EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 401k Plan overview

Plan Name	EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST
Plan identification number	002

EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1. Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met. Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash. Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities. Participant-directed brokerage accounts provided as an investment option under the plan. Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account. Plan covering Self-Employed individuals. Life insurance

401k Sponsoring company profile

EASTMAN & SMITH LTD has sponsored the creation of one or more 401k plans.

Company Name:	EASTMAN & SMITH LTD
Employer identification number (EIN):	344404967
NAIC Classification:	541110
NAIC Description:	Offices of Lawyers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	LAWRENCE CRYAN		LAWRENCE CRYAN	2018-09-24
002	2016-01-01	LAWRENCE CRYAN
002	2016-01-01
002	2015-01-01	LAWRENCE CRYAN
002	2015-01-01	LAWRENCE CRYAN
002	2014-09-01	LAWRENCE CRYAN
002	2013-09-01	LAWRENCE CRYAN
002	2012-09-01	LAWRENCE CRYAN		GARY M. HARDEN	2014-06-16
002	2011-09-01	LAWRENCE CRYAN		GARY M. HARDEN	2014-06-16
002	2009-09-01	LAWRENCE CRYAN

Plan Statistics for EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST

401k plan membership statisitcs for EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST

Measure	Date	Value
2022: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2022 401k membership
Total participants, beginning-of-year	2022-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	118
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	42
Total of all active and inactive participants	2022-01-01	160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	160
Number of participants with account balances	2022-01-01	158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2021 401k membership
Total participants, beginning-of-year	2021-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	112
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	39
Total of all active and inactive participants	2021-01-01	151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	151
Number of participants with account balances	2021-01-01	146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	138
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	106
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	38
Total of all active and inactive participants	2020-01-01	144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	144
Number of participants with account balances	2020-01-01	142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	143
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	110
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	28
Total of all active and inactive participants	2019-01-01	138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	138
Number of participants with account balances	2019-01-01	138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	148
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	109
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	34
Total of all active and inactive participants	2018-01-01	143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	143
Number of participants with account balances	2018-01-01	143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2017 401k membership
Total participants, beginning-of-year	2017-01-01	149
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	33
Total of all active and inactive participants	2017-01-01	148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	148
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	0
2016: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2016 401k membership
Total participants, beginning-of-year	2016-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	110
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	39
Total of all active and inactive participants	2016-01-01	149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	149
Number of participants with account balances	2016-01-01	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2015 401k membership
Total participants, beginning-of-year	2015-01-01	161
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	121
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	35
Total of all active and inactive participants	2015-01-01	156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	156
Number of participants with account balances	2015-01-01	149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2014 401k membership
Total participants, beginning-of-year	2014-09-01	161
Total number of active participants reported on line 7a of the Form 5500	2014-09-01	117
Number of retired or separated participants receiving benefits	2014-09-01	0
Number of other retired or separated participants entitled to future benefits	2014-09-01	40
Total of all active and inactive participants	2014-09-01	157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-09-01	0
Total participants	2014-09-01	157
Number of participants with account balances	2014-09-01	156
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-09-01	0
2013: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2013 401k membership
Total participants, beginning-of-year	2013-09-01	175
Total number of active participants reported on line 7a of the Form 5500	2013-09-01	117
Number of retired or separated participants receiving benefits	2013-09-01	0
Number of other retired or separated participants entitled to future benefits	2013-09-01	42
Total of all active and inactive participants	2013-09-01	159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-09-01	0
Total participants	2013-09-01	159
Number of participants with account balances	2013-09-01	159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-09-01	0
2012: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year	2012-09-01	173
Total number of active participants reported on line 7a of the Form 5500	2012-09-01	134
Number of retired or separated participants receiving benefits	2012-09-01	0
Number of other retired or separated participants entitled to future benefits	2012-09-01	41
Total of all active and inactive participants	2012-09-01	175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-09-01	0
Total participants	2012-09-01	175
Number of participants with account balances	2012-09-01	170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-09-01	0
2011: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year	2011-09-01	182
Total number of active participants reported on line 7a of the Form 5500	2011-09-01	132
Number of retired or separated participants receiving benefits	2011-09-01	0
Number of other retired or separated participants entitled to future benefits	2011-09-01	40
Total of all active and inactive participants	2011-09-01	172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-09-01	0
Total participants	2011-09-01	172
Number of participants with account balances	2011-09-01	171
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-09-01	0
2009: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year	2009-09-01	174
Total number of active participants reported on line 7a of the Form 5500	2009-09-01	142
Number of retired or separated participants receiving benefits	2009-09-01	0
Number of other retired or separated participants entitled to future benefits	2009-09-01	35
Total of all active and inactive participants	2009-09-01	177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-09-01	0
Total participants	2009-09-01	177
Number of participants with account balances	2009-09-01	177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-09-01	0

Financial Data on EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST

Measure	Date	Value
2022 : EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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	$-11,592,431
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,476,581
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,445,177
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$2,463,688
Value of total assets at end of year	2022-12-31	$82,631,454
Value of total assets at beginning of year	2022-12-31	$95,700,466
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$31,404
Total interest from all sources	2022-12-31	$55,643
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$3,004,768
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$3,004,768
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,092,899
Participant contributions at end of year	2022-12-31	$176,261
Participant contributions at beginning of year	2022-12-31	$203,058
Participant contributions at end of year	2022-12-31	$136,500
Participant contributions at beginning of year	2022-12-31	$133,142
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$11,640,308
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$12,787,463
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$16,898
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$65,529
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$24,127
Other income not declared elsewhere	2022-12-31	$-1,287,800
Administrative expenses (other) incurred	2022-12-31	$31,404
Total non interest bearing cash at end of year	2022-12-31	$104,688
Total non interest bearing cash at beginning of year	2022-12-31	$194,969
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	$-13,069,012
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$82,631,454
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$95,700,466
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$64,351,851
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$75,858,056
Interest on participant loans	2022-12-31	$11,120
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$4,831,904
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$5,179,746
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$5,179,746
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$44,523
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$36,925
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-15,828,730
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	$1,353,891
Employer contributions (assets) at end of year	2022-12-31	$1,324,413
Employer contributions (assets) at beginning of year	2022-12-31	$1,319,905
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,408,252
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	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2022-12-31	410746749
2021 : EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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	$14,198,561
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$3,384,923
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$3,363,529
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$2,246,604
Value of total assets at end of year	2021-12-31	$95,700,466
Value of total assets at beginning of year	2021-12-31	$84,886,828
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$21,394
Total interest from all sources	2021-12-31	$18,174
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$5,239,479
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$5,239,479
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$926,699
Participant contributions at end of year	2021-12-31	$203,058
Participant contributions at beginning of year	2021-12-31	$313,802
Participant contributions at end of year	2021-12-31	$133,142
Participant contributions at beginning of year	2021-12-31	$216,049
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$12,787,463
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$12,962,083
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$24,127
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$23,006
Other income not declared elsewhere	2021-12-31	$1,882,991
Administrative expenses (other) incurred	2021-12-31	$21,394
Total non interest bearing cash at end of year	2021-12-31	$194,969
Total non interest bearing cash at beginning of year	2021-12-31	$192,879
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	$10,813,638
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$95,700,466
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$84,886,828
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$75,858,056
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$65,038,692
Interest on participant loans	2021-12-31	$16,833
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$5,179,746
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$4,930,778
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$4,930,778
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$1,341
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$42,841
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$4,811,313
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	Yes
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	$1,319,905
Employer contributions (assets) at end of year	2021-12-31	$1,319,905
Employer contributions (assets) at beginning of year	2021-12-31	$1,209,539
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$3,320,688
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	GILMORE, JASION, MAHLER, LTD
Accountancy firm EIN	2021-12-31	341827159
2020 : EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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	$138,091
Total income from all sources (including contributions)	2020-12-31	$13,179,911
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,854,153
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,839,830
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$2,103,365
Value of total assets at end of year	2020-12-31	$84,886,828
Value of total assets at beginning of year	2020-12-31	$73,699,161
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$14,323
Total interest from all sources	2020-12-31	$33,353
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$2,909,167
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$2,909,167
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$893,825
Participant contributions at end of year	2020-12-31	$313,802
Participant contributions at beginning of year	2020-12-31	$315,481
Participant contributions at end of year	2020-12-31	$216,049
Participant contributions at beginning of year	2020-12-31	$166,500
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$12,962,083
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$12,434,660
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$23,006
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$37,809
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$138,091
Other income not declared elsewhere	2020-12-31	$986,559
Administrative expenses (other) incurred	2020-12-31	$14,323
Total non interest bearing cash at end of year	2020-12-31	$192,879
Total non interest bearing cash at beginning of year	2020-12-31	$107,156
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	$11,325,758
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$84,886,828
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$73,561,070
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	$65,038,692
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$56,145,219
Interest on participant loans	2020-12-31	$17,197
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$4,930,778
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$3,290,788
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$3,290,788
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$16,156
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$40,883
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$7,147,467
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$1,209,540
Employer contributions (assets) at end of year	2020-12-31	$1,209,539
Employer contributions (assets) at beginning of year	2020-12-31	$1,201,548
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,798,947
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	GILMORE, JASION, MAHLER, LTD
Accountancy firm EIN	2020-12-31	341827159
2019 : EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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	$138,091
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	$14,811,464
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,903,032
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,873,694
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$2,110,072
Value of total assets at end of year	2019-12-31	$73,699,161
Value of total assets at beginning of year	2019-12-31	$60,652,638
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$29,338
Total interest from all sources	2019-12-31	$70,071
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$2,183,121
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$2,183,121
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$881,634
Participant contributions at end of year	2019-12-31	$315,481
Participant contributions at beginning of year	2019-12-31	$312,875
Participant contributions at end of year	2019-12-31	$166,500
Participant contributions at beginning of year	2019-12-31	$148,095
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$12,434,660
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$9,632,920
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$26,890
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$37,809
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$45,046
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$138,091
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$1,685,213
Administrative expenses (other) incurred	2019-12-31	$29,338
Total non interest bearing cash at end of year	2019-12-31	$107,156
Total non interest bearing cash at beginning of year	2019-12-31	$138,237
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	$12,908,432
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$73,561,070
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$60,652,638
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	$56,145,219
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$46,072,090
Interest on participant loans	2019-12-31	$19,038
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$3,290,788
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$3,067,424
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$3,067,424
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$51,033
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$29,500
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$8,762,987
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	$1,201,548
Employer contributions (assets) at end of year	2019-12-31	$1,201,548
Employer contributions (assets) at beginning of year	2019-12-31	$1,235,951
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,844,194
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	GILMORE, JASION, MAHLER, LTD
Accountancy firm EIN	2019-12-31	341827159
2018 : EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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	$53,349
Total income from all sources (including contributions)	2018-12-31	$-455,000
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$644,661
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$630,642
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$2,082,110
Value of total assets at end of year	2018-12-31	$60,652,638
Value of total assets at beginning of year	2018-12-31	$61,805,648
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$14,019
Total interest from all sources	2018-12-31	$55,001
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$3,371,398
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$3,371,398
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$846,159
Participant contributions at end of year	2018-12-31	$312,875
Participant contributions at beginning of year	2018-12-31	$324,919
Participant contributions at end of year	2018-12-31	$148,095
Participant contributions at beginning of year	2018-12-31	$74,600
Assets. Other investments not covered elsewhere at end of year	2018-12-31	$9,632,920
Assets. Other investments not covered elsewhere at beginning of year	2018-12-31	$9,807,832
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$45,046
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$85,247
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$53,349
Other income not declared elsewhere	2018-12-31	$-368,324
Administrative expenses (other) incurred	2018-12-31	$14,019
Total non interest bearing cash at end of year	2018-12-31	$138,237
Total non interest bearing cash at beginning of year	2018-12-31	$95,123
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	$-1,099,661
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$60,652,638
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$61,752,299
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	$46,072,090
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$47,871,621
Interest on participant loans	2018-12-31	$14,502
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$3,067,424
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$2,352,863
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$2,352,863
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$40,499
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$43,883
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-5,595,185
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	$1,235,951
Employer contributions (assets) at end of year	2018-12-31	$1,235,951
Employer contributions (assets) at beginning of year	2018-12-31	$1,193,443
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$586,759
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	GILMORE, JASION, MAHLER, LTD
Accountancy firm EIN	2018-12-31	341827159
2017 : EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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	$53,349
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	$10,754,609
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$3,037,852
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$3,022,914
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,976,214
Value of total assets at end of year	2017-12-31	$61,805,648
Value of total assets at beginning of year	2017-12-31	$54,035,542
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$14,938
Total interest from all sources	2017-12-31	$41,942
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$2,092,150
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$2,092,150
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$782,771
Participant contributions at end of year	2017-12-31	$324,919
Participant contributions at beginning of year	2017-12-31	$356,677
Participant contributions at end of year	2017-12-31	$74,600
Participant contributions at beginning of year	2017-12-31	$76,500
Assets. Other investments not covered elsewhere at end of year	2017-12-31	$9,807,832
Assets. Other investments not covered elsewhere at beginning of year	2017-12-31	$8,645,833
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$85,247
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$17,396
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$53,349
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$0
Administrative expenses (other) incurred	2017-12-31	$14,938
Total non interest bearing cash at end of year	2017-12-31	$95,123
Total non interest bearing cash at beginning of year	2017-12-31	$88,716
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	$7,716,757
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$61,752,299
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$54,035,542
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$47,871,621
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$41,651,640
Interest on participant loans	2017-12-31	$14,800
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$2,352,863
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$2,097,302
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$2,097,302
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$27,142
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$41,925
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$6,644,303
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	$1,193,443
Employer contributions (assets) at end of year	2017-12-31	$1,193,443
Employer contributions (assets) at beginning of year	2017-12-31	$1,101,478
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$2,980,989
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	GILMORE, JASION, MAHLER, LTD
Accountancy firm EIN	2017-12-31	341827159
2016 : EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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	$5,733,908
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$2,414,184
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,380,458
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,924,128
Value of total assets at end of year	2016-12-31	$54,035,542
Value of total assets at beginning of year	2016-12-31	$50,715,818
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$33,726
Total interest from all sources	2016-12-31	$25,894
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$1,344,742
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$1,344,742
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$769,404
Participant contributions at end of year	2016-12-31	$356,677
Participant contributions at beginning of year	2016-12-31	$400,966
Participant contributions at end of year	2016-12-31	$76,500
Participant contributions at beginning of year	2016-12-31	$70,000
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$8,645,833
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$8,362,740
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$53,246
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$17,396
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$13,574
Other income not declared elsewhere	2016-12-31	$1,293,106
Administrative expenses (other) incurred	2016-12-31	$33,726
Total non interest bearing cash at end of year	2016-12-31	$88,716
Total non interest bearing cash at beginning of year	2016-12-31	$122,545
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	$3,319,724
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$54,035,542
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$50,715,818
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$41,651,640
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$38,807,522
Interest on participant loans	2016-12-31	$16,660
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$2,097,302
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$1,825,345
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$1,825,345
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$9,234
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$45,841
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$1,146,038
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	$1,101,478
Employer contributions (assets) at end of year	2016-12-31	$1,101,478
Employer contributions (assets) at beginning of year	2016-12-31	$1,113,126
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$2,334,617
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	GILMORE, JASION, MAHLER, LTD
Accountancy firm EIN	2016-12-31	341827159
2015 : EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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	$1,784,941
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$7,613,437
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$7,581,266
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$2,398,378
Value of total assets at end of year	2015-12-31	$50,715,818
Value of total assets at beginning of year	2015-12-31	$56,544,314
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$32,171
Total interest from all sources	2015-12-31	$18,731
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$2,083,036
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$2,083,036
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$899,555
Participant contributions at end of year	2015-12-31	$400,966
Participant contributions at beginning of year	2015-12-31	$378,049
Participant contributions at end of year	2015-12-31	$70,000
Participant contributions at beginning of year	2015-12-31	$60,586
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$8,362,740
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$11,668,093
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$20,996
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$13,574
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$9,801
Other income not declared elsewhere	2015-12-31	$-825,505
Administrative expenses (other) incurred	2015-12-31	$32,171
Total non interest bearing cash at end of year	2015-12-31	$122,545
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	$-5,828,496
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$50,715,818
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$56,544,314
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	$38,807,522
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$41,360,603
Interest on participant loans	2015-12-31	$16,995
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$1,825,345
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$2,298,020
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$2,298,020
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$1,736
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$45,365
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-1,889,699
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	$1,477,827
Employer contributions (assets) at end of year	2015-12-31	$1,113,126
Employer contributions (assets) at beginning of year	2015-12-31	$769,162
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$7,535,901
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	GILMORE, JASION, MAHLER, LTD
Accountancy firm EIN	2015-12-31	341827159
2014 : EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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	$357,660
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$3,099,631
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$3,096,181
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$112,707
Value of total assets at end of year	2014-12-31	$56,544,314
Value of total assets at beginning of year	2014-12-31	$59,286,285
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$3,450
Total interest from all sources	2014-12-31	$5,748
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$1,543,735
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$1,543,735
Administrative expenses professional fees incurred	2014-12-31	$3,450
Assets. Corporate prefeered stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2014-12-31	$115,450
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
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
Participant contributions at end of year	2014-12-31	$378,049
Participant contributions at beginning of year	2014-12-31	$413,709
Participant contributions at end of year	2014-12-31	$60,586
Participant contributions at beginning of year	2014-12-31	$175,212
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$11,668,093
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$1,097,292
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$112,707
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$9,801
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$19,478
Other income not declared elsewhere	2014-12-31	$64,992
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	$-2,741,971
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$56,544,314
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$59,286,285
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
Assets. partnership/joint venture interests at end of year	2014-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2014-12-31	$124,599
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$41,360,603
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$49,281,992
Interest on participant loans	2014-12-31	$5,610
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$2,298,020
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$3,905,782
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$3,905,782
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$138
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$597,683
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$16,913
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-1,369,522
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
Employer contributions (assets) at end of year	2014-12-31	$769,162
Employer contributions (assets) at beginning of year	2014-12-31	$1,077,754
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$3,079,268
Asset. Corporate debt instrument debt (other) at end of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2014-12-31	$357,682
Assets. Corporate common stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2014-12-31	$2,119,652
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
Unrealized appreciation/depreciation of other (non real estate) assets	2014-08-31	$3,053,249
Total unrealized appreciation/depreciation of assets	2014-08-31	$3,053,249
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-08-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-08-31	$0
Total income from all sources (including contributions)	2014-08-31	$9,579,695
Total loss/gain on sale of assets	2014-08-31	$71,552
Total of all expenses incurred	2014-08-31	$6,502,177
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-08-31	$6,477,877
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-08-31	$1,965,502
Value of total assets at end of year	2014-08-31	$59,286,285
Value of total assets at beginning of year	2014-08-31	$56,208,767
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-08-31	$24,300
Total interest from all sources	2014-08-31	$36,500
Total dividends received (eg from common stock, registered investment company shares)	2014-08-31	$2,057,544
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-08-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-08-31	$2,007,819
Administrative expenses professional fees incurred	2014-08-31	$22,436
Assets. Corporate prefeered stocks other than exployer securities at end of year	2014-08-31	$115,450
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2014-08-31	$112,818
Was this plan covered by a fidelity bond	2014-08-31	Yes
Value of fidelity bond cover	2014-08-31	$500,000
If this is an individual account plan, was there a blackout period	2014-08-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-08-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-08-31	No
Contributions received from participants	2014-08-31	$887,741
Participant contributions at end of year	2014-08-31	$413,709
Participant contributions at beginning of year	2014-08-31	$384,543
Participant contributions at end of year	2014-08-31	$175,212
Participant contributions at beginning of year	2014-08-31	$257,609
Assets. Other investments not covered elsewhere at end of year	2014-08-31	$1,097,292
Assets. Other investments not covered elsewhere at beginning of year	2014-08-31	$936,837
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-08-31	$19,478
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-08-31	$22,913
Other income not declared elsewhere	2014-08-31	$284,035
Administrative expenses (other) incurred	2014-08-31	$820
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-08-31	No
Value of net income/loss	2014-08-31	$3,077,518
Value of net assets at end of year (total assets less liabilities)	2014-08-31	$59,286,285
Value of net assets at beginning of year (total assets less liabilities)	2014-08-31	$56,208,767
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-08-31	No
Were any leases to which the plan was party in default or uncollectible	2014-08-31	No
Assets. partnership/joint venture interests at end of year	2014-08-31	$124,599
Assets. partnership/joint venture interests at beginning of year	2014-08-31	$71,148
Investment advisory and management fees	2014-08-31	$1,044
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-08-31	$49,281,992
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-08-31	$44,028,837
Interest on participant loans	2014-08-31	$17,379
Interest earned on other investments	2014-08-31	$5,377
Income. Interest from US Government securities	2014-08-31	$-505
Income. Interest from corporate debt instruments	2014-08-31	$13,442
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-08-31	$3,905,782
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-08-31	$5,939,757
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-08-31	$5,939,757
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-08-31	$807
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-08-31	$597,683
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-08-31	$498,442
Expenses. Payments to insurance carriers foe the provision of benefits	2014-08-31	$57,283
Asset value of US Government securities at end of year	2014-08-31	$0
Asset value of US Government securities at beginning of year	2014-08-31	$69,964
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-08-31	$2,111,313
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-08-31	No
Was there a failure to transmit to the plan any participant contributions	2014-08-31	No
Has the plan failed to provide any benefit when due under the plan	2014-08-31	No
Contributions received in cash from employer	2014-08-31	$1,077,761
Employer contributions (assets) at end of year	2014-08-31	$1,077,754
Employer contributions (assets) at beginning of year	2014-08-31	$1,091,904
Income. Dividends from preferred stock	2014-08-31	$6,211
Income. Dividends from common stock	2014-08-31	$43,514
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-08-31	$6,420,594
Asset. Corporate debt instrument debt (other) at end of year	2014-08-31	$357,682
Asset. Corporate debt instrument debt (other) at beginning of year	2014-08-31	$508,181
Assets. Corporate common stocks other than exployer securities at end of year	2014-08-31	$2,119,652
Assets. Corporate common stocks other than exployer securities at beginning of year	2014-08-31	$2,285,814
Did the plan have assets held for investment	2014-08-31	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	2014-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-08-31	No
Aggregate proceeds on sale of assets	2014-08-31	$546,033
Aggregate carrying amount (costs) on sale of assets	2014-08-31	$474,481
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-08-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-08-31	Disclaimer
Accountancy firm name	2014-08-31	GILMORE, JASION, MAHLER, LTD
Accountancy firm EIN	2014-08-31	341827159
2013 : EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2013-08-31	$331,519
Total unrealized appreciation/depreciation of assets	2013-08-31	$331,519
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-08-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-08-31	$0
Total income from all sources (including contributions)	2013-08-31	$7,386,926
Total loss/gain on sale of assets	2013-08-31	$-110,418
Total of all expenses incurred	2013-08-31	$2,777,304
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-08-31	$2,771,276
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-08-31	$2,192,533
Value of total assets at end of year	2013-08-31	$56,208,767
Value of total assets at beginning of year	2013-08-31	$51,599,145
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-08-31	$6,028
Total interest from all sources	2013-08-31	$47,839
Total dividends received (eg from common stock, registered investment company shares)	2013-08-31	$1,413,260
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-08-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-08-31	$1,351,194
Administrative expenses professional fees incurred	2013-08-31	$6,028
Assets. Corporate prefeered stocks other than exployer securities at end of year	2013-08-31	$112,818
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2013-08-31	$109,802
Was this plan covered by a fidelity bond	2013-08-31	Yes
Value of fidelity bond cover	2013-08-31	$500,000
If this is an individual account plan, was there a blackout period	2013-08-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-08-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-08-31	No
Contributions received from participants	2013-08-31	$1,054,185
Participant contributions at end of year	2013-08-31	$384,543
Participant contributions at beginning of year	2013-08-31	$368,428
Participant contributions at end of year	2013-08-31	$257,609
Participant contributions at beginning of year	2013-08-31	$168,742
Assets. Other investments not covered elsewhere at end of year	2013-08-31	$936,837
Assets. Other investments not covered elsewhere at beginning of year	2013-08-31	$1,236,008
Income. Received or receivable in cash from other sources (including rollovers)	2013-08-31	$46,444
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-08-31	$58,791
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-08-31	$22,913
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-08-31	$28,785
Other income not declared elsewhere	2013-08-31	$170,736
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-08-31	No
Value of net income/loss	2013-08-31	$4,609,622
Value of net assets at end of year (total assets less liabilities)	2013-08-31	$56,208,767
Value of net assets at beginning of year (total assets less liabilities)	2013-08-31	$51,599,145
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-08-31	No
Were any leases to which the plan was party in default or uncollectible	2013-08-31	No
Assets. partnership/joint venture interests at end of year	2013-08-31	$71,148
Assets. partnership/joint venture interests at beginning of year	2013-08-31	$99,008
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-08-31	$44,028,837
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-08-31	$40,067,634
Interest on participant loans	2013-08-31	$14,981
Interest earned on other investments	2013-08-31	$4,251
Income. Interest from US Government securities	2013-08-31	$3,399
Income. Interest from corporate debt instruments	2013-08-31	$21,078
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-08-31	$5,939,757
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-08-31	$5,485,236
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-08-31	$5,485,236
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-08-31	$4,130
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-08-31	$498,442
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-08-31	$0
Asset value of US Government securities at end of year	2013-08-31	$69,964
Asset value of US Government securities at beginning of year	2013-08-31	$121,092
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-08-31	$3,341,457
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-08-31	No
Was there a failure to transmit to the plan any participant contributions	2013-08-31	No
Has the plan failed to provide any benefit when due under the plan	2013-08-31	No
Contributions received in cash from employer	2013-08-31	$1,091,904
Employer contributions (assets) at end of year	2013-08-31	$1,091,904
Employer contributions (assets) at beginning of year	2013-08-31	$1,161,925
Income. Dividends from preferred stock	2013-08-31	$6,225
Income. Dividends from common stock	2013-08-31	$55,841
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-08-31	$2,712,485
Asset. Corporate debt instrument debt (other) at end of year	2013-08-31	$508,181
Asset. Corporate debt instrument debt (other) at beginning of year	2013-08-31	$496,563
Assets. Corporate common stocks other than exployer securities at end of year	2013-08-31	$2,285,814
Assets. Corporate common stocks other than exployer securities at beginning of year	2013-08-31	$2,255,922
Did the plan have assets held for investment	2013-08-31	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	2013-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-08-31	No
Aggregate proceeds on sale of assets	2013-08-31	$17,790,953
Aggregate carrying amount (costs) on sale of assets	2013-08-31	$17,901,371
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-08-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-08-31	Disclaimer
Accountancy firm name	2013-08-31	GILMORE JASION & MAHLER, LTD
Accountancy firm EIN	2013-08-31	341827159
2012 : EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2012-08-31	$291,355
Total unrealized appreciation/depreciation of assets	2012-08-31	$291,355
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-08-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-08-31	$0
Total income from all sources (including contributions)	2012-08-31	$6,963,880
Total loss/gain on sale of assets	2012-08-31	$34,520
Total of all expenses incurred	2012-08-31	$2,433,191
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-08-31	$2,432,865
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-08-31	$2,976,460
Value of total assets at end of year	2012-08-31	$51,599,145
Value of total assets at beginning of year	2012-08-31	$47,068,456
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-08-31	$326
Total interest from all sources	2012-08-31	$71,611
Total dividends received (eg from common stock, registered investment company shares)	2012-08-31	$1,145,700
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-08-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-08-31	$1,074,777
Administrative expenses professional fees incurred	2012-08-31	$326
Assets. Corporate prefeered stocks other than exployer securities at end of year	2012-08-31	$109,802
Was this plan covered by a fidelity bond	2012-08-31	Yes
Value of fidelity bond cover	2012-08-31	$500,000
If this is an individual account plan, was there a blackout period	2012-08-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-08-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-08-31	No
Contributions received from participants	2012-08-31	$920,083
Participant contributions at end of year	2012-08-31	$368,428
Participant contributions at beginning of year	2012-08-31	$470,047
Participant contributions at end of year	2012-08-31	$168,742
Participant contributions at beginning of year	2012-08-31	$125,846
Assets. Other investments not covered elsewhere at end of year	2012-08-31	$1,236,008
Assets. Other investments not covered elsewhere at beginning of year	2012-08-31	$1,240,946
Income. Received or receivable in cash from other sources (including rollovers)	2012-08-31	$858,836
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-08-31	$49,286
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-08-31	$28,785
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-08-31	$25,184
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-08-31	No
Value of net income/loss	2012-08-31	$4,530,689
Value of net assets at end of year (total assets less liabilities)	2012-08-31	$51,599,145
Value of net assets at beginning of year (total assets less liabilities)	2012-08-31	$47,068,456
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-08-31	No
Were any leases to which the plan was party in default or uncollectible	2012-08-31	No
Assets. partnership/joint venture interests at end of year	2012-08-31	$99,008
Assets. partnership/joint venture interests at beginning of year	2012-08-31	$59,189
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-08-31	$40,067,634
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-08-31	$36,500,982
Interest on participant loans	2012-08-31	$17,690
Income. Interest from US Government securities	2012-08-31	$35,244
Income. Interest from corporate debt instruments	2012-08-31	$15,425
Value of interest in common/collective trusts at beginning of year	2012-08-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-08-31	$5,485,236
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-08-31	$3,906,815
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-08-31	$3,906,815
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-08-31	$3,252
Asset value of US Government securities at end of year	2012-08-31	$121,092
Asset value of US Government securities at beginning of year	2012-08-31	$150,128
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-08-31	$2,444,234
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-08-31	No
Was there a failure to transmit to the plan any participant contributions	2012-08-31	No
Has the plan failed to provide any benefit when due under the plan	2012-08-31	No
Contributions received in cash from employer	2012-08-31	$1,197,541
Employer contributions (assets) at end of year	2012-08-31	$1,161,925
Employer contributions (assets) at beginning of year	2012-08-31	$1,208,132
Income. Dividends from common stock	2012-08-31	$70,923
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-08-31	$2,383,579
Asset. Corporate debt instrument debt (other) at end of year	2012-08-31	$496,563
Assets. Corporate common stocks other than exployer securities at end of year	2012-08-31	$2,255,922
Assets. Corporate common stocks other than exployer securities at beginning of year	2012-08-31	$3,381,187
Did the plan have assets held for investment	2012-08-31	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	2012-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-08-31	No
Aggregate proceeds on sale of assets	2012-08-31	$2,670,881
Aggregate carrying amount (costs) on sale of assets	2012-08-31	$2,636,361
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-08-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-08-31	Disclaimer
Accountancy firm name	2012-08-31	GILMORE, JASION, MAHLER, LTD
Accountancy firm EIN	2012-08-31	341827159
2011 : EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-08-31	$3,589,731
Total unrealized appreciation/depreciation of assets	2011-08-31	$3,589,731
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-08-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-08-31	$0
Total income from all sources (including contributions)	2011-08-31	$6,780,050
Total loss/gain on sale of assets	2011-08-31	$60,271
Total of all expenses incurred	2011-08-31	$2,545,316
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-08-31	$2,545,316
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-08-31	$2,097,361
Value of total assets at end of year	2011-08-31	$47,068,456
Value of total assets at beginning of year	2011-08-31	$42,833,722
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-08-31	$0
Total interest from all sources	2011-08-31	$334,290
Total dividends received (eg from common stock, registered investment company shares)	2011-08-31	$61,682
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-08-31	No
Was this plan covered by a fidelity bond	2011-08-31	Yes
Value of fidelity bond cover	2011-08-31	$500,000
If this is an individual account plan, was there a blackout period	2011-08-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-08-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-08-31	No
Contributions received from participants	2011-08-31	$783,520
Participant contributions at end of year	2011-08-31	$470,047
Participant contributions at beginning of year	2011-08-31	$404,790
Participant contributions at end of year	2011-08-31	$125,846
Participant contributions at beginning of year	2011-08-31	$166,796
Assets. Other investments not covered elsewhere at end of year	2011-08-31	$1,240,946
Assets. Other investments not covered elsewhere at beginning of year	2011-08-31	$1,556,313
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-08-31	$246,350
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-08-31	$25,184
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-08-31	$27,623
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-08-31	No
Value of net income/loss	2011-08-31	$4,234,734
Value of net assets at end of year (total assets less liabilities)	2011-08-31	$47,068,456
Value of net assets at beginning of year (total assets less liabilities)	2011-08-31	$42,833,722
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-08-31	No
Were any leases to which the plan was party in default or uncollectible	2011-08-31	No
Assets. partnership/joint venture interests at end of year	2011-08-31	$59,189
Assets. partnership/joint venture interests at beginning of year	2011-08-31	$64,505
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-08-31	$36,500,982
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-08-31	$27,439,534
Interest on participant loans	2011-08-31	$19,796
Income. Interest from US Government securities	2011-08-31	$292,710
Income. Interest from corporate debt instruments	2011-08-31	$15,113
Value of interest in common/collective trusts at end of year	2011-08-31	$0
Value of interest in common/collective trusts at beginning of year	2011-08-31	$1,720,396
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-08-31	$3,906,815
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-08-31	$3,426,036
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-08-31	$3,426,036
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-08-31	$6,671
Asset value of US Government securities at end of year	2011-08-31	$150,128
Asset value of US Government securities at beginning of year	2011-08-31	$147,128
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-08-31	$612,595
Net investment gain or loss from common/collective trusts	2011-08-31	$24,120
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-08-31	No
Was there a failure to transmit to the plan any participant contributions	2011-08-31	No
Has the plan failed to provide any benefit when due under the plan	2011-08-31	No
Contributions received in cash from employer	2011-08-31	$1,313,841
Employer contributions (assets) at end of year	2011-08-31	$1,208,132
Employer contributions (assets) at beginning of year	2011-08-31	$1,389,518
Income. Dividends from common stock	2011-08-31	$61,682
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-08-31	$2,298,966
Assets. Corporate common stocks other than exployer securities at end of year	2011-08-31	$3,381,187
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-08-31	$6,491,083
Did the plan have assets held for investment	2011-08-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-08-31	No
Aggregate proceeds on sale of assets	2011-08-31	$790,100
Aggregate carrying amount (costs) on sale of assets	2011-08-31	$729,829
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-08-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-08-31	Disclaimer
Accountancy firm name	2011-08-31	GILMORE, JASION & MAHLER, LTD
Accountancy firm EIN	2011-08-31	341827159
2010 : EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-08-31	$0

Form 5500 Responses for EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST

2022: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 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: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
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: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	Yes
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: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2014 form 5500 responses
2014-09-01	Type of plan entity	Single employer plan
2014-09-01	Submission has been amended	No
2014-09-01	This submission is the final filing	No
2014-09-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2014-09-01	Plan is a collectively bargained plan	No
2014-09-01	Plan funding arrangement – Insurance	Yes
2014-09-01	Plan funding arrangement – Trust	Yes
2014-09-01	Plan benefit arrangement – Insurance	Yes
2014-09-01	Plan benefit arrangement - Trust	Yes
2013: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2013 form 5500 responses
2013-09-01	Type of plan entity	Single employer plan
2013-09-01	Submission has been amended	No
2013-09-01	This submission is the final filing	No
2013-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-09-01	Plan is a collectively bargained plan	No
2013-09-01	Plan funding arrangement – Insurance	Yes
2013-09-01	Plan funding arrangement – Trust	Yes
2013-09-01	Plan benefit arrangement – Insurance	Yes
2013-09-01	Plan benefit arrangement - Trust	Yes
2012: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2012 form 5500 responses
2012-09-01	Type of plan entity	Single employer plan
2012-09-01	Submission has been amended	No
2012-09-01	This submission is the final filing	No
2012-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-09-01	Plan is a collectively bargained plan	No
2012-09-01	Plan funding arrangement – Insurance	Yes
2012-09-01	Plan funding arrangement – Trust	Yes
2012-09-01	Plan benefit arrangement – Insurance	Yes
2012-09-01	Plan benefit arrangement - Trust	Yes
2011: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2011 form 5500 responses
2011-09-01	Type of plan entity	Single employer plan
2011-09-01	Submission has been amended	Yes
2011-09-01	This submission is the final filing	No
2011-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-09-01	Plan is a collectively bargained plan	No
2011-09-01	Plan funding arrangement – Insurance	Yes
2011-09-01	Plan funding arrangement – Trust	Yes
2011-09-01	Plan benefit arrangement – Insurance	Yes
2011-09-01	Plan benefit arrangement - Trust	Yes
2009: EASTMAN & SMITH LTD PROFIT SHARING AND SAVINGS PLAN & TRUST 2009 form 5500 responses
2009-09-01	Type of plan entity	Single employer plan
2009-09-01	Submission has been amended	No
2009-09-01	This submission is the final filing	No
2009-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-09-01	Plan is a collectively bargained plan	No
2009-09-01	Plan funding arrangement – Trust	Yes
2009-09-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	15604450
Policy instance	3
Insurance contract or identification number 15604450 Number of Individuals Covered 1 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $265 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Commission paid to Insurance Broker USD $265 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
(National Association of Insurance Commissioners NAIC id number: )
Policy contract number	2103056890
Policy instance	1
Insurance contract or identification number 2103056890 Number of Individuals Covered 1 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? 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? Yes
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	U00001612
Policy instance	2
Insurance contract or identification number U00001612 Number of Individuals Covered 1 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? 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? Yes
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	3375867
Policy instance	4
Insurance contract or identification number 3375867 Number of Individuals Covered 1 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Commission paid to Insurance Broker USD $0 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
MML BAYSTATE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70416 )
Policy contract number	L007867283
Policy instance	5
Insurance contract or identification number L007867283 Number of Individuals Covered 1 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $59 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Commission paid to Insurance Broker USD $42 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	49279000
Policy instance	6
Insurance contract or identification number 49279000 Number of Individuals Covered 1 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	31187
Policy instance	7
Insurance contract or identification number 31187 Number of Individuals Covered 1 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	39295
Policy instance	8
Insurance contract or identification number 39295 Number of Individuals Covered 1 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	E1201242
Policy instance	9
Insurance contract or identification number E1201242 Number of Individuals Covered 1 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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? Yes
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	000000395651
Policy instance	10
Insurance contract or identification number 000000395651 Number of Individuals Covered 1 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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? Yes
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	3375867
Policy instance	4
Insurance contract or identification number 3375867 Number of Individuals Covered 1 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Commission paid to Insurance Broker USD $0 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	15604450
Policy instance	3
Insurance contract or identification number 15604450 Number of Individuals Covered 1 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $286 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Commission paid to Insurance Broker USD $286 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
(National Association of Insurance Commissioners NAIC id number: )
Policy contract number	2103056890
Policy instance	1
Insurance contract or identification number 2103056890 Number of Individuals Covered 1 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $268 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? 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 Commission paid to Insurance Broker USD $268 Insurance broker organization code? 3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	U00001612
Policy instance	2
Insurance contract or identification number U00001612 Number of Individuals Covered 1 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $548 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? 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 Commission paid to Insurance Broker USD $548 Insurance broker organization code? 3
MML BAYSTATE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70416 )
Policy contract number	L007867283
Policy instance	5
Insurance contract or identification number L007867283 Number of Individuals Covered 1 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $69 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Commission paid to Insurance Broker USD $49 Insurance broker organization code? 3 Amount paid for insurance broker fees 0
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	49279000
Policy instance	6
Insurance contract or identification number 49279000 Number of Individuals Covered 1 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	31187
Policy instance	7
Insurance contract or identification number 31187 Number of Individuals Covered 1 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	39295
Policy instance	8
Insurance contract or identification number 39295 Number of Individuals Covered 1 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	E1201242
Policy instance	9
Insurance contract or identification number E1201242 Number of Individuals Covered 1 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $388 Are there contracts with allocated funds for individual policies? 1 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 Amount paid for insurance broker fees 388 Additional information about fees paid to insurance broker SALES FIXED EXPENSE Insurance broker organization code? 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	000000395651
Policy instance	10
Insurance contract or identification number 000000395651 Number of Individuals Covered 101 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $5,085 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Commission paid to Insurance Broker USD $5,085 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
(National Association of Insurance Commissioners NAIC id number: )
Policy contract number	2103056890
Policy instance	1
Insurance contract or identification number 2103056890 Number of Individuals Covered 1 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $222 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? 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 Commission paid to Insurance Broker USD $222 Insurance broker organization code? 3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	U00001612
Policy instance	2
Insurance contract or identification number U00001612 Number of Individuals Covered 1 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $431 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? 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 Commission paid to Insurance Broker USD $431 Insurance broker organization code? 3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	15604450
Policy instance	3
Insurance contract or identification number 15604450 Number of Individuals Covered 1 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $245 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Commission paid to Insurance Broker USD $245 Insurance broker organization code? 3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	3375867
Policy instance	4
Insurance contract or identification number 3375867 Number of Individuals Covered 1 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? 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
MML BAYSTATE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70416 )
Policy contract number	L007867283
Policy instance	5
Insurance contract or identification number L007867283 Number of Individuals Covered 1 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $59 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Commission paid to Insurance Broker USD $42 Insurance broker organization code? 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	49279000
Policy instance	6
Insurance contract or identification number 49279000 Number of Individuals Covered 1 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? 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
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	31187
Policy instance	7
Insurance contract or identification number 31187 Number of Individuals Covered 1 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	39295
Policy instance	8
Insurance contract or identification number 39295 Number of Individuals Covered 1 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	E1201242
Policy instance	9
Insurance contract or identification number E1201242 Number of Individuals Covered 1 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $2,836 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? 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 Commission paid to Insurance Broker USD $2,836 Insurance broker organization code? 3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	U00001612
Policy instance	2
Insurance contract or identification number U00001612 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? 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 Insurance broker organization code? 3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	15604450
Policy instance	3
Insurance contract or identification number 15604450 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Insurance broker organization code? 3
MML BAYSTATE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70416 )
Policy contract number	L007867283
Policy instance	4
Insurance contract or identification number L007867283 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Insurance broker organization code? 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	7584178
Policy instance	5
Insurance contract or identification number 7584178 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? 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
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	31187
Policy instance	6
Insurance contract or identification number 31187 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	39295
Policy instance	7
Insurance contract or identification number 39295 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	E1201242
Policy instance	8
Insurance contract or identification number E1201242 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? 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 Insurance broker organization code? 3
WILTON REASSURANCE LIFE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60704 )
Policy contract number	04023216
Policy instance	9
Insurance contract or identification number 04023216 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Insurance broker organization code? 3
(National Association of Insurance Commissioners NAIC id number: )
Policy contract number	2103056890
Policy instance	1
Insurance contract or identification number 2103056890 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? 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 Insurance broker organization code? 3
WILTON REASSURANCE LIFE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60704 )
Policy contract number	04023216
Policy instance	9
Insurance contract or identification number 04023216 Number of Individuals Covered 1 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	2103056890
Policy instance	1
Insurance contract or identification number 2103056890 Number of Individuals Covered 1 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $178 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? 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 Commission paid to Insurance Broker USD $178 Insurance broker organization code? 3 Insurance broker name NOT PROVIDED
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	04008119
Policy instance	2
Insurance contract or identification number 04008119 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $28 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? 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 Commission paid to Insurance Broker USD $14 Insurance broker organization code? 3 Insurance broker name WILCOX FINANCIAL
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	15604450
Policy instance	3
Insurance contract or identification number 15604450 Number of Individuals Covered 1 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $219 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Commission paid to Insurance Broker USD $213 Insurance broker organization code? 3 Insurance broker name KLINGER BRUCE D
MML BAYSTATE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70416 )
Policy contract number	L007867283
Policy instance	4
Insurance contract or identification number L007867283 Number of Individuals Covered 1 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $87 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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 Commission paid to Insurance Broker USD $68 Insurance broker organization code? 3 Insurance broker name
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	7584178
Policy instance	5
Insurance contract or identification number 7584178 Number of Individuals Covered 1 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	31187
Policy instance	6
Insurance contract or identification number 31187 Number of Individuals Covered 1 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	39295
Policy instance	7
Insurance contract or identification number 39295 Number of Individuals Covered 1 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 1 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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	E1201242
Policy instance	8
Insurance contract or identification number E1201242 Number of Individuals Covered 1 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $1,497 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? 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 Commission paid to Insurance Broker USD $1,497 Insurance broker organization code? 3 Insurance broker name THOMAS SNOW
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	15604450
Policy instance	5
Insurance contract or identification number 15604450 Number of Individuals Covered 1 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $255 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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 Commission paid to Insurance Broker USD $241 Insurance broker organization code? 3 Insurance broker name KLINGER BRUCE D
MML BAYSTATE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70416 )
Policy contract number	7867283
Policy instance	4
Insurance contract or identification number 7867283 Number of Individuals Covered 1 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $109 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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 Commission paid to Insurance Broker USD $109 Insurance broker organization code? 3 Insurance broker name RUFF ROBERT C
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	3375867
Policy instance	3
Insurance contract or identification number 3375867 Number of Individuals Covered 1 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	04008119
Policy instance	2
Insurance contract or identification number 04008119 Number of Individuals Covered 1 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $28 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 Commission paid to Insurance Broker USD $14 Insurance broker organization code? 3 Insurance broker name WILCOX FINANCIAL
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	U00001612
Policy instance	1
Insurance contract or identification number U00001612 Number of Individuals Covered 1 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $1,880 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 Commission paid to Insurance Broker USD $1,410 Insurance broker organization code? 3 Insurance broker name WILCOX FINANCIAL
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	7584178
Policy instance	6
Insurance contract or identification number 7584178 Number of Individuals Covered 1 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	39295
Policy instance	7
Insurance contract or identification number 39295 Number of Individuals Covered 1 Insurance policy start date 2015-09-01 Insurance policy end date 2016-08-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	E1201242
Policy instance	8
Insurance contract or identification number E1201242 Number of Individuals Covered 1 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $2,384 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 Commission paid to Insurance Broker USD $1,192 Insurance broker organization code? 3 Insurance broker name SCHEIB, JAMES W
MML BAYSTATE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70416 )
Policy contract number	L007867283
Policy instance	2
Insurance contract or identification number L007867283 Number of Individuals Covered 1 Insurance policy start date 2014-09-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? Yes 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	7584178/4927900
Policy instance	3
Insurance contract or identification number 7584178/4927900 Number of Individuals Covered 1 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? Yes 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
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	U00001612, ETC.
Policy instance	4
Insurance contract or identification number U00001612, ETC. Number of Individuals Covered 2 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $1,913 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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 $1,425 Insurance broker organization code? 3 Insurance broker name MARK L. FERRIS
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	3375867
Policy instance	1
Insurance contract or identification number 3375867 Number of Individuals Covered 1 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? Yes 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
MML BAYSTATE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70416 )
Policy contract number	L007867283
Policy instance	4
Insurance contract or identification number L007867283 Number of Individuals Covered 1 Insurance policy start date 2013-09-01 Insurance policy end date 2014-08-31 Total amount of commissions paid to insurance broker USD $144 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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 $144 Insurance broker organization code? 3 Insurance broker name ROBERT C RUFF
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	31187,39295
Policy instance	3
Insurance contract or identification number 31187,39295 Number of Individuals Covered 2 Insurance policy start date 2013-09-01 Insurance policy end date 2014-08-31 Are there contracts with allocated funds for individual policies? Yes 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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	15604450
Policy instance	2
Insurance contract or identification number 15604450 Number of Individuals Covered 1 Insurance policy start date 2013-09-01 Insurance policy end date 2014-08-31 Total amount of commissions paid to insurance broker USD $453 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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 $447 Insurance broker organization code? 3 Insurance broker name DALE J SEYMOUR
KEYSTONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11681 )
Policy contract number	04023216
Policy instance	1
Insurance contract or identification number 04023216 Number of Individuals Covered 1 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $160 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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 $160 Insurance broker organization code? 3 Insurance broker name BOYD MONTGOMERY
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	7584178
Policy instance	5
Insurance contract or identification number 7584178 Number of Individuals Covered 1 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $74 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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 $74 Insurance broker organization code? 3 Insurance broker name NEW ENGLAND FINANCIAL
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	15604450
Policy instance	2
Insurance contract or identification number 15604450 Number of Individuals Covered 1 Insurance policy start date 2012-09-01 Insurance policy end date 2013-08-31 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? Yes 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 $421 Amount paid for insurance broker fees 0 Insurance broker organization code? 3 Insurance broker name DALE SEYMOUR
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	39295,31187
Policy instance	1
Insurance contract or identification number 39295,31187 Number of Individuals Covered 2 Insurance policy start date 2012-09-01 Insurance policy end date 2013-08-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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
KEYSTONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11681 )
Policy contract number	04023216
Policy instance	3
Insurance contract or identification number 04023216 Number of Individuals Covered 1 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $160 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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 $160 Insurance broker organization code? 3 Insurance broker name BOYD MONTGOMERY
UNION CENTRAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 80837 )
Policy contract number	0004008119
Policy instance	4
Insurance contract or identification number 0004008119 Number of Individuals Covered 1 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $32 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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 $14 Insurance broker organization code? 3 Insurance broker name MARK FERRIS
ACACIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60038 )
Policy contract number	U00001612K
Policy instance	5
Insurance contract or identification number U00001612K Number of Individuals Covered 1 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $1,880 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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 $1,410 Insurance broker organization code? 3 Insurance broker name WILCOX FINANCIAL AGENCY
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	E1201242
Policy instance	6
Insurance contract or identification number E1201242 Number of Individuals Covered 1 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? Yes 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? Yes Other information about contract INDIVIDUAL ANNUITY
MML BAYSTATE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70416 )
Policy contract number	L007867283
Policy instance	7
Insurance contract or identification number L007867283 Number of Individuals Covered 1 Insurance policy start date 2012-09-01 Insurance policy end date 2013-08-31 Total amount of commissions paid to insurance broker USD $136 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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 Commission paid to Insurance Broker USD $136 Insurance broker organization code? 3 Insurance broker name ROBERT RUFF
UNION CENTRAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 80837 )
Policy contract number	U00001612K
Policy instance	1
Insurance contract or identification number U00001612K Number of Individuals Covered 1 Insurance policy start date 2011-09-01 Insurance policy end date 2012-08-31 Total amount of commissions paid to insurance broker USD $1,567 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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
UNION CENTRAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 80837 )
Policy contract number	04008119
Policy instance	2
Insurance contract or identification number 04008119 Number of Individuals Covered 1 Insurance policy start date 2011-09-01 Insurance policy end date 2012-08-31 Total amount of commissions paid to insurance broker USD $32 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number	2759424
Policy instance	3
Insurance contract or identification number 2759424 Number of Individuals Covered 1 Insurance policy start date 2011-09-01 Insurance policy end date 2012-08-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	15604450
Policy instance	4
Insurance contract or identification number 15604450 Number of Individuals Covered 1 Insurance policy start date 2011-09-01 Insurance policy end date 2012-08-31 Total amount of commissions paid to insurance broker USD $458 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	31187,39295
Policy instance	5
Insurance contract or identification number 31187,39295 Number of Individuals Covered 2 Insurance policy start date 2011-09-01 Insurance policy end date 2012-08-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? Yes 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

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