401k Plan data: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN plan

ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 401k Plan overview

Plan Name	ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN
Plan identification number	001

ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
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

ADVENTURE HOMES, LLC has sponsored the creation of one or more 401k plans.

Company Name: ADVENTURE HOMES, LLC

Employer identification number (EIN): 270575823

NAIC Classification: 336990

Additional information about ADVENTURE HOMES, LLC

Jurisdiction of Incorporation: Colorado Department of State

Incorporation Date: 2018-07-10

Company Identification Number: 20181544088

Legal Registered Office Address: 10570 Hungate Road

Colorado Springs
United States of America (USA)
80908

More information about ADVENTURE HOMES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 SUSAN KASINGER
001 2016-01-01 WALTER COMER 2017-04-21
001 2015-01-01 WALTER COMER 2016-06-14
001 2014-01-01 WALTER COMER 2015-04-06
001 2013-01-01 WALTER COMER 2014-05-13
001 2012-01-01 WALTER COMER 2013-04-12
001 2011-01-01 WALTER COMER 2012-08-31
001 2010-01-01 WALTER COMER 2011-03-31

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	SUSAN KASINGER
001	2016-01-01	WALTER COMER	2017-04-21
001	2015-01-01	WALTER COMER	2016-06-14
001	2014-01-01	WALTER COMER	2015-04-06
001	2013-01-01	WALTER COMER	2014-05-13
001	2012-01-01	WALTER COMER	2013-04-12
001	2011-01-01	WALTER COMER	2012-08-31
001	2010-01-01	WALTER COMER	2011-03-31

Plan Statistics for ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN

401k plan membership statisitcs for ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN

Measure Date Value
2022: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 185
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 186
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 1
Total of all active and inactive participants 2022-01-01 187
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 187
Number of participants with account balances 2022-01-01 35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 193
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 179
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 1
Total of all active and inactive participants 2021-01-01 180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 180
Number of participants with account balances 2021-01-01 32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 184
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 173
Number of retired or separated participants receiving benefits 2020-01-01 6
Number of other retired or separated participants entitled to future benefits 2020-01-01 4
Total of all active and inactive participants 2020-01-01 183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 183
Number of participants with account balances 2020-01-01 44
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 172
Number of retired or separated participants receiving benefits 2019-01-01 1
Number of other retired or separated participants entitled to future benefits 2019-01-01 5
Total of all active and inactive participants 2019-01-01 178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 178
Number of participants with account balances 2019-01-01 39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 159
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 152
Number of retired or separated participants receiving benefits 2018-01-01 2
Number of other retired or separated participants entitled to future benefits 2018-01-01 6
Total of all active and inactive participants 2018-01-01 160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 160
Number of participants with account balances 2018-01-01 42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 1
2017: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 148
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 7
Total of all active and inactive participants 2017-01-01 155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 155
Number of participants with account balances 2017-01-01 40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0

Measure	Date	Value
2022: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	185
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	186
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	1
Total of all active and inactive participants	2022-01-01	187
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	187
Number of participants with account balances	2022-01-01	35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	193
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	179
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	1
Total of all active and inactive participants	2021-01-01	180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	180
Number of participants with account balances	2021-01-01	32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	184
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	173
Number of retired or separated participants receiving benefits	2020-01-01	6
Number of other retired or separated participants entitled to future benefits	2020-01-01	4
Total of all active and inactive participants	2020-01-01	183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	183
Number of participants with account balances	2020-01-01	44
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	172
Number of retired or separated participants receiving benefits	2019-01-01	1
Number of other retired or separated participants entitled to future benefits	2019-01-01	5
Total of all active and inactive participants	2019-01-01	178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	178
Number of participants with account balances	2019-01-01	39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	159
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	152
Number of retired or separated participants receiving benefits	2018-01-01	2
Number of other retired or separated participants entitled to future benefits	2018-01-01	6
Total of all active and inactive participants	2018-01-01	160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	160
Number of participants with account balances	2018-01-01	42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	1
2017: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	148
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	7
Total of all active and inactive participants	2017-01-01	155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	155
Number of participants with account balances	2017-01-01	40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0

Financial Data on ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN

Measure	Date	Value
2022 : ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING 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	$73,328
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$101,315
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$96,862
Expenses. Certain deemed distributions of participant loans	2022-12-31	$4,128
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$258,159
Value of total assets at end of year	2022-12-31	$1,478,608
Value of total assets at beginning of year	2022-12-31	$1,506,595
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$325
Total interest from all sources	2022-12-31	$2,591
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
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$75,000
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	$101,473
Participant contributions at end of year	2022-12-31	$24,876
Participant contributions at beginning of year	2022-12-31	$46,447
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$156,686
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	$-27,987
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$1,478,608
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$1,506,595
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 pooled separate accounts at end of year	2022-12-31	$1,228,431
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$1,174,814
Interest on participant loans	2022-12-31	$2,591
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$225,301
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$285,334
Net investment gain/loss from pooled separate accounts	2022-12-31	$-187,422
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$96,862
Contract administrator fees	2022-12-31	$325
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	DULIN, WARD & DEWALD, INC.
Accountancy firm EIN	2022-12-31	351344820
2021 : ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING 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	$264,696
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$265,620
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$264,784
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$123,099
Value of total assets at end of year	2021-12-31	$1,506,595
Value of total assets at beginning of year	2021-12-31	$1,507,519
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$836
Total interest from all sources	2021-12-31	$4,513
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	$75,000
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	$123,069
Participant contributions at end of year	2021-12-31	$46,447
Participant contributions at beginning of year	2021-12-31	$41,953
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$3,807
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$30
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	$-924
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$1,506,595
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$1,507,519
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 pooled separate accounts at end of year	2021-12-31	$1,174,814
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$1,110,080
Interest on participant loans	2021-12-31	$3,067
Interest earned on other investments	2021-12-31	$1,446
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$285,334
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$351,679
Net investment gain/loss from pooled separate accounts	2021-12-31	$137,084
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$264,784
Contract administrator fees	2021-12-31	$836
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	DULIN, WARD & DEWALD, INC.
Accountancy firm EIN	2021-12-31	351344820
2020 : ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING 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	$283,116
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$233,590
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$233,115
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$124,381
Value of total assets at end of year	2020-12-31	$1,507,519
Value of total assets at beginning of year	2020-12-31	$1,457,993
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$475
Total interest from all sources	2020-12-31	$7,813
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
Administrative expenses professional fees incurred	2020-12-31	$475
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$120,000
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	$124,381
Participant contributions at end of year	2020-12-31	$41,953
Participant contributions at beginning of year	2020-12-31	$56,874
Participant contributions at end of year	2020-12-31	$3,807
Participant contributions at beginning of year	2020-12-31	$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	2020-12-31	No
Value of net income/loss	2020-12-31	$49,526
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,507,519
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,457,993
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 pooled separate accounts at end of year	2020-12-31	$1,110,080
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$1,074,232
Interest on participant loans	2020-12-31	$3,568
Interest earned on other investments	2020-12-31	$4,245
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$351,679
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$326,887
Net investment gain/loss from pooled separate accounts	2020-12-31	$150,922
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	Yes
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	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$233,115
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	DULIN, WARD & DEWALD, INC.
Accountancy firm EIN	2020-12-31	351344820
2019 : ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
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 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 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	$392,544
Total income from all sources (including contributions)	2019-12-31	$392,544
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$317,467
Total of all expenses incurred	2019-12-31	$317,467
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$316,317
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$316,317
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$176,539
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$176,539
Value of total assets at end of year	2019-12-31	$1,457,993
Value of total assets at end of year	2019-12-31	$1,457,993
Value of total assets at beginning of year	2019-12-31	$1,382,916
Value of total assets at beginning of year	2019-12-31	$1,382,916
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$1,150
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$1,150
Total interest from all sources	2019-12-31	$8,150
Total interest from all sources	2019-12-31	$8,150
Total dividends received (eg from common stock, registered investment company shares)	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
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
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$120,000
Value of fidelity bond cover	2019-12-31	$120,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
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
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$129,345
Contributions received from participants	2019-12-31	$129,345
Participant contributions at end of year	2019-12-31	$56,874
Participant contributions at end of year	2019-12-31	$56,874
Participant contributions at beginning of year	2019-12-31	$52,489
Participant contributions at beginning of year	2019-12-31	$52,489
Participant contributions at end of year	2019-12-31	$0
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$47,194
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$47,194
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
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	$75,077
Value of net income/loss	2019-12-31	$75,077
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,457,993
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,457,993
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,382,916
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,382,916
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
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 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
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$1,074,232
Value of interest in pooled separate accounts at end of year	2019-12-31	$1,074,232
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$955,927
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$955,927
Interest on participant loans	2019-12-31	$3,320
Interest on participant loans	2019-12-31	$3,320
Interest earned on other investments	2019-12-31	$4,830
Interest earned on other investments	2019-12-31	$4,830
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$326,887
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$326,887
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$374,500
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$374,500
Net investment gain/loss from pooled separate accounts	2019-12-31	$207,855
Net investment gain/loss from pooled separate accounts	2019-12-31	$207,855
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
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	Yes
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$316,317
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$316,317
Contract administrator fees	2019-12-31	$1,150
Contract administrator fees	2019-12-31	$1,150
Did the plan have assets held for investment	2019-12-31	Yes
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
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
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
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	DULIN, WARD & DEWALD, INC.
Accountancy firm name	2019-12-31	DULIN, WARD & DEWALD, INC.
Accountancy firm EIN	2019-12-31	351344820
Accountancy firm EIN	2019-12-31	351344820
2018 : ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING 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	$40,832
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$121,317
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$120,042
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$119,394
Value of total assets at end of year	2018-12-31	$1,382,916
Value of total assets at beginning of year	2018-12-31	$1,463,401
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$1,275
Total interest from all sources	2018-12-31	$3,799
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	$120,000
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	$119,394
Participant contributions at end of year	2018-12-31	$52,489
Participant contributions at beginning of year	2018-12-31	$51,944
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$5,571
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	$-80,485
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,382,916
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,463,401
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 pooled separate accounts at end of year	2018-12-31	$955,927
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$1,337,959
Interest on participant loans	2018-12-31	$3,174
Interest earned on other investments	2018-12-31	$625
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$374,500
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$67,927
Net investment gain/loss from pooled separate accounts	2018-12-31	$-82,361
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	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$120,042
Contract administrator fees	2018-12-31	$1,275
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	DULIN, WARD & DEWALD, INC.
Accountancy firm EIN	2018-12-31	351344820
2017 : ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING 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	$284,423
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$12,749
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$12,049
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$116,032
Value of total assets at end of year	2017-12-31	$1,463,401
Value of total assets at beginning of year	2017-12-31	$1,191,727
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$700
Total interest from all sources	2017-12-31	$2,467
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
Administrative expenses professional fees incurred	2017-12-31	$700
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$120,000
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	$116,032
Participant contributions at end of year	2017-12-31	$51,944
Participant contributions at beginning of year	2017-12-31	$43,601
Participant contributions at end of year	2017-12-31	$5,571
Participant contributions at beginning of year	2017-12-31	$1,489
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	$271,674
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,463,401
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,191,727
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 pooled separate accounts at end of year	2017-12-31	$1,337,959
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$1,087,314
Interest on participant loans	2017-12-31	$2,143
Interest earned on other investments	2017-12-31	$324
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$67,927
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$59,323
Net investment gain/loss from pooled separate accounts	2017-12-31	$165,924
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	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$12,049
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	DULIN, WARD & DEWALD, INC.
Accountancy firm EIN	2017-12-31	351344820

Form 5500 Responses for ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING PLAN

2022: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING 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: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING 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: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING 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: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING 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: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING 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: ADVENTURE HOMES, LLC 401(K) AND PROFIT SHARING 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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37778

Policy instance

Insurance contract or identification number	G37778
Number of Individuals Covered	34
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,381
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,381
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37778

Policy instance

Insurance contract or identification number	G37778
Number of Individuals Covered	31
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $4,747
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,747
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37778

Policy instance

Insurance contract or identification number	G37778
Number of Individuals Covered	43
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $43
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $43
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37778

Policy instance

Insurance contract or identification number	G37778
Number of Individuals Covered	39
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $4,479
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,479
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37778

Policy instance

Insurance contract or identification number	G37778
Number of Individuals Covered	41
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $4,166
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,166
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37778

Policy instance

Insurance contract or identification number	G37778
Number of Individuals Covered	39
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $3,872
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,872
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	INSURANCE RESOURCE GROUP INC

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Company Name:	ADVENTURE HOMES, LLC
Employer identification number (EIN):	270575823
NAIC Classification:	336990

Jurisdiction of Incorporation:	Colorado Department of State
Incorporation Date:	2018-07-10
Company Identification Number:	20181544088
Legal Registered Office Address:	10570 Hungate Road Colorado Springs United States of America (USA) 80908