401k Plan data: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. plan

401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 401k Plan overview

Plan Name	401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC.
Plan identification number	002

401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 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

BREVILLIER VILLAGE FOUNDATION,INC. has sponsored the creation of one or more 401k plans.

Company Name: BREVILLIER VILLAGE FOUNDATION,INC.

Employer identification number (EIN): 251548657

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

Additional information about BREVILLIER VILLAGE FOUNDATION,INC.

Jurisdiction of Incorporation: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE

Incorporation Date:

Company Identification Number: 946392

More information about BREVILLIER VILLAGE FOUNDATION,INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 CINDI S. SEBOLT CINDI S. SEBOLT 2018-10-12
002 2016-01-01 CINDI S. SEBOLT CINDI S. SEBOLT 2017-10-16
002 2015-01-01 CINDI SEBOLT CINDI SEBOLT 2016-10-14
002 2014-01-01 CINDI SEBOLT CINDI SEBOLT 2015-10-15
002 2013-01-01 CINDI SEBOLT CINDI SEBOLT 2015-09-08
002 2012-01-01 JEFFREY F WIESER JEFFREY F WIESER 2013-07-26
002 2011-01-01 JEFFREY F WIESER JEFFREY F WIESER 2012-07-25
002 2010-01-01 JEFFREY F WIESER JEFFREY F WIESER 2011-07-25
002 2009-01-01 JEFFREY F WIESER JEFFREY F WIESER 2010-07-29

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	CINDI S. SEBOLT	CINDI S. SEBOLT	2018-10-12
002	2016-01-01	CINDI S. SEBOLT	CINDI S. SEBOLT	2017-10-16
002	2015-01-01	CINDI SEBOLT	CINDI SEBOLT	2016-10-14
002	2014-01-01	CINDI SEBOLT	CINDI SEBOLT	2015-10-15
002	2013-01-01	CINDI SEBOLT	CINDI SEBOLT	2015-09-08
002	2012-01-01	JEFFREY F WIESER	JEFFREY F WIESER	2013-07-26
002	2011-01-01	JEFFREY F WIESER	JEFFREY F WIESER	2012-07-25
002	2010-01-01	JEFFREY F WIESER	JEFFREY F WIESER	2011-07-25
002	2009-01-01	JEFFREY F WIESER	JEFFREY F WIESER	2010-07-29

Plan Statistics for 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC.

401k plan membership statisitcs for 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC.

Measure Date Value
2022: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2022 401k membership
Total participants, beginning-of-year 2022-01-01 211
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 152
Number of retired or separated participants receiving benefits 2022-01-01 3
Number of other retired or separated participants entitled to future benefits 2022-01-01 72
Total of all active and inactive participants 2022-01-01 227
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 227
Number of participants with account balances 2022-01-01 162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2021 401k membership
Total participants, beginning-of-year 2021-01-01 219
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 144
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 67
Total of all active and inactive participants 2021-01-01 211
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 211
Number of participants with account balances 2021-01-01 166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2020 401k membership
Total participants, beginning-of-year 2020-01-01 170
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 159
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 58
Total of all active and inactive participants 2020-01-01 217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 2
Total participants 2020-01-01 219
Number of participants with account balances 2020-01-01 169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2019 401k membership
Total participants, beginning-of-year 2019-01-01 172
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 114
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 56
Total of all active and inactive participants 2019-01-01 170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 170
Number of participants with account balances 2019-01-01 170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2018 401k membership
Total participants, beginning-of-year 2018-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 128
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 43
Total of all active and inactive participants 2018-01-01 171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 1
Total participants 2018-01-01 172
Number of participants with account balances 2018-01-01 172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2017 401k membership
Total participants, beginning-of-year 2017-01-01 154
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 132
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 40
Total of all active and inactive participants 2017-01-01 172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 173
Number of participants with account balances 2017-01-01 171
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2016 401k membership
Total participants, beginning-of-year 2016-01-01 146
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 114
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 40
Total of all active and inactive participants 2016-01-01 154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 154
Number of participants with account balances 2016-01-01 154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 10
2015: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2015 401k membership
Total participants, beginning-of-year 2015-01-01 155
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 108
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 37
Total of all active and inactive participants 2015-01-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 1
Total participants 2015-01-01 146
Number of participants with account balances 2015-01-01 145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 12
2014: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2014 401k membership
Total participants, beginning-of-year 2014-01-01 158
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 148
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 42
Total of all active and inactive participants 2014-01-01 190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 191
Number of participants with account balances 2014-01-01 154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2013 401k membership
Total participants, beginning-of-year 2013-01-01 162
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 121
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 37
Total of all active and inactive participants 2013-01-01 158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 158
Number of participants with account balances 2013-01-01 158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2012 401k membership
Total participants, beginning-of-year 2012-01-01 168
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 130
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 32
Total of all active and inactive participants 2012-01-01 162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 162
Number of participants with account balances 2012-01-01 162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2011 401k membership
Total participants, beginning-of-year 2011-01-01 145
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 133
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 35
Total of all active and inactive participants 2011-01-01 168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 168
Number of participants with account balances 2011-01-01 168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2010 401k membership
Total participants, beginning-of-year 2010-01-01 132
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 117
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 28
Total of all active and inactive participants 2010-01-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 145
Number of participants with account balances 2010-01-01 145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2009 401k membership
Total participants, beginning-of-year 2009-01-01 136
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 103
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 29
Total of all active and inactive participants 2009-01-01 132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 132
Number of participants with account balances 2009-01-01 132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2022: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2022 401k membership
Total participants, beginning-of-year	2022-01-01	211
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	152
Number of retired or separated participants receiving benefits	2022-01-01	3
Number of other retired or separated participants entitled to future benefits	2022-01-01	72
Total of all active and inactive participants	2022-01-01	227
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	227
Number of participants with account balances	2022-01-01	162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2021 401k membership
Total participants, beginning-of-year	2021-01-01	219
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	144
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	67
Total of all active and inactive participants	2021-01-01	211
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	211
Number of participants with account balances	2021-01-01	166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2020 401k membership
Total participants, beginning-of-year	2020-01-01	170
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	159
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	58
Total of all active and inactive participants	2020-01-01	217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	2
Total participants	2020-01-01	219
Number of participants with account balances	2020-01-01	169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2019 401k membership
Total participants, beginning-of-year	2019-01-01	172
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	114
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	56
Total of all active and inactive participants	2019-01-01	170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	170
Number of participants with account balances	2019-01-01	170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2018 401k membership
Total participants, beginning-of-year	2018-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	128
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	43
Total of all active and inactive participants	2018-01-01	171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	1
Total participants	2018-01-01	172
Number of participants with account balances	2018-01-01	172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2017 401k membership
Total participants, beginning-of-year	2017-01-01	154
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	132
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	40
Total of all active and inactive participants	2017-01-01	172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	173
Number of participants with account balances	2017-01-01	171
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2016 401k membership
Total participants, beginning-of-year	2016-01-01	146
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	114
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	40
Total of all active and inactive participants	2016-01-01	154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	154
Number of participants with account balances	2016-01-01	154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	10
2015: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2015 401k membership
Total participants, beginning-of-year	2015-01-01	155
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	108
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	37
Total of all active and inactive participants	2015-01-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	1
Total participants	2015-01-01	146
Number of participants with account balances	2015-01-01	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	12
2014: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2014 401k membership
Total participants, beginning-of-year	2014-01-01	158
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	148
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	42
Total of all active and inactive participants	2014-01-01	190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	191
Number of participants with account balances	2014-01-01	154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2013 401k membership
Total participants, beginning-of-year	2013-01-01	162
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	121
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	37
Total of all active and inactive participants	2013-01-01	158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	158
Number of participants with account balances	2013-01-01	158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2012 401k membership
Total participants, beginning-of-year	2012-01-01	168
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	130
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	32
Total of all active and inactive participants	2012-01-01	162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	162
Number of participants with account balances	2012-01-01	162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2011 401k membership
Total participants, beginning-of-year	2011-01-01	145
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	133
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	35
Total of all active and inactive participants	2011-01-01	168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	168
Number of participants with account balances	2011-01-01	168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2010 401k membership
Total participants, beginning-of-year	2010-01-01	132
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	117
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	28
Total of all active and inactive participants	2010-01-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	145
Number of participants with account balances	2010-01-01	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2009 401k membership
Total participants, beginning-of-year	2009-01-01	136
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	103
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	29
Total of all active and inactive participants	2009-01-01	132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	132
Number of participants with account balances	2009-01-01	132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC.

Measure	Date	Value
2022 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$0
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total transfer of assets to this plan	2022-12-31	$0
Total transfer of assets from this plan	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-1,123,945
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$704,830
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$702,544
Expenses. Certain deemed distributions of participant loans	2022-12-31	$0
Value of total corrective distributions	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$361,997
Value of total assets at end of year	2022-12-31	$7,413,102
Value of total assets at beginning of year	2022-12-31	$9,241,877
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$2,286
Total interest from all sources	2022-12-31	$10,591
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$0
Assets. Real estate other than employer real property at end of year	2022-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-12-31	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$242,251
Participant contributions at end of year	2022-12-31	$217,426
Participant contributions at beginning of year	2022-12-31	$178,424
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$3,491
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-12-31	$0
Assets. Loans (other than to participants) at end of year	2022-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2022-12-31	$0
Other income not declared elsewhere	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$2,286
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$-1,828,775
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$7,413,102
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$9,241,877
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Assets. partnership/joint venture interests at end of year	2022-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$5,871,285
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$7,909,118
Value of interest in pooled separate accounts at end of year	2022-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$0
Interest on participant loans	2022-12-31	$7,347
Income. Interest from loans (other than to participants)	2022-12-31	$0
Interest earned on other investments	2022-12-31	$3,244
Income. Interest from US Government securities	2022-12-31	$0
Income. Interest from corporate debt instruments	2022-12-31	$0
Value of interest in master investment trust accounts at end of year	2022-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2022-12-31	$0
Value of interest in common/collective trusts at end of year	2022-12-31	$0
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$1,324,391
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,154,335
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Asset value of US Government securities at end of year	2022-12-31	$0
Asset value of US Government securities at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$0
Net investment gain/loss from pooled separate accounts	2022-12-31	$-1,496,533
Net investment gain or loss from common/collective trusts	2022-12-31	$0
Net gain/loss from 103.12 investment entities	2022-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$116,255
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Income. Dividends from preferred stock	2022-12-31	$0
Income. Dividends from common stock	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$702,544
Asset. Corporate debt instrument preferred debt at end of year	2022-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$0
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Aggregate proceeds on sale of assets	2022-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2022-12-31	$0
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	FELIX & GLOEKLER P.C.
Accountancy firm EIN	2022-12-31	250001555
2021 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,610,302
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$432,244
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$411,826
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$413,709
Value of total assets at end of year	2021-12-31	$9,241,877
Value of total assets at beginning of year	2021-12-31	$8,063,819
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$20,418
Total interest from all sources	2021-12-31	$19,606
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$261,861
Participant contributions at end of year	2021-12-31	$178,424
Participant contributions at beginning of year	2021-12-31	$206,163
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$31,873
Other income not declared elsewhere	2021-12-31	$0
Administrative expenses (other) incurred	2021-12-31	$20,418
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$1,178,058
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$9,241,877
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$8,063,819
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$7,909,118
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$6,838,074
Interest on participant loans	2021-12-31	$8,713
Interest earned on other investments	2021-12-31	$10,893
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,154,335
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,019,582
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Net investment gain/loss from pooled separate accounts	2021-12-31	$1,176,987
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$119,975
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$411,826
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	FELIX & GLOEKLER. P.C.
Accountancy firm EIN	2021-12-31	250001555
2020 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,513,205
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$484,067
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$480,921
Expenses. Certain deemed distributions of participant loans	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$406,321
Value of total assets at end of year	2020-12-31	$8,063,819
Value of total assets at beginning of year	2020-12-31	$7,034,681
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$3,146
Total interest from all sources	2020-12-31	$21,662
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$260,999
Participant contributions at end of year	2020-12-31	$206,163
Participant contributions at beginning of year	2020-12-31	$228,854
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$28,020
Other income not declared elsewhere	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$3,146
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$1,029,138
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$8,063,819
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$7,034,681
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$6,838,074
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$5,751,326
Interest on participant loans	2020-12-31	$11,380
Interest earned on other investments	2020-12-31	$10,282
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,019,582
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$1,054,501
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from pooled separate accounts	2020-12-31	$1,085,222
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$117,302
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$480,921
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	FELIX & GLOEKLER, P.C.
Accountancy firm EIN	2020-12-31	260001555
2019 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$1,597,904
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$311,421
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$302,758
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$457,260
Value of total assets at end of year	2019-12-31	$7,034,681
Value of total assets at beginning of year	2019-12-31	$5,748,198
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$8,663
Total interest from all sources	2019-12-31	$29,981
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$260,545
Participant contributions at end of year	2019-12-31	$228,853
Participant contributions at beginning of year	2019-12-31	$323,935
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$69,895
Other income not declared elsewhere	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$8,663
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,286,483
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$7,034,681
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$5,748,198
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$5,751,326
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$4,487,029
Interest on participant loans	2019-12-31	$12,949
Interest earned on other investments	2019-12-31	$17,032
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,054,502
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$937,234
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from pooled separate accounts	2019-12-31	$1,110,663
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$126,820
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$302,758
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	FELIX & GLOEKLER, P.C.
Accountancy firm EIN	2019-12-31	260001555
2018 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$172,355
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$135,408
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$132,840
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$499,278
Value of total assets at end of year	2018-12-31	$5,748,777
Value of total assets at beginning of year	2018-12-31	$5,711,830
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$2,568
Total interest from all sources	2018-12-31	$21,146
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$236,384
Participant contributions at end of year	2018-12-31	$324,514
Participant contributions at beginning of year	2018-12-31	$308,483
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$6,898
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$126,272
Other income not declared elsewhere	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$2,568
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$36,947
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$5,748,777
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$5,711,830
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$4,487,029
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$4,536,979
Interest on participant loans	2018-12-31	$12,033
Interest earned on other investments	2018-12-31	$9,113
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$937,234
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$854,330
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from pooled separate accounts	2018-12-31	$-348,069
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$136,622
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$5,140
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$132,840
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	SEAN T SULLIVAN CPA PC
Accountancy firm EIN	2018-12-31	251808286
2017 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$1,007,392
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$939,492
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$917,374
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$332,267
Value of total assets at end of year	2017-12-31	$5,711,830
Value of total assets at beginning of year	2017-12-31	$5,643,930
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$22,118
Total interest from all sources	2017-12-31	$22,508
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$192,158
Participant contributions at end of year	2017-12-31	$308,483
Participant contributions at beginning of year	2017-12-31	$300,133
Participant contributions at end of year	2017-12-31	$6,898
Other income not declared elsewhere	2017-12-31	$0
Administrative expenses (other) incurred	2017-12-31	$22,118
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$67,900
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$5,711,830
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$5,643,930
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$4,536,979
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,837,651
Interest on participant loans	2017-12-31	$11,761
Interest earned on other investments	2017-12-31	$10,747
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$854,330
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$1,479,941
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from pooled separate accounts	2017-12-31	$652,617
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$140,109
Employer contributions (assets) at end of year	2017-12-31	$5,140
Employer contributions (assets) at beginning of year	2017-12-31	$26,205
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$917,374
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	SEAN T SULLIVAN CPA PC
Accountancy firm EIN	2017-12-31	251808286
2016 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$791,199
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$676,688
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$643,283
Expenses. Certain deemed distributions of participant loans	2016-12-31	$31,197
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$401,015
Value of total assets at end of year	2016-12-31	$5,643,930
Value of total assets at beginning of year	2016-12-31	$5,529,419
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$2,208
Total interest from all sources	2016-12-31	$23,471
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$195,193
Participant contributions at end of year	2016-12-31	$300,133
Participant contributions at beginning of year	2016-12-31	$262,603
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$31,748
Other income not declared elsewhere	2016-12-31	$0
Administrative expenses (other) incurred	2016-12-31	$2,208
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$114,511
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$5,643,930
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$5,529,419
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$3,837,651
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$4,123,020
Interest on participant loans	2016-12-31	$11,412
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$12,059
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$1,479,941
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$1,139,354
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Net investment gain/loss from pooled separate accounts	2016-12-31	$366,713
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$174,074
Employer contributions (assets) at end of year	2016-12-31	$26,205
Employer contributions (assets) at beginning of year	2016-12-31	$4,442
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$643,283
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	SEAN T SULLIVAN CPA PC
Accountancy firm EIN	2016-12-31	251808286
2015 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$389,785
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$391,351
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$390,216
Expenses. Certain deemed distributions of participant loans	2015-12-31	$2
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$381,737
Value of total assets at end of year	2015-12-31	$5,529,419
Value of total assets at beginning of year	2015-12-31	$5,530,985
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,133
Total interest from all sources	2015-12-31	$22,475
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$249,592
Participant contributions at end of year	2015-12-31	$262,603
Participant contributions at beginning of year	2015-12-31	$207,485
Other income not declared elsewhere	2015-12-31	$0
Administrative expenses (other) incurred	2015-12-31	$1,133
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-1,566
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$5,529,419
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$5,530,985
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$4,123,020
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$4,043,299
Interest on participant loans	2015-12-31	$9,518
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$12,957
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$1,139,354
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$1,280,201
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$0
Net investment gain/loss from pooled separate accounts	2015-12-31	$-14,427
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$132,145
Employer contributions (assets) at end of year	2015-12-31	$4,442
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$390,216
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	SEAN T. SULLIVAN CPA PC
Accountancy firm EIN	2015-12-31	251808286
2014 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$675,499
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$190,488
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$170,039
Expenses. Certain deemed distributions of participant loans	2014-12-31	$20,449
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$371,741
Value of total assets at end of year	2014-12-31	$5,530,985
Value of total assets at beginning of year	2014-12-31	$5,045,974
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$0
Total interest from all sources	2014-12-31	$21,026
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$325,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$233,727
Participant contributions at end of year	2014-12-31	$207,485
Participant contributions at beginning of year	2014-12-31	$210,540
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$0
Other income not declared elsewhere	2014-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$485,011
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$5,530,985
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$5,045,974
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$4,043,299
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$3,604,083
Interest on participant loans	2014-12-31	$8,179
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$12,847
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$1,280,201
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,231,351
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$0
Net investment gain/loss from pooled separate accounts	2014-12-31	$282,732
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$138,014
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$170,039
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	SEAN T SULLIVAN CPA PC
Accountancy firm EIN	2014-12-31	251808286
2013 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$1,114,646
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$224,059
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$224,059
Expenses. Certain deemed distributions of participant loans	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$434,480
Value of total assets at end of year	2013-12-31	$5,045,456
Value of total assets at beginning of year	2013-12-31	$4,154,869
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$0
Total interest from all sources	2013-12-31	$20,561
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$350,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$221,953
Participant contributions at end of year	2013-12-31	$210,022
Participant contributions at beginning of year	2013-12-31	$163,698
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$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	2013-12-31	No
Value of net income/loss	2013-12-31	$890,587
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$5,045,456
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$4,154,869
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$3,604,083
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$2,729,409
Interest on participant loans	2013-12-31	$7,055
Interest earned on other investments	2013-12-31	$13,506
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1,231,351
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$1,261,762
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$0
Net investment gain/loss from pooled separate accounts	2013-12-31	$659,605
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$212,527
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$224,059
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	SEAN T SULLIVAN, CPA, PC
Accountancy firm EIN	2013-12-31	251808286
2012 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$747,948
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$85,850
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$82,843
Expenses. Certain deemed distributions of participant loans	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$425,319
Value of total assets at end of year	2012-12-31	$4,154,869
Value of total assets at beginning of year	2012-12-31	$3,492,771
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$3,007
Total interest from all sources	2012-12-31	$24,019
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$350,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$209,994
Participant contributions at end of year	2012-12-31	$163,698
Participant contributions at beginning of year	2012-12-31	$131,706
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$2,641
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$662,098
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$4,154,869
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$3,492,771
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$2,729,409
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$2,278,793
Interest on participant loans	2012-12-31	$5,541
Interest earned on other investments	2012-12-31	$18,478
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$1,261,762
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$1,082,272
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$0
Net investment gain/loss from pooled separate accounts	2012-12-31	$298,610
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$212,684
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$82,843
Contract administrator fees	2012-12-31	$3,007
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	SEAN T SULLIVAN, CPA PC
Accountancy firm EIN	2012-12-31	251808286
2011 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$408,343
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$175,702
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$172,863
Expenses. Certain deemed distributions of participant loans	2011-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$426,322
Value of total assets at end of year	2011-12-31	$3,492,771
Value of total assets at beginning of year	2011-12-31	$3,260,130
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$2,839
Total interest from all sources	2011-12-31	$25,968
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$350,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$193,401
Participant contributions at end of year	2011-12-31	$131,706
Participant contributions at beginning of year	2011-12-31	$119,299
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$0
Administrative expenses (other) incurred	2011-12-31	$2,839
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$232,641
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$3,492,771
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$3,260,130
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$2,278,793
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$2,133,145
Interest on participant loans	2011-12-31	$4,923
Interest earned on other investments	2011-12-31	$21,045
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,082,272
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$1,007,686
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$0
Net investment gain/loss from pooled separate accounts	2011-12-31	$-43,947
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$232,921
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$172,863
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	SEAN T. SULLIVAN, CPA PC
Accountancy firm EIN	2011-12-31	251808286
2010 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$652,612
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$285,245
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$282,747
Expenses. Certain deemed distributions of participant loans	2010-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$353,924
Value of total assets at end of year	2010-12-31	$3,260,130
Value of total assets at beginning of year	2010-12-31	$2,892,763
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$2,498
Total interest from all sources	2010-12-31	$32,726
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$350,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$179,381
Participant contributions at end of year	2010-12-31	$119,299
Participant contributions at beginning of year	2010-12-31	$66,351
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$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	2010-12-31	No
Value of net income/loss	2010-12-31	$367,367
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$3,260,130
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$2,892,763
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$2,133,145
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$1,730,393
Interest on participant loans	2010-12-31	$3,648
Interest earned on other investments	2010-12-31	$29,078
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$1,007,686
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$1,096,019
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$0
Net investment gain/loss from pooled separate accounts	2010-12-31	$265,962
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$174,543
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$282,747
Contract administrator fees	2010-12-31	$2,498
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	SEAN T SULLIVAN, CPA PC
Accountancy firm EIN	2010-12-31	251808286
2009 : 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 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 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC.

2022: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 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 – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 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 – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 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
2013: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	Yes
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
2012: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 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
2011: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BREVILLIER VILLAGE FOUNDATION, INC. 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

052760

Policy instance

Insurance contract or identification number	052760
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $134
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	1
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
Amount paid for insurance broker fees	134
Additional information about fees paid to insurance broker	INCENTIVE COMPENSATION
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

052760I

Policy instance

Insurance contract or identification number	052760I
Number of Individuals Covered	166
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $833
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	1
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	833
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

052760I

Policy instance

Insurance contract or identification number	052760I
Number of Individuals Covered	170
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $833
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	1
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	833
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

052760I

Policy instance

Insurance contract or identification number	052760I
Number of Individuals Covered	170
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $630
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	1
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	630
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

052760I

Policy instance

Insurance contract or identification number	052760I
Number of Individuals Covered	172
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,602
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	1
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	1602
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

052760I

Policy instance

Insurance contract or identification number	052760I
Number of Individuals Covered	173
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,945
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	1
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	1945
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?	3
Insurance broker name	PITTSBURGH REGIONAL OFFICE

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See full terms and conditions

Company Name:	BREVILLIER VILLAGE FOUNDATION,INC.
Employer identification number (EIN):	251548657
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE
Incorporation Date:
Company Identification Number:	946392