401k Plan data: ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN plan

ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN
Plan identification number	001

ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

ROOSIEN LAND SURVEYS has sponsored the creation of one or more 401k plans.

Company Name: ROOSIEN LAND SURVEYS

Employer identification number (EIN): 352187084

NAIC Classification: 541370
NAIC Description: Surveying and Mapping (except Geophysical) Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2020-01-01 DEBORAH TIESENGA 2021-06-07
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2016-01-01 KEVIN ROOSIEN 2017-03-30
001 2015-01-01 KEVIN ROOSIEN 2016-06-23
001 2014-01-01 KEVIN ROOSIEN 2015-03-31
001 2013-01-01 KEVIN ROOSIEN 2014-06-10
001 2012-01-01 KEVIN ROOSIEN KEVIN ROOSIEN 2013-06-12
001 2011-01-01 KEVIN ROOSIEN KEVIN ROOSIEN 2012-07-13
001 2009-01-01 KEVIN ROOSIEN KEVIN ROOSIEN 2010-09-24

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2020-01-01	DEBORAH TIESENGA	2021-06-07
001	2019-01-01
001	2018-01-01
001	2017-01-01
001	2016-01-01	KEVIN ROOSIEN	2017-03-30
001	2015-01-01	KEVIN ROOSIEN	2016-06-23
001	2014-01-01	KEVIN ROOSIEN	2015-03-31
001	2013-01-01	KEVIN ROOSIEN	2014-06-10
001	2012-01-01	KEVIN ROOSIEN		KEVIN ROOSIEN	2013-06-12
001	2011-01-01	KEVIN ROOSIEN		KEVIN ROOSIEN	2012-07-13
001	2009-01-01	KEVIN ROOSIEN		KEVIN ROOSIEN	2010-09-24

Plan Statistics for ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN

Measure Date Value
2012: ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 6
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 3
Total of all active and inactive participants 2012-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 9
Number of participants with account balances 2012-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 8
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 2
Total of all active and inactive participants 2011-01-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 10
Number of participants with account balances 2011-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 7
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 4
Total of all active and inactive participants 2009-01-01 11
Total participants 2009-01-01 11
Number of participants with account balances 2009-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2012: ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	6
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	3
Total of all active and inactive participants	2012-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	9
Number of participants with account balances	2012-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	8
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	2
Total of all active and inactive participants	2011-01-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	10
Number of participants with account balances	2011-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	7
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	4
Total of all active and inactive participants	2009-01-01	11
Total participants	2009-01-01	11
Number of participants with account balances	2009-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN

Measure	Date	Value
2012 : ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$81,672
Expenses. Total of all expenses incurred	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$510,708
Total plan assets at beginning of year	2012-12-31	$429,036
Value of fidelity bond covering the plan	2012-12-31	$60,000
Total contributions received or receivable from participants	2012-12-31	$16,296
Other income received	2012-12-31	$62,236
Net income (gross income less expenses)	2012-12-31	$81,672
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$510,708
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$429,036
Total contributions received or receivable from employer(s)	2012-12-31	$3,140
2011 : ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$1,360
Expenses. Total of all expenses incurred	2011-12-31	$46,222
Benefits paid (including direct rollovers)	2011-12-31	$46,222
Total plan assets at end of year	2011-12-31	$429,036
Total plan assets at beginning of year	2011-12-31	$473,898
Value of fidelity bond covering the plan	2011-12-31	$60,000
Total contributions received or receivable from participants	2011-12-31	$15,660
Other income received	2011-12-31	$-17,329
Net income (gross income less expenses)	2011-12-31	$-44,862
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$429,036
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$473,898
Total contributions received or receivable from employer(s)	2011-12-31	$3,029
2010 : ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$65,564
Expenses. Total of all expenses incurred	2010-12-31	$18,729
Benefits paid (including direct rollovers)	2010-12-31	$18,729
Total plan assets at end of year	2010-12-31	$473,898
Total plan assets at beginning of year	2010-12-31	$427,063
Value of fidelity bond covering the plan	2010-12-31	$60,000
Total contributions received or receivable from participants	2010-12-31	$9,987
Other income received	2010-12-31	$53,612
Net income (gross income less expenses)	2010-12-31	$46,835
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$473,898
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$427,063
Assets. Value of participant loans	2010-12-31	$0
Total contributions received or receivable from employer(s)	2010-12-31	$1,965

Form 5500 Responses for ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN

2012: ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

42-M632,44-M633

Policy instance

Insurance contract or identification number	42-M632,44-M633
Number of Individuals Covered	9
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,901
Total amount of fees paid to insurance company	USD $121
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $951
Insurance broker organization code?	3
Amount paid for insurance broker fees	121
Additional information about fees paid to insurance broker	PER PARTICIPANT ACCOUNTING FEES
Insurance broker name	BUSINESS PLANNING ASSOCIATES, INC.

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

Policy contract number

42-M632,44-M633

Policy instance

Insurance contract or identification number	42-M632,44-M633
Number of Individuals Covered	10
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,934
Total amount of fees paid to insurance company	USD $124
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes

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

Policy contract number

42-M632,44-M633

Policy instance

Insurance contract or identification number	42-M632,44-M633
Number of Individuals Covered	11
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,696
Total amount of fees paid to insurance company	USD $62
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $848
Insurance broker organization code?	3
Amount paid for insurance broker fees	62
Additional information about fees paid to insurance broker	PER PARTICIPANT ACCOUNTING FEES
Insurance broker name	BUSINESS PLANNING ASSOCIATES, INC.

Potentially related plans

ROOSIEN LAND SURVEYS EMPLOYEE BENEFIT PLAN [EIN = 863731106]

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Company Name:	ROOSIEN LAND SURVEYS
Employer identification number (EIN):	352187084
NAIC Classification:	541370
NAIC Description:	Surveying and Mapping (except Geophysical) Services