401k Plan data: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN plan

OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 401k Plan overview

Plan Name	OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN
Plan identification number	001

OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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(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.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
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

OHIO DISTRICT 5 AREA AGENCY ON AGING has sponsored the creation of one or more 401k plans.

Company Name: OHIO DISTRICT 5 AREA AGENCY ON AGING

Employer identification number (EIN): 341617183

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 TERESA CLAYTON 2023-10-12 TERESA CLAYTON 2023-10-12
001 2021-01-01 TERESA CLAYTON 2022-10-06
001 2020-01-01 JIM HAIRSTON 2021-09-20
001 2019-01-01 JIM HAIRSTON 2020-10-07
001 2018-01-01 JIM HAIRSTON 2019-10-08
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 JIM HAIRSTON
001 2013-01-01 JIM HAIRSTON
001 2012-01-01 JIM HAIRSTON
001 2011-01-01 DUANA PATTON
001 2010-01-01 DUANA PATTON
001 2009-01-01 DUANA PATTON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	TERESA CLAYTON	2023-10-12	TERESA CLAYTON	2023-10-12
001	2021-01-01	TERESA CLAYTON	2022-10-06
001	2020-01-01	JIM HAIRSTON	2021-09-20
001	2019-01-01	JIM HAIRSTON	2020-10-07
001	2018-01-01	JIM HAIRSTON	2019-10-08
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	JIM HAIRSTON
001	2013-01-01	JIM HAIRSTON
001	2012-01-01	JIM HAIRSTON
001	2011-01-01	DUANA PATTON
001	2010-01-01	DUANA PATTON
001	2009-01-01	DUANA PATTON

Plan Statistics for OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN

401k plan membership statisitcs for OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN

Measure Date Value
2022: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 148
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 124
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 31
Total of all active and inactive participants 2022-01-01 155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 155
Number of participants with account balances 2022-01-01 140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 1
2021: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 119
Number of retired or separated participants receiving benefits 2021-01-01 7
Number of other retired or separated participants entitled to future benefits 2021-01-01 22
Total of all active and inactive participants 2021-01-01 148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 148
Number of participants with account balances 2021-01-01 135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 2
2020: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 160
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 110
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 44
Total of all active and inactive participants 2020-01-01 154
Total participants 2020-01-01 154
Number of participants with account balances 2020-01-01 148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1
2019: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 148
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 115
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 0
Total of all active and inactive participants 2019-01-01 115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 43
Total participants 2019-01-01 158
Number of participants with account balances 2019-01-01 145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 117
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 31
Total of all active and inactive participants 2018-01-01 148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 148
Number of participants with account balances 2018-01-01 138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 115
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 34
Total of all active and inactive participants 2017-01-01 149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 149
Number of participants with account balances 2017-01-01 147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 1
2016: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 146
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 119
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 37
Total of all active and inactive participants 2016-01-01 156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 156
Number of participants with account balances 2016-01-01 143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 9
2015: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 136
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 129
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 16
Total of all active and inactive participants 2015-01-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 145
Number of participants with account balances 2015-01-01 140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 1
2014: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 116
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 111
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 25
Total of all active and inactive participants 2014-01-01 136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 136
Number of participants with account balances 2014-01-01 124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 119
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 98
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 18
Total of all active and inactive participants 2013-01-01 116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 116
Number of participants with account balances 2013-01-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 4
2012: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 98
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 21
Total of all active and inactive participants 2012-01-01 119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 119
Number of participants with account balances 2012-01-01 117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 3
2011: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 103
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 20
Total of all active and inactive participants 2011-01-01 123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 123
Number of participants with account balances 2011-01-01 119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 5
2010: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 102
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 107
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 8
Total of all active and inactive participants 2010-01-01 115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 115
Number of participants with account balances 2010-01-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 104
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 97
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 5
Total of all active and inactive participants 2009-01-01 102
Total participants 2009-01-01 102
Number of participants with account balances 2009-01-01 101

Measure	Date	Value
2022: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	148
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	124
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	31
Total of all active and inactive participants	2022-01-01	155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	155
Number of participants with account balances	2022-01-01	140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	1
2021: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	119
Number of retired or separated participants receiving benefits	2021-01-01	7
Number of other retired or separated participants entitled to future benefits	2021-01-01	22
Total of all active and inactive participants	2021-01-01	148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	148
Number of participants with account balances	2021-01-01	135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	2
2020: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	160
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	110
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	44
Total of all active and inactive participants	2020-01-01	154
Total participants	2020-01-01	154
Number of participants with account balances	2020-01-01	148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1
2019: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	148
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	115
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	0
Total of all active and inactive participants	2019-01-01	115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	43
Total participants	2019-01-01	158
Number of participants with account balances	2019-01-01	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	117
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	31
Total of all active and inactive participants	2018-01-01	148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	148
Number of participants with account balances	2018-01-01	138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	115
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	34
Total of all active and inactive participants	2017-01-01	149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	149
Number of participants with account balances	2017-01-01	147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	1
2016: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	146
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	119
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	37
Total of all active and inactive participants	2016-01-01	156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	156
Number of participants with account balances	2016-01-01	143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	9
2015: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	136
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	129
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	16
Total of all active and inactive participants	2015-01-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	145
Number of participants with account balances	2015-01-01	140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	1
2014: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	116
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	111
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	25
Total of all active and inactive participants	2014-01-01	136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	136
Number of participants with account balances	2014-01-01	124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	119
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	98
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	18
Total of all active and inactive participants	2013-01-01	116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	116
Number of participants with account balances	2013-01-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	4
2012: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	98
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	21
Total of all active and inactive participants	2012-01-01	119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	119
Number of participants with account balances	2012-01-01	117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	3
2011: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	103
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	20
Total of all active and inactive participants	2011-01-01	123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	123
Number of participants with account balances	2011-01-01	119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	5
2010: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	102
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	107
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	8
Total of all active and inactive participants	2010-01-01	115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	115
Number of participants with account balances	2010-01-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	104
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	97
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	5
Total of all active and inactive participants	2009-01-01	102
Total participants	2009-01-01	102
Number of participants with account balances	2009-01-01	101

Financial Data on OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN

Measure	Date	Value
2022 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT 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	$-71,541
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$435,014
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$391,645
Expenses. Certain deemed distributions of participant loans	2022-12-31	$1,307
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$353,324
Value of total assets at end of year	2022-12-31	$2,374,985
Value of total assets at beginning of year	2022-12-31	$2,881,540
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$42,062
Total interest from all sources	2022-12-31	$1,915
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	$300,000
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	$196,867
Participant contributions at end of year	2022-12-31	$54,942
Participant contributions at beginning of year	2022-12-31	$31,079
Participant contributions at end of year	2022-12-31	$5,570
Participant contributions at beginning of year	2022-12-31	$7,330
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$955
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$934
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$1,238
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	$-506,555
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$2,374,985
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$2,881,540
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
Investment advisory and management fees	2022-12-31	$41,837
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$2,119,235
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$2,632,867
Interest on participant loans	2022-12-31	$1,915
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$188,205
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$202,597
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-426,780
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	$155,502
Employer contributions (assets) at end of year	2022-12-31	$6,099
Employer contributions (assets) at beginning of year	2022-12-31	$6,429
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$391,645
Contract administrator fees	2022-12-31	$225
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	HOLBROOK & MANTER, CPAS
Accountancy firm EIN	2022-12-31	310998651
2021 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT 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	$749,961
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$444,886
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$366,765
Expenses. Certain deemed distributions of participant loans	2021-12-31	$30,377
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$404,309
Value of total assets at end of year	2021-12-31	$2,881,540
Value of total assets at beginning of year	2021-12-31	$2,576,465
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$47,744
Total interest from all sources	2021-12-31	$1,330
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	$300,000
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	$193,134
Participant contributions at end of year	2021-12-31	$31,079
Participant contributions at beginning of year	2021-12-31	$63,221
Participant contributions at end of year	2021-12-31	$7,330
Participant contributions at beginning of year	2021-12-31	$7,341
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$58,082
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$1,238
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$331
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	$305,075
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,881,540
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,576,465
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
Investment advisory and management fees	2021-12-31	$47,569
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$2,632,867
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$2,242,822
Interest on participant loans	2021-12-31	$1,330
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$202,597
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$257,299
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$344,322
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	$153,093
Employer contributions (assets) at end of year	2021-12-31	$6,429
Employer contributions (assets) at beginning of year	2021-12-31	$5,451
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$366,765
Contract administrator fees	2021-12-31	$175
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	HOLBROOK & MANTER, CPAS
Accountancy firm EIN	2021-12-31	310998651
2020 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT 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	$631,066
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$403,150
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$347,614
Expenses. Certain deemed distributions of participant loans	2020-12-31	$16,597
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$293,993
Value of total assets at end of year	2020-12-31	$2,576,465
Value of total assets at beginning of year	2020-12-31	$2,348,549
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$38,939
Total interest from all sources	2020-12-31	$3,297
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	$250
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$300,000
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	$154,471
Participant contributions at end of year	2020-12-31	$63,221
Participant contributions at beginning of year	2020-12-31	$92,195
Participant contributions at end of year	2020-12-31	$7,341
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$331
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$331
Value of other receiveables (less allowance for doubtful accounts) 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	$227,916
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,576,465
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,348,549
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	$2,242,822
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$1,977,384
Interest on participant loans	2020-12-31	$3,297
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$257,299
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$278,970
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$333,776
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	$139,191
Employer contributions (assets) at end of year	2020-12-31	$5,451
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$347,614
Contract administrator fees	2020-12-31	$38,689
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	HOLBROOK & MANTER, CPAS
Accountancy firm EIN	2020-12-31	310998651
2019 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT 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	$691,079
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$366,665
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$307,598
Expenses. Certain deemed distributions of participant loans	2019-12-31	$24,166
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$310,295
Value of total assets at end of year	2019-12-31	$2,348,549
Value of total assets at beginning of year	2019-12-31	$2,024,135
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$34,901
Total interest from all sources	2019-12-31	$3,729
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
Administrative expenses professional fees incurred	2019-12-31	$250
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$300,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$143,612
Participant contributions at end of year	2019-12-31	$92,195
Participant contributions at beginning of year	2019-12-31	$78,258
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$23,283
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$29,870
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	$324,414
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,348,549
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,024,135
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	$1,977,384
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,654,063
Interest on participant loans	2019-12-31	$3,729
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$5,646
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$5,646
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$278,970
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$240,122
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$377,055
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	$136,813
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$22,763
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$307,598
Contract administrator fees	2019-12-31	$34,651
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	HOLBROOK & MANTER, CPAS
Accountancy firm EIN	2019-12-31	310998651
2018 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT 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	$131,864
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$321,370
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$248,716
Expenses. Certain deemed distributions of participant loans	2018-12-31	$37,673
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$263,145
Value of total assets at end of year	2018-12-31	$2,024,135
Value of total assets at beginning of year	2018-12-31	$2,213,641
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$34,981
Total interest from all sources	2018-12-31	$1,995
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	$300,000
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	$123,061
Participant contributions at end of year	2018-12-31	$78,258
Participant contributions at beginning of year	2018-12-31	$45,126
Participant contributions at end of year	2018-12-31	$23,283
Participant contributions at beginning of year	2018-12-31	$4,908
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$1,661
Other income not declared elsewhere	2018-12-31	$-3
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	$-189,506
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,024,135
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,213,641
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	$1,654,063
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$1,927,306
Interest on participant loans	2018-12-31	$1,995
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$5,646
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$3,815
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$3,815
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$240,122
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$227,198
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-133,273
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	$138,423
Employer contributions (assets) at end of year	2018-12-31	$22,763
Employer contributions (assets) at beginning of year	2018-12-31	$5,288
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$248,716
Contract administrator fees	2018-12-31	$34,981
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	HOLBROOK & MANTER, CPAS
Accountancy firm EIN	2018-12-31	310998651
2017 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT 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	$553,776
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$715,552
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$678,414
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$258,498
Value of total assets at end of year	2017-12-31	$2,213,641
Value of total assets at beginning of year	2017-12-31	$2,375,417
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$37,138
Total interest from all sources	2017-12-31	$1,365
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	$300,000
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	$126,435
Participant contributions at end of year	2017-12-31	$45,126
Participant contributions at beginning of year	2017-12-31	$45,743
Participant contributions at end of year	2017-12-31	$4,908
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$278
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	$-161,776
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,213,641
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,375,417
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
Investment advisory and management fees	2017-12-31	$3,008
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$1,927,306
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$1,937,312
Interest on participant loans	2017-12-31	$1,365
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$3,815
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$46,174
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$46,174
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$227,198
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$346,188
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$293,913
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	$131,785
Employer contributions (assets) at end of year	2017-12-31	$5,288
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$678,414
Contract administrator fees	2017-12-31	$34,130
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	HOLBROOK & MANTER, CPAS
Accountancy firm EIN	2017-12-31	310998651
2016 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$413,224
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$218,126
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$185,758
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$256,306
Value of total assets at end of year	2016-12-31	$2,375,417
Value of total assets at beginning of year	2016-12-31	$2,180,319
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$32,368
Total interest from all sources	2016-12-31	$1,702
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$150,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$116,419
Participant contributions at end of year	2016-12-31	$45,743
Participant contributions at beginning of year	2016-12-31	$61,264
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$12,376
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$195,098
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,375,417
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,180,319
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$6,690
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$1,937,312
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,683,212
Interest on participant loans	2016-12-31	$1,702
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$46,174
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$17,849
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$17,849
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$346,188
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$417,994
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$155,216
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$127,511
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$185,758
Contract administrator fees	2016-12-31	$25,678
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	HOLBROOK & MANTER, CPAS
Accountancy firm EIN	2016-12-31	310998651
2015 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$187,461
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$174,495
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$142,383
Expenses. Certain deemed distributions of participant loans	2015-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$234,415
Value of total assets at end of year	2015-12-31	$2,180,319
Value of total assets at beginning of year	2015-12-31	$2,167,353
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$32,112
Total interest from all sources	2015-12-31	$1,830
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$150,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$114,117
Participant contributions at end of year	2015-12-31	$61,264
Participant contributions at beginning of year	2015-12-31	$85,145
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$4,697
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$9,312
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$12,966
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$2,180,319
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$2,167,353
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$1,683,212
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,685,771
Interest on participant loans	2015-12-31	$2,096
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$17,849
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$12,690
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$12,690
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$-266
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$417,994
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$374,663
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-48,784
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$110,986
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$4,387
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$142,383
Contract administrator fees	2015-12-31	$32,112
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	HOLBROOK & MANTER, CPAS
Accountancy firm EIN	2015-12-31	310998651
2014 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$266,865
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$152,912
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$115,858
Expenses. Certain deemed distributions of participant loans	2014-12-31	$6,315
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$193,201
Value of total assets at end of year	2014-12-31	$2,167,353
Value of total assets at beginning of year	2014-12-31	$2,053,400
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$30,739
Total interest from all sources	2014-12-31	$2,004
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$150,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$114,536
Participant contributions at end of year	2014-12-31	$85,145
Participant contributions at beginning of year	2014-12-31	$53,124
Participant contributions at end of year	2014-12-31	$4,697
Participant contributions at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$11,076
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$113,953
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$2,167,353
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$2,053,400
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$1,685,771
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,636,957
Interest on participant loans	2014-12-31	$2,191
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$12,690
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$7,454
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$7,454
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$-187
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$374,663
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$355,865
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$71,660
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$67,589
Employer contributions (assets) at end of year	2014-12-31	$4,387
Employer contributions (assets) at beginning of year	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$115,858
Contract administrator fees	2014-12-31	$30,739
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	HOLBROOK & MANTER, CPAS
Accountancy firm EIN	2014-12-31	310998651
2013 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$408,619
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$265,041
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$250,009
Expenses. Certain deemed distributions of participant loans	2013-12-31	$14,657
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$176,507
Value of total assets at end of year	2013-12-31	$2,053,400
Value of total assets at beginning of year	2013-12-31	$1,909,822
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$375
Total interest from all sources	2013-12-31	$2,794
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$125,182
Participant contributions at end of year	2013-12-31	$53,124
Participant contributions at beginning of year	2013-12-31	$109,780
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$1,113
Other income not declared elsewhere	2013-12-31	$1,155
Administrative expenses (other) incurred	2013-12-31	$375
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$143,578
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$2,053,400
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,909,822
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$1,636,957
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,521,080
Interest on participant loans	2013-12-31	$2,794
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$7,454
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$54,144
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$54,144
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$355,865
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$224,818
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$228,163
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$50,212
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$250,009
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	HOWARD, WERSHBALE & CO.
Accountancy firm EIN	2013-12-31	341663157
2012 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$376,457
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$696,118
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$693,278
Expenses. Certain deemed distributions of participant loans	2012-12-31	$2,415
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$191,051
Value of total assets at end of year	2012-12-31	$1,909,822
Value of total assets at beginning of year	2012-12-31	$2,229,483
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$425
Total interest from all sources	2012-12-31	$3,016
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$132,226
Participant contributions at end of year	2012-12-31	$109,780
Participant contributions at beginning of year	2012-12-31	$63,387
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$5,725
Other income not declared elsewhere	2012-12-31	$-26
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$-319,661
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,909,822
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$2,229,483
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$425
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$1,521,080
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$1,606,016
Interest on participant loans	2012-12-31	$3,016
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$54,144
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$164,256
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$164,256
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$224,818
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$395,824
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$182,416
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$53,100
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$693,278
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	HOWARD, WERSHBALE & CO.
Accountancy firm EIN	2012-12-31	341663157
2011 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$131,491
Expenses. Total of all expenses incurred	2011-12-31	$122,379
Benefits paid (including direct rollovers)	2011-12-31	$111,927
Total plan assets at end of year	2011-12-31	$2,229,457
Total plan assets at beginning of year	2011-12-31	$2,220,345
Value of fidelity bond covering the plan	2011-12-31	$2,000,000
Total contributions received or receivable from participants	2011-12-31	$124,557
Other income received	2011-12-31	$-72,580
Net income (gross income less expenses)	2011-12-31	$9,112
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$2,229,457
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$2,220,345
Assets. Value of participant loans	2011-12-31	$63,362
Total contributions received or receivable from employer(s)	2011-12-31	$79,514
Value of certain deemed distributions of participant loans	2011-12-31	$9,752
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$700
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$674,161
Expenses. Total of all expenses incurred	2010-12-31	$194,849
Benefits paid (including direct rollovers)	2010-12-31	$194,149
Total plan assets at end of year	2010-12-31	$2,220,345
Total plan assets at beginning of year	2010-12-31	$1,741,033
Value of fidelity bond covering the plan	2010-12-31	$2,000,000
Total contributions received or receivable from participants	2010-12-31	$117,156
Contributions received from other sources (not participants or employers)	2010-12-31	$31,399
Other income received	2010-12-31	$425,952
Net income (gross income less expenses)	2010-12-31	$479,312
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$2,220,345
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,741,033
Assets. Value of participant loans	2010-12-31	$53,987
Total contributions received or receivable from employer(s)	2010-12-31	$99,654
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$700
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN

2022: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT 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: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT 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: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT 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: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT 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: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT 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: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT 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
2016: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: OHIO DISTRICT 5 AREA AGENCY ON AGING 403B RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	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-B2-LJ5A

Policy instance

Insurance contract or identification number	GAP-B2-LJ5A
Number of Individuals Covered	15
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,098
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
Commission paid to Insurance Broker	USD $2,098
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR26167

Policy instance

Insurance contract or identification number	CR26167
Number of Individuals Covered	6
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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-B2-LJ5A

Policy instance

Insurance contract or identification number	GAP-B2-LJ5A
Number of Individuals Covered	13
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $2,528
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
Commission paid to Insurance Broker	USD $2,528
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR26167

Policy instance

Insurance contract or identification number	CR26167
Number of Individuals Covered	8
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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-B2-LJ5A

Policy instance

Insurance contract or identification number	GAP-B2-LJ5A
Number of Individuals Covered	19
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,403
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
Commission paid to Insurance Broker	USD $2,403
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR26167

Policy instance

Insurance contract or identification number	CR26167
Number of Individuals Covered	8
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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-B2-LJ5A

Policy instance

Insurance contract or identification number	GAP-B2-LJ5A
Number of Individuals Covered	22
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,759
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
Commission paid to Insurance Broker	USD $1,759
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR26167

Policy instance

Insurance contract or identification number	CR26167
Number of Individuals Covered	9
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $7
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
Commission paid to Insurance Broker	USD $7
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	SALES AND BASE COMMISSIONS
Insurance broker organization code?	4

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

Policy contract number

GAP-B2-RS65

Policy instance

Insurance contract or identification number	GAP-B2-RS65
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $533
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
Commission paid to Insurance Broker	USD $533
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR26167

Policy instance

Insurance contract or identification number	CR26167
Number of Individuals Covered	13
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $513
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
Commission paid to Insurance Broker	USD $513
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	SALES AND BASE COMMISSIONS
Insurance broker organization code?	4

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

Policy contract number

GAP-B2-RS65

Policy instance

Insurance contract or identification number	GAP-B2-RS65
Number of Individuals Covered	23
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $2,047
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
Commission paid to Insurance Broker	USD $2,047
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

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

Policy contract number

GAP-B2-RS65

Policy instance

Insurance contract or identification number	GAP-B2-RS65
Number of Individuals Covered	24
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2,995
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
Commission paid to Insurance Broker	USD $2,995
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INVESTMENT
Insurance broker organization code?	3
Insurance broker name	INVEST FINANCIAL CORPORATION

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR26167

Policy instance

Insurance contract or identification number	CR26167
Number of Individuals Covered	11
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $124
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
Commission paid to Insurance Broker	USD $124
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	SALES AND BASE COMMISSIONS
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR26167

Policy instance

Insurance contract or identification number	CR26167
Number of Individuals Covered	14
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $504
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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
Commission paid to Insurance Broker	USD $504
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	SALES AND BASE COMMISSIONS
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

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

Policy contract number

GAP-B2-RS65

Policy instance

Insurance contract or identification number	GAP-B2-RS65
Number of Individuals Covered	132
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,090
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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
Commission paid to Insurance Broker	USD $2,090
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INVESTMENT
Insurance broker organization code?	3
Insurance broker name	INVEST FINANCIAL CORPORATION

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR26167

Policy instance

Insurance contract or identification number	CR26167
Number of Individuals Covered	14
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $426
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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
Commission paid to Insurance Broker	USD $426
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	SALES AND BASE COMMISSIONS
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

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

Policy contract number

GAP-B2-RS65

Policy instance

Insurance contract or identification number	GAP-B2-RS65
Number of Individuals Covered	124
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $770
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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
Commission paid to Insurance Broker	USD $770
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INVESTMENT
Insurance broker organization code?	3
Insurance broker name	INVEST FINANCIAL CORPORATION

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

Policy contract number

GAP-B2-RS65

Policy instance

Insurance contract or identification number	GAP-B2-RS65
Number of Individuals Covered	115
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $537
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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
Commission paid to Insurance Broker	USD $537
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INVESTMENT
Insurance broker organization code?	3
Insurance broker name	INVEST FINANCIAL CORPORATION

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR26167

Policy instance

Insurance contract or identification number	CR26167
Number of Individuals Covered	15
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $345
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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
Commission paid to Insurance Broker	USD $345
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	SALES AND BASE COMMISSIONS
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

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

Policy contract number

GAP-B2-RS65

Policy instance

Insurance contract or identification number	GAP-B2-RS65
Number of Individuals Covered	98
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $667
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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
Commission paid to Insurance Broker	USD $667
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INVESTMENT
Insurance broker organization code?	3
Insurance broker name	INVEST FINANCIAL CORPORATION

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

Policy contract number

GAP-B2-RS65

Policy instance

Insurance contract or identification number	GAP-B2-RS65
Number of Individuals Covered	119
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $959
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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-B2-RS65

Policy instance

Insurance contract or identification number	GAP-B2-RS65
Number of Individuals Covered	115
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,204
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,204
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	INVESTMENT
Insurance broker organization code?	3
Insurance broker name	INVEST FINANCIAL CORPORATION

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Company Name:	OHIO DISTRICT 5 AREA AGENCY ON AGING
Employer identification number (EIN):	341617183
NAIC Classification:	624100
NAIC Description:	Individual and Family Services