Number of Individuals Covered	1
Insurance policy start date	2021-07-01
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?	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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

832945

Policy instance

Insurance contract or identification number	832945
Number of Individuals Covered	1
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
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?	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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

346549

Policy instance

Insurance contract or identification number	346549
Number of Individuals Covered	209
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
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?	Yes
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

346549

Policy instance

Insurance contract or identification number	346549
Number of Individuals Covered	204
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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?	Yes
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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

832945

Policy instance

Insurance contract or identification number	832945
Number of Individuals Covered	1
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

832945

Policy instance

Insurance contract or identification number	832945
Number of Individuals Covered	1
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
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?	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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

346549

Policy instance

Insurance contract or identification number	346549
Number of Individuals Covered	193
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
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?	Yes
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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

832945

Policy instance

Insurance contract or identification number	832945
Number of Individuals Covered	1
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
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?	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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

346549

Policy instance

Insurance contract or identification number	346549
Number of Individuals Covered	193
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
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?	Yes
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

346549

Policy instance

Insurance contract or identification number	346549
Number of Individuals Covered	168
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
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?	Yes
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

METLIFE INVESTORS (National Association of Insurance Commissioners NAIC id number: 80950 )

Policy contract number

832945

Policy instance

Insurance contract or identification number	832945
Number of Individuals Covered	1
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

346549

Policy instance

Insurance contract or identification number	346549
Number of Individuals Covered	165
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
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?	Yes
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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

832945

Policy instance

Insurance contract or identification number	832945
Number of Individuals Covered	1
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

346549

Policy instance

Insurance contract or identification number	346549
Number of Individuals Covered	157
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
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?	Yes
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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

832945

Policy instance

Insurance contract or identification number	832945
Number of Individuals Covered	1
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

832945

Policy instance

Insurance contract or identification number	832945
Number of Individuals Covered	1
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

346549

Policy instance

Insurance contract or identification number	346549
Number of Individuals Covered	137
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $0
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?	Yes
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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

832945

Policy instance

Insurance contract or identification number	832945
Number of Individuals Covered	1
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

346549

Policy instance

Insurance contract or identification number	346549
Number of Individuals Covered	117
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
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?	Yes
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

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

346549

Policy instance

Insurance contract or identification number	346549
Number of Individuals Covered	109
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
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?	Yes
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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

832945

Policy instance

Insurance contract or identification number	832945
Number of Individuals Covered	1
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	EVERGREEN CENTER, INC.
Employer identification number (EIN):	042753469
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities