401k Plan data: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN plan

GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 401k Plan overview

Plan Name	GAZELLE SPORTS EMPLOYEE SAVINGS PLAN
Plan identification number	001

GAZELLE SPORTS EMPLOYEE SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

GAZELLE SPORTS INC has sponsored the creation of one or more 401k plans.

Company Name: GAZELLE SPORTS INC

Employer identification number (EIN): 263912439

NAIC Classification: 451110
NAIC Description: Sporting Goods Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GAZELLE SPORTS EMPLOYEE SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 JEAN SEQUITE 2023-10-12
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 JEAN SEQUITE JEAN SEQUITE 2018-10-10
001 2016-01-01 JEAN SEQUITE 2017-07-19 JEAN SEQUITE 2017-07-19
001 2015-01-01 JEAN SEQUITE 2016-07-21
001 2014-01-01 JEAN SEQUITE 2015-07-10 JEAN SEQUITE 2015-07-10
001 2013-01-01 JEAN SEQUITE 2014-07-25 JEAN SEQUITE 2014-07-25
001 2012-01-01 JEAN SEQUITE 2013-07-01 JEAN SEQUITE 2013-07-01
001 2011-01-01 JEAN SEQUITE 2012-07-18 JEAN SEQUITE 2012-07-18
001 2010-01-01 JEAN SEQUITE 2011-07-18 JEAN SEQUITE 2011-07-18

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	JEAN SEQUITE	2023-10-12
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	JEAN SEQUITE		JEAN SEQUITE	2018-10-10
001	2016-01-01	JEAN SEQUITE	2017-07-19	JEAN SEQUITE	2017-07-19
001	2015-01-01	JEAN SEQUITE	2016-07-21
001	2014-01-01	JEAN SEQUITE	2015-07-10	JEAN SEQUITE	2015-07-10
001	2013-01-01	JEAN SEQUITE	2014-07-25	JEAN SEQUITE	2014-07-25
001	2012-01-01	JEAN SEQUITE	2013-07-01	JEAN SEQUITE	2013-07-01
001	2011-01-01	JEAN SEQUITE	2012-07-18	JEAN SEQUITE	2012-07-18
001	2010-01-01	JEAN SEQUITE	2011-07-18	JEAN SEQUITE	2011-07-18

Plan Statistics for GAZELLE SPORTS EMPLOYEE SAVINGS PLAN

401k plan membership statisitcs for GAZELLE SPORTS EMPLOYEE SAVINGS PLAN

Measure Date Value
2022: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 136
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 154
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 22
Total of all active and inactive participants 2022-01-01 176
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 176
Number of participants with account balances 2022-01-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 5
2021: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 126
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 75
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 43
Total of all active and inactive participants 2021-01-01 118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 118
Number of participants with account balances 2021-01-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 13
2020: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 148
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 97
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 29
Total of all active and inactive participants 2020-01-01 126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 126
Number of participants with account balances 2020-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 14
2019: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 143
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 110
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 31
Total of all active and inactive participants 2019-01-01 141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 141
Number of participants with account balances 2019-01-01 124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 10
2018: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 142
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 107
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 34
Total of all active and inactive participants 2018-01-01 141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 141
Number of participants with account balances 2018-01-01 124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 25
2017: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 117
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 20
Total of all active and inactive participants 2017-01-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 137
Number of participants with account balances 2017-01-01 121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 15

Measure	Date	Value
2022: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	136
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	154
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	22
Total of all active and inactive participants	2022-01-01	176
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	176
Number of participants with account balances	2022-01-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	5
2021: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	126
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	75
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	43
Total of all active and inactive participants	2021-01-01	118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	118
Number of participants with account balances	2021-01-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	13
2020: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	148
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	97
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	29
Total of all active and inactive participants	2020-01-01	126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	126
Number of participants with account balances	2020-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	14
2019: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	143
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	110
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	31
Total of all active and inactive participants	2019-01-01	141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	141
Number of participants with account balances	2019-01-01	124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	10
2018: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	142
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	107
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	34
Total of all active and inactive participants	2018-01-01	141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	141
Number of participants with account balances	2018-01-01	124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	25
2017: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	117
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	20
Total of all active and inactive participants	2017-01-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	137
Number of participants with account balances	2017-01-01	121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	15

Financial Data on GAZELLE SPORTS EMPLOYEE SAVINGS PLAN

Measure	Date	Value
2022 : GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	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	$-492,271
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$572,469
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$552,561
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$288,662
Value of total assets at end of year	2022-12-31	$3,631,772
Value of total assets at beginning of year	2022-12-31	$4,696,512
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$19,908
Total interest from all sources	2022-12-31	$3,676
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
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	Yes
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$247,395
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$12,403
Total non interest bearing cash at end of year	2022-12-31	$6
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
Value of net income/loss	2022-12-31	$-1,064,740
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$3,631,772
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$4,696,512
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$3,474,208
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$4,556,570
Interest earned on other investments	2022-12-31	$3,676
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$157,558
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$139,942
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-784,609
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	$28,864
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$552,561
Contract administrator fees	2022-12-31	$19,908
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2022-12-31	Yes
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
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	CLARK SCHAEFFER HACKETT & CO
Accountancy firm EIN	2022-12-31	310800053
2021 : GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 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	$789,049
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$194,416
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$154,203
Value of total corrective distributions	2021-12-31	$1,819
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$249,356
Value of total assets at end of year	2021-12-31	$4,696,512
Value of total assets at beginning of year	2021-12-31	$4,101,879
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$38,394
Total interest from all sources	2021-12-31	$0
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	Yes
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	$219,142
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	$594,633
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$4,696,512
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,101,879
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	$4,556,570
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$3,971,545
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$139,942
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$130,334
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$539,693
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	$30,214
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$154,203
Contract administrator fees	2021-12-31	$38,394
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2021-12-31	Yes
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	Unqualified
Accountancy firm name	2021-12-31	CLARK SCHAEFER HACKETT & CO
Accountancy firm EIN	2021-12-31	310800053
2020 : GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 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	$816,428
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$150,250
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$115,033
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$247,296
Value of total assets at end of year	2020-12-31	$4,101,879
Value of total assets at beginning of year	2020-12-31	$3,435,701
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$35,217
Total interest from all sources	2020-12-31	$0
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	$400,000
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	$190,278
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$29,217
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	$666,178
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$4,101,879
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,435,701
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	$3,971,545
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$3,318,864
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$130,334
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$116,837
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$569,132
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	$27,801
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$115,033
Contract administrator fees	2020-12-31	$35,217
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	CLARK SCHAEFER HACKETT & CO
Accountancy firm EIN	2020-12-31	310800053
2019 : GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 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	$922,249
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$625,516
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$594,529
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$253,892
Value of total assets at end of year	2019-12-31	$3,435,701
Value of total assets at beginning of year	2019-12-31	$3,138,968
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$30,987
Total interest from all sources	2019-12-31	$0
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	$400,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$223,468
Participant contributions at beginning of year	2019-12-31	$7,602
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	$296,733
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,435,701
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,138,968
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	$3,318,864
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$3,045,394
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$116,837
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$84,796
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$668,357
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	$30,424
Employer contributions (assets) at beginning of year	2019-12-31	$1,176
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$594,529
Contract administrator fees	2019-12-31	$30,987
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	CLARK SCHAEFER HACKETT & CO
Accountancy firm EIN	2019-12-31	310800053
2018 : GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 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	$48,745
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$91,915
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$59,820
Value of total corrective distributions	2018-12-31	$72
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$242,332
Value of total assets at end of year	2018-12-31	$3,138,968
Value of total assets at beginning of year	2018-12-31	$3,182,138
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$32,023
Total interest from all sources	2018-12-31	$0
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	$400,000
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	$211,710
Participant contributions at end of year	2018-12-31	$7,602
Participant contributions at beginning of year	2018-12-31	$7,807
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	$-43,170
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$3,138,968
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$3,182,138
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	$3,045,394
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$3,138,715
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$84,796
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$34,358
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-193,587
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	$30,622
Employer contributions (assets) at end of year	2018-12-31	$1,176
Employer contributions (assets) at beginning of year	2018-12-31	$1,258
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$59,820
Contract administrator fees	2018-12-31	$32,023
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	CLARK SCHAEFER HACKETT & CO
Accountancy firm EIN	2018-12-31	310800053
2017 : GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 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	$761,546
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$782,580
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$751,256
Value of total corrective distributions	2017-12-31	$235
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$222,786
Value of total assets at end of year	2017-12-31	$3,182,138
Value of total assets at beginning of year	2017-12-31	$3,203,172
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$31,089
Total interest from all sources	2017-12-31	$0
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	$400,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$193,053
Participant contributions at end of year	2017-12-31	$7,807
Participant contributions at beginning of year	2017-12-31	$7,265
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	$-21,034
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$3,182,138
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,203,172
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	$3,138,715
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,164,073
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$34,358
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$30,727
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$538,760
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	$29,733
Employer contributions (assets) at end of year	2017-12-31	$1,258
Employer contributions (assets) at beginning of year	2017-12-31	$1,107
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$751,256
Contract administrator fees	2017-12-31	$31,089
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	WARMELS & COMSTOCK, PLLC
Accountancy firm EIN	2017-12-31	383204593

Form 5500 Responses for GAZELLE SPORTS EMPLOYEE SAVINGS PLAN

2022: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 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 funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 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 funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 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 funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 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 funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 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 funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: GAZELLE SPORTS EMPLOYEE SAVINGS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-GS4B

Policy instance

Insurance contract or identification number	GAP-CP-GS4B
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 $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

815547

Policy instance

Insurance contract or identification number	815547
Number of Individuals Covered	176
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 $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-GS4B

Policy instance

Insurance contract or identification number	GAP-CP-GS4B
Number of Individuals Covered	118
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 $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-GS4B

Policy instance

Insurance contract or identification number	GAP-CP-GS4B
Number of Individuals Covered	126
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 $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-GS4B

Policy instance

Insurance contract or identification number	GAP-CP-GS4B
Number of Individuals Covered	141
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 $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-GS4B

Policy instance

Insurance contract or identification number	GAP-CP-GS4B
Number of Individuals Covered	141
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 $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-GS4B

Policy instance

Insurance contract or identification number	GAP-CP-GS4B
Number of Individuals Covered	121
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 $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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Company Name:	GAZELLE SPORTS INC
Employer identification number (EIN):	263912439
NAIC Classification:	451110
NAIC Description:	Sporting Goods Stores