401k Plan data: PETER PACE & COMPANY, LLC 401(K) PLAN plan

PETER PACE & COMPANY, LLC 401(K) PLAN 401k Plan overview

Plan Name	PETER PACE & COMPANY, LLC 401(K) PLAN
Plan identification number	002

PETER PACE & COMPANY, LLC 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

PETER PACE & COMPANY, LLC has sponsored the creation of one or more 401k plans.

Company Name: PETER PACE & COMPANY, LLC

Employer identification number (EIN): 205732623

NAIC Classification: 524210
NAIC Description: Insurance Agencies and Brokerages

Additional information about PETER PACE & COMPANY, LLC

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 2006-09-22

Company Identification Number: 3416204

Legal Registered Office Address: 20 MILLER PLACE
Nassau
SYOSSET
United States of America (USA)
11791

More information about PETER PACE & COMPANY, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PETER PACE & COMPANY, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 PETER W. PACE 2023-05-10 PETER W. PACE 2023-05-10
002 2021-01-01 PETER W PACE 2022-03-22 PETER W PACE 2022-03-22
002 2020-01-01 PETER W PACE 2021-06-25 PETER W PACE 2021-06-25
002 2019-01-01 PETER PACE 2020-08-03 PETER PACE 2020-08-03
002 2018-01-01 PETER PACE 2019-09-17
002 2017-01-01 PETER PACE PETER PACE 2018-10-09
002 2016-01-01 PETER PACE
002 2015-01-01 PETER PACE PETER PACE 2016-05-02
002 2014-01-01 PETER PACE
002 2013-01-01 PETER PACE
002 2012-01-01 PETER PACE
002 2011-01-01 PETER PACE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01	PETER W. PACE	2023-05-10	PETER W. PACE	2023-05-10
002	2021-01-01	PETER W PACE	2022-03-22	PETER W PACE	2022-03-22
002	2020-01-01	PETER W PACE	2021-06-25	PETER W PACE	2021-06-25
002	2019-01-01	PETER PACE	2020-08-03	PETER PACE	2020-08-03
002	2018-01-01	PETER PACE	2019-09-17
002	2017-01-01	PETER PACE		PETER PACE	2018-10-09
002	2016-01-01	PETER PACE
002	2015-01-01	PETER PACE		PETER PACE	2016-05-02
002	2014-01-01	PETER PACE
002	2013-01-01	PETER PACE
002	2012-01-01	PETER PACE
002	2011-01-01	PETER PACE

Plan Statistics for PETER PACE & COMPANY, LLC 401(K) PLAN

401k plan membership statisitcs for PETER PACE & COMPANY, LLC 401(K) PLAN

Measure Date Value
2017: PETER PACE & COMPANY, LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 8
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 8
Number of participants with account balances 2017-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: PETER PACE & COMPANY, LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 9
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 9
Number of participants with account balances 2016-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: PETER PACE & COMPANY, LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 8
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 8
Number of participants with account balances 2015-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: PETER PACE & COMPANY, LLC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 8
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 8
Number of participants with account balances 2014-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: PETER PACE & COMPANY, LLC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 8
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 8
Number of participants with account balances 2013-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: PETER PACE & COMPANY, LLC 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 8
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 8
Number of participants with account balances 2012-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: PETER PACE & COMPANY, LLC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 9
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 9
Number of participants with account balances 2011-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2017: PETER PACE & COMPANY, LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	8
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	8
Number of participants with account balances	2017-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: PETER PACE & COMPANY, LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	9
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	9
Number of participants with account balances	2016-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: PETER PACE & COMPANY, LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	8
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	8
Number of participants with account balances	2015-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: PETER PACE & COMPANY, LLC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	8
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	8
Number of participants with account balances	2014-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: PETER PACE & COMPANY, LLC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	8
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	8
Number of participants with account balances	2013-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: PETER PACE & COMPANY, LLC 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	8
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	8
Number of participants with account balances	2012-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: PETER PACE & COMPANY, LLC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	9
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	9
Number of participants with account balances	2011-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on PETER PACE & COMPANY, LLC 401(K) PLAN

Measure	Date	Value
2017 : PETER PACE & COMPANY, LLC 401(K) PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$235,848
Expenses. Total of all expenses incurred	2017-12-31	$12,655
Benefits paid (including direct rollovers)	2017-12-31	$10,000
Total plan assets at end of year	2017-12-31	$1,965,652
Total plan assets at beginning of year	2017-12-31	$1,742,459
Value of fidelity bond covering the plan	2017-12-31	$265,000
Total contributions received or receivable from participants	2017-12-31	$31,720
Expenses. Other expenses not covered elsewhere	2017-12-31	$2,655
Other income received	2017-12-31	$204,128
Net income (gross income less expenses)	2017-12-31	$223,193
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$1,965,652
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$1,742,459
Assets. Value of participant loans	2017-12-31	$76,033
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : PETER PACE & COMPANY, LLC 401(K) PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$235,476
Expenses. Total of all expenses incurred	2016-12-31	$5,642
Benefits paid (including direct rollovers)	2016-12-31	$3,039
Total plan assets at end of year	2016-12-31	$1,742,459
Total plan assets at beginning of year	2016-12-31	$1,512,625
Value of fidelity bond covering the plan	2016-12-31	$265,000
Total contributions received or receivable from participants	2016-12-31	$45,025
Expenses. Other expenses not covered elsewhere	2016-12-31	$2,603
Other income received	2016-12-31	$187,294
Net income (gross income less expenses)	2016-12-31	$229,834
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$1,742,459
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$1,512,625
Assets. Value of participant loans	2016-12-31	$93,981
Total contributions received or receivable from employer(s)	2016-12-31	$3,157
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : PETER PACE & COMPANY, LLC 401(K) PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$-96,474
Expenses. Total of all expenses incurred	2015-12-31	$4,589
Benefits paid (including direct rollovers)	2015-12-31	$2,000
Total plan assets at end of year	2015-12-31	$1,512,625
Total plan assets at beginning of year	2015-12-31	$1,613,688
Value of fidelity bond covering the plan	2015-12-31	$265,000
Total contributions received or receivable from participants	2015-12-31	$16,050
Expenses. Other expenses not covered elsewhere	2015-12-31	$2,589
Other income received	2015-12-31	$-112,524
Net income (gross income less expenses)	2015-12-31	$-101,063
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$1,512,625
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$1,613,688
Assets. Value of participant loans	2015-12-31	$15,948
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : PETER PACE & COMPANY, LLC 401(K) PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$153,810
Expenses. Total of all expenses incurred	2014-12-31	$2,580
Total plan assets at end of year	2014-12-31	$1,613,688
Total plan assets at beginning of year	2014-12-31	$1,462,458
Value of fidelity bond covering the plan	2014-12-31	$265,000
Total contributions received or receivable from participants	2014-12-31	$11,025
Expenses. Other expenses not covered elsewhere	2014-12-31	$2,580
Other income received	2014-12-31	$58,853
Net income (gross income less expenses)	2014-12-31	$151,230
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,613,688
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,462,458
Assets. Value of participant loans	2014-12-31	$18,755
Total contributions received or receivable from employer(s)	2014-12-31	$83,932
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : PETER PACE & COMPANY, LLC 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$1,282,629
Expenses. Total of all expenses incurred	2013-12-31	$8,850
Benefits paid (including direct rollovers)	2013-12-31	$8,850
Total plan assets at end of year	2013-12-31	$1,462,458
Total plan assets at beginning of year	2013-12-31	$188,679
Value of fidelity bond covering the plan	2013-12-31	$265,000
Total contributions received or receivable from participants	2013-12-31	$10,667
Contributions received from other sources (not participants or employers)	2013-12-31	$1,182,547
Other income received	2013-12-31	$89,415
Net income (gross income less expenses)	2013-12-31	$1,273,779
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,462,458
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$188,679
Assets. Value of participant loans	2013-12-31	$6,673
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : PETER PACE & COMPANY, LLC 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$31,310
Expenses. Total of all expenses incurred	2012-12-31	$28,848
Benefits paid (including direct rollovers)	2012-12-31	$18,458
Total plan assets at end of year	2012-12-31	$188,679
Total plan assets at beginning of year	2012-12-31	$186,217
Value of fidelity bond covering the plan	2012-12-31	$265,000
Total contributions received or receivable from participants	2012-12-31	$10,799
Other income received	2012-12-31	$20,511
Net income (gross income less expenses)	2012-12-31	$2,462
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$188,679
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$186,217
Assets. Value of participant loans	2012-12-31	$10,082
Value of certain deemed distributions of participant loans	2012-12-31	$10,390
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : PETER PACE & COMPANY, LLC 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$18,959
Expenses. Total of all expenses incurred	2011-12-31	$12,528
Benefits paid (including direct rollovers)	2011-12-31	$12,528
Total plan assets at end of year	2011-12-31	$186,217
Total plan assets at beginning of year	2011-12-31	$179,786
Total contributions received or receivable from participants	2011-12-31	$16,755
Other income received	2011-12-31	$2,204
Net income (gross income less expenses)	2011-12-31	$6,431
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$186,217
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$179,786
Assets. Value of participant loans	2011-12-31	$28,532

Form 5500 Responses for PETER PACE & COMPANY, LLC 401(K) PLAN

2017: PETER PACE & COMPANY, LLC 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: PETER PACE & COMPANY, LLC 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: PETER PACE & COMPANY, LLC 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: PETER PACE & COMPANY, LLC 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: PETER PACE & COMPANY, LLC 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: PETER PACE & COMPANY, LLC 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: PETER PACE & COMPANY, LLC 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 25178 )

Policy contract number

AS-0117-2673

Policy instance

Insurance contract or identification number	AS-0117-2673
Number of Individuals Covered	1
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	1
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 25178 )

Policy contract number

AS-0117-2673

Policy instance

Insurance contract or identification number	AS-0117-2673
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2016-12-31
Are there contracts with allocated funds for individual policies?	Yes
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 25178 )

Policy contract number

AS-0117-2673

Policy instance

Insurance contract or identification number	AS-0117-2673
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Are there contracts with allocated funds for individual policies?	Yes
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	PETER PACE & COMPANY, LLC
Employer identification number (EIN):	205732623
NAIC Classification:	524210
NAIC Description:	Insurance Agencies and Brokerages

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	2006-09-22
Company Identification Number:	3416204
Legal Registered Office Address:	20 MILLER PLACE Nassau SYOSSET United States of America (USA) 11791