401k Plan data: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN plan

TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	002

TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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

TESTRITE INSTRUMENT COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name: TESTRITE INSTRUMENT COMPANY, INC.

Employer identification number (EIN): 222374879

NAIC Classification: 332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2021-01-01 JEFFREY RUBIN 2022-05-12 JEFFREY RUBIN 2022-05-12
002 2020-01-01 LAURENCE RUBIN 2021-03-25 LAURENCE RUBIN 2021-03-25
002 2019-01-01 LAURENCE RUBIN 2020-04-08 LAURENCE RUBIN 2020-04-08
002 2018-01-01 LAURENCE RUBIN 2019-05-08 LAURENCE RUBIN 2019-05-08
002 2017-01-01 LAURENCE RUBIN 2018-04-18 LAURENCE RUBIN 2018-04-18
002 2016-01-01 LAURENCE RUBIN 2017-06-06
002 2015-01-01 LAURENCE RUBIN 2016-07-14
002 2014-01-01 LAURENCE RUBIN
002 2013-01-01 LAURENCE RUBIN
002 2012-01-01 LAURENCE RUBIN
002 2011-01-01 LARRY RUBIN
002 2010-01-01 LARRY RUBIN
002 2009-01-01 LARRY RUBIN
002 2009-01-01 LARRY RUBIN
002 2009-01-01 LARRY RUBIN
002 2009-01-01 LARRY RUBIN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2021-01-01	JEFFREY RUBIN	2022-05-12	JEFFREY RUBIN	2022-05-12
002	2020-01-01	LAURENCE RUBIN	2021-03-25	LAURENCE RUBIN	2021-03-25
002	2019-01-01	LAURENCE RUBIN	2020-04-08	LAURENCE RUBIN	2020-04-08
002	2018-01-01	LAURENCE RUBIN	2019-05-08	LAURENCE RUBIN	2019-05-08
002	2017-01-01	LAURENCE RUBIN	2018-04-18	LAURENCE RUBIN	2018-04-18
002	2016-01-01	LAURENCE RUBIN	2017-06-06
002	2015-01-01	LAURENCE RUBIN	2016-07-14
002	2014-01-01	LAURENCE RUBIN
002	2013-01-01	LAURENCE RUBIN
002	2012-01-01	LAURENCE RUBIN
002	2011-01-01	LARRY RUBIN
002	2010-01-01	LARRY RUBIN
002	2009-01-01	LARRY RUBIN
002	2009-01-01	LARRY RUBIN
002	2009-01-01	LARRY RUBIN
002	2009-01-01	LARRY RUBIN

Plan Statistics for TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2014: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 43
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 39
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 7
Total of all active and inactive participants 2014-01-01 46
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 46
Number of participants with account balances 2014-01-01 41
2013: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 41
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 38
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 5
Total of all active and inactive participants 2013-01-01 43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 43
Number of participants with account balances 2013-01-01 37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 38
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 37
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 4
Total of all active and inactive participants 2012-01-01 41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 41
Number of participants with account balances 2012-01-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 28
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 33
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 5
Total of all active and inactive participants 2011-01-01 38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 38
Number of participants with account balances 2011-01-01 30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 35
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 25
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 3
Total of all active and inactive participants 2010-01-01 28
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 28
Number of participants with account balances 2010-01-01 27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 30
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 27
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 5
Total of all active and inactive participants 2009-01-01 32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 32
Number of participants with account balances 2009-01-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2014: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	43
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	39
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	7
Total of all active and inactive participants	2014-01-01	46
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	46
Number of participants with account balances	2014-01-01	41
2013: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	41
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	38
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	5
Total of all active and inactive participants	2013-01-01	43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	43
Number of participants with account balances	2013-01-01	37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	38
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	37
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	4
Total of all active and inactive participants	2012-01-01	41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	41
Number of participants with account balances	2012-01-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	28
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	33
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	5
Total of all active and inactive participants	2011-01-01	38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	38
Number of participants with account balances	2011-01-01	30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	35
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	25
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	3
Total of all active and inactive participants	2010-01-01	28
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	28
Number of participants with account balances	2010-01-01	27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	30
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	27
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	5
Total of all active and inactive participants	2009-01-01	32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	32
Number of participants with account balances	2009-01-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2014 : TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$992,801
Expenses. Total of all expenses incurred	2014-12-31	$10,547
Benefits paid (including direct rollovers)	2014-12-31	$7,491
Total plan assets at end of year	2014-12-31	$8,649,789
Total plan assets at beginning of year	2014-12-31	$7,667,535
Value of fidelity bond covering the plan	2014-12-31	$654,581
Total contributions received or receivable from participants	2014-12-31	$112,438
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$580,363
Net income (gross income less expenses)	2014-12-31	$982,254
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$8,649,789
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$7,667,535
Assets. Value of participant loans	2014-12-31	$45,245
Total contributions received or receivable from employer(s)	2014-12-31	$300,000
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$3,056
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$1,693,526
Expenses. Total of all expenses incurred	2013-12-31	$6,808
Benefits paid (including direct rollovers)	2013-12-31	$3,726
Total plan assets at end of year	2013-12-31	$7,667,535
Total plan assets at beginning of year	2013-12-31	$5,980,817
Value of fidelity bond covering the plan	2013-12-31	$654,581
Total contributions received or receivable from participants	2013-12-31	$77,373
Expenses. Other expenses not covered elsewhere	2013-12-31	$3,082
Other income received	2013-12-31	$1,341,153
Net income (gross income less expenses)	2013-12-31	$1,686,718
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$7,667,535
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$5,980,817
Assets. Value of participant loans	2013-12-31	$48,442
Total contributions received or receivable from employer(s)	2013-12-31	$275,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$1,024,641
Expenses. Total of all expenses incurred	2012-12-31	$32,166
Benefits paid (including direct rollovers)	2012-12-31	$31,025
Total plan assets at end of year	2012-12-31	$5,980,817
Total plan assets at beginning of year	2012-12-31	$4,988,342
Value of fidelity bond covering the plan	2012-12-31	$450,000
Total contributions received or receivable from participants	2012-12-31	$52,948
Expenses. Other expenses not covered elsewhere	2012-12-31	$1,141
Contributions received from other sources (not participants or employers)	2012-12-31	$10,971
Other income received	2012-12-31	$710,722
Net income (gross income less expenses)	2012-12-31	$992,475
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$5,980,817
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$4,988,342
Assets. Value of participant loans	2012-12-31	$70,181
Total contributions received or receivable from employer(s)	2012-12-31	$250,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$6,340
Expenses. Total of all expenses incurred	2011-12-31	$6,530
Benefits paid (including direct rollovers)	2011-12-31	$6,250
Total plan assets at end of year	2011-12-31	$4,988,342
Total plan assets at beginning of year	2011-12-31	$4,988,532
Value of fidelity bond covering the plan	2011-12-31	$450,000
Total contributions received or receivable from participants	2011-12-31	$73,018
Other income received	2011-12-31	$-266,678
Net income (gross income less expenses)	2011-12-31	$-190
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$4,988,342
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$4,988,532
Assets. Value of participant loans	2011-12-31	$78,882
Total contributions received or receivable from employer(s)	2011-12-31	$200,000
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$280
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$828,253
Expenses. Total of all expenses incurred	2010-12-31	$28,498
Benefits paid (including direct rollovers)	2010-12-31	$28,123
Total plan assets at end of year	2010-12-31	$4,988,532
Total plan assets at beginning of year	2010-12-31	$4,188,777
Value of fidelity bond covering the plan	2010-12-31	$450,000
Total contributions received or receivable from participants	2010-12-31	$75,585
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$652,668
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$799,755
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$4,988,532
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$4,188,777
Assets. Value of participant loans	2010-12-31	$67,022
Total contributions received or receivable from employer(s)	2010-12-31	$100,000
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$375
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN

2014: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING 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 – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING 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 – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: TESTRITE INSTRUMENT COMPANY, INC. 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 )

Policy contract number

0885737L

Policy instance

Insurance contract or identification number	0885737L
Number of Individuals Covered	0
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ROBERT BERGER

THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 )

Policy contract number

0885737L

Policy instance

Insurance contract or identification number	0885737L
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 )

Policy contract number

0885737L

Policy instance

Insurance contract or identification number	0885737L
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Insurance broker organization code?	3
Insurance broker name	ROBERT BERGER

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Company Name:	TESTRITE INSTRUMENT COMPANY, INC.
Employer identification number (EIN):	222374879
NAIC Classification:	332900