401k Plan data: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. plan

TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 401k Plan overview

Plan Name	TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC.
Plan identification number	002

TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.

401k Sponsoring company profile

GOODWILL INDUSTRIES OF NORTHERN ILLINOIS AND WISCONSIN STATELINE AREA has sponsored the creation of one or more 401k plans.

Company Name: GOODWILL INDUSTRIES OF NORTHERN ILLINOIS AND WISCONSIN STATELINE AREA

Employer identification number (EIN): 362167846

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2017-01-01
002 2016-01-01
002 2015-01-01
002 2014-01-01 NAOMI S BYARS
002 2013-01-01 NAOMI S BYARS
002 2012-01-01 NAOMI S BYARS
002 2011-01-01 NAOMI S BYARS
002 2009-01-01 NAOMI S BYARS

Plan Statistics for TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC.

401k plan membership statisitcs for TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC.

Measure Date Value
2017: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2017 401k membership
Total participants, beginning-of-year 2017-01-01 517
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
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 0
Total of all active and inactive participants 2017-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
Number of participants with account balances 2017-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2016 401k membership
Total participants, beginning-of-year 2016-01-01 508
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 508
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 9
Total of all active and inactive participants 2016-01-01 517
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 517
Number of participants with account balances 2016-01-01 62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2015 401k membership
Total participants, beginning-of-year 2015-01-01 471
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 497
Number of other retired or separated participants entitled to future benefits 2015-01-01 10
Total of all active and inactive participants 2015-01-01 507
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 1
Total participants 2015-01-01 508
Number of participants with account balances 2015-01-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2014 401k membership
Total participants, beginning-of-year 2014-01-01 334
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 462
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 8
Total of all active and inactive participants 2014-01-01 470
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 471
Number of participants with account balances 2014-01-01 62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2013 401k membership
Total participants, beginning-of-year 2013-01-01 288
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 326
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 8
Total of all active and inactive participants 2013-01-01 334
Total participants 2013-01-01 334
Number of participants with account balances 2013-01-01 53
2012: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2012 401k membership
Total participants, beginning-of-year 2012-01-01 205
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 281
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 7
Total of all active and inactive participants 2012-01-01 288
Total participants 2012-01-01 288
Number of participants with account balances 2012-01-01 44
2011: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2011 401k membership
Total participants, beginning-of-year 2011-01-01 215
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 198
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 7
Total of all active and inactive participants 2011-01-01 205
Total participants 2011-01-01 205
Number of participants with account balances 2011-01-01 47
2009: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2009 401k membership
Total participants, beginning-of-year 2009-01-01 194
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 175
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 5
Total of all active and inactive participants 2009-01-01 180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 180
Number of participants with account balances 2009-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2017: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2017 401k membership
Total participants, beginning-of-year	2017-01-01	517
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
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	0
Total of all active and inactive participants	2017-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
Number of participants with account balances	2017-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2016 401k membership
Total participants, beginning-of-year	2016-01-01	508
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	508
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	9
Total of all active and inactive participants	2016-01-01	517
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	517
Number of participants with account balances	2016-01-01	62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2015 401k membership
Total participants, beginning-of-year	2015-01-01	471
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	497
Number of other retired or separated participants entitled to future benefits	2015-01-01	10
Total of all active and inactive participants	2015-01-01	507
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	1
Total participants	2015-01-01	508
Number of participants with account balances	2015-01-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2014 401k membership
Total participants, beginning-of-year	2014-01-01	334
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	462
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	8
Total of all active and inactive participants	2014-01-01	470
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	471
Number of participants with account balances	2014-01-01	62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2013 401k membership
Total participants, beginning-of-year	2013-01-01	288
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	326
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	8
Total of all active and inactive participants	2013-01-01	334
Total participants	2013-01-01	334
Number of participants with account balances	2013-01-01	53
2012: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2012 401k membership
Total participants, beginning-of-year	2012-01-01	205
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	281
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	7
Total of all active and inactive participants	2012-01-01	288
Total participants	2012-01-01	288
Number of participants with account balances	2012-01-01	44
2011: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2011 401k membership
Total participants, beginning-of-year	2011-01-01	215
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	198
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	7
Total of all active and inactive participants	2011-01-01	205
Total participants	2011-01-01	205
Number of participants with account balances	2011-01-01	47
2009: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2009 401k membership
Total participants, beginning-of-year	2009-01-01	194
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	175
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	5
Total of all active and inactive participants	2009-01-01	180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	180
Number of participants with account balances	2009-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC.

Measure	Date	Value
2017 : TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$179,131
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$913,656
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$913,223
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$71,801
Value of total assets at end of year	2017-12-31	$0
Value of total assets at beginning of year	2017-12-31	$734,525
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$433
Total interest from all sources	2017-12-31	$1,012
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-12-31	$0
Administrative expenses professional fees incurred	2017-12-31	$433
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$100,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$62,825
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$3,343
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$8,976
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	$-734,525
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$734,525
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in pooled separate accounts at end of year	2017-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$678,194
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$1,012
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$52,988
Net investment gain/loss from pooled separate accounts	2017-12-31	$106,318
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$913,223
Did the plan have assets held for investment	2017-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	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	Yes
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	SIKICH LLP
Accountancy firm EIN	2017-12-31	363168081
2016 : TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 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	$148,686
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$48,019
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$47,392
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$94,562
Value of total assets at end of year	2016-12-31	$734,525
Value of total assets at beginning of year	2016-12-31	$633,858
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$627
Total interest from all sources	2016-12-31	$990
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$100,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$93,005
Participant contributions at end of year	2016-12-31	$3,343
Participant contributions at beginning of year	2016-12-31	$2,578
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$1,557
Administrative expenses (other) incurred	2016-12-31	$627
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	$100,667
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$734,525
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$633,858
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 pooled separate accounts at end of year	2016-12-31	$678,194
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$572,371
Interest earned on other investments	2016-12-31	$990
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$52,988
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$58,909
Net investment gain/loss from pooled separate accounts	2016-12-31	$53,134
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$47,392
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	SIKICH LLP
Accountancy firm EIN	2016-12-31	363168081
2015 : TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 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	$79,715
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$51,385
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$50,718
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$91,038
Value of total assets at end of year	2015-12-31	$633,858
Value of total assets at beginning of year	2015-12-31	$605,528
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$667
Total interest from all sources	2015-12-31	$1,704
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Administrative expenses professional fees incurred	2015-12-31	$667
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$91,038
Participant contributions at end of year	2015-12-31	$2,578
Participant contributions at beginning of year	2015-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$28,330
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$633,858
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$605,528
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 pooled separate accounts at end of year	2015-12-31	$572,371
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$514,139
Interest earned on other investments	2015-12-31	$1,704
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$58,909
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$91,389
Net investment gain/loss from pooled separate accounts	2015-12-31	$-13,027
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$50,718
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	SIKICH LLP
Accountancy firm EIN	2015-12-31	363168081
2014 : TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 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	$116,986
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$135,337
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$134,741
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$87,877
Value of total assets at end of year	2014-12-31	$605,528
Value of total assets at beginning of year	2014-12-31	$623,879
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$596
Total interest from all sources	2014-12-31	$2,052
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$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
Contributions received from participants	2014-12-31	$82,883
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$4,994
Administrative expenses (other) incurred	2014-12-31	$596
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	$-18,351
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$605,528
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$623,879
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in pooled separate accounts at end of year	2014-12-31	$514,139
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$532,110
Interest earned on other investments	2014-12-31	$2,052
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$91,389
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$91,769
Net investment gain/loss from pooled separate accounts	2014-12-31	$27,057
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$134,741
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	SIKICH LLP
Accountancy firm EIN	2014-12-31	363168081
2013 : TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$233,860
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$131,761
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$131,257
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$121,293
Value of total assets at end of year	2013-12-31	$623,879
Value of total assets at beginning of year	2013-12-31	$521,780
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$504
Total interest from all sources	2013-12-31	$2,615
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$71,076
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$50,217
Administrative expenses (other) incurred	2013-12-31	$504
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$102,099
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$623,879
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$521,780
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in pooled separate accounts at end of year	2013-12-31	$532,110
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$455,208
Interest earned on other investments	2013-12-31	$2,615
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$91,769
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$66,572
Net investment gain/loss from pooled separate accounts	2013-12-31	$109,952
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$131,257
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	SIKICH LLP
Accountancy firm EIN	2013-12-31	363168081
2012 : TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$119,138
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$12,150
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$11,770
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$70,701
Value of total assets at end of year	2012-12-31	$521,780
Value of total assets at beginning of year	2012-12-31	$414,792
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$380
Total interest from all sources	2012-12-31	$1,834
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$100,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$64,538
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$6,163
Administrative expenses (other) incurred	2012-12-31	$380
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$106,988
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$521,780
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$414,792
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$455,208
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$350,130
Interest earned on other investments	2012-12-31	$1,834
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$66,572
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$64,662
Net investment gain/loss from pooled separate accounts	2012-12-31	$46,603
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$11,770
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	SIKICH LLP
Accountancy firm EIN	2012-12-31	363168081
2011 : TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$51,512
Total of all expenses incurred	2011-12-31	$59,577
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$59,238
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$61,105
Value of total assets at end of year	2011-12-31	$414,792
Value of total assets at beginning of year	2011-12-31	$422,857
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$339
Total interest from all sources	2011-12-31	$2,964
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$100,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$61,105
Administrative expenses (other) incurred	2011-12-31	$339
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-8,065
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$414,792
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$422,857
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$350,130
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$310,807
Interest earned on other investments	2011-12-31	$2,964
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$64,662
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$112,050
Net investment gain/loss from pooled separate accounts	2011-12-31	$-12,557
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$59,238
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	SIKICH LLP
Accountancy firm EIN	2011-12-31	363168081
2010 : TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$101,330
Total of all expenses incurred	2010-12-31	$26,678
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$26,393
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$54,215
Value of total assets at end of year	2010-12-31	$422,857
Value of total assets at beginning of year	2010-12-31	$348,205
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$285
Total interest from all sources	2010-12-31	$3,335
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$100,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$47,461
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$6,754
Administrative expenses (other) incurred	2010-12-31	$285
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$74,652
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$422,857
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$348,205
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$310,807
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$234,405
Interest earned on other investments	2010-12-31	$3,335
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$112,050
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$113,800
Net investment gain/loss from pooled separate accounts	2010-12-31	$43,780
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$26,393
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	SIKICH LLP
Accountancy firm EIN	2010-12-31	363168081
2009 : TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC.

2017: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 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	Yes
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 benefit arrangement – Insurance	Yes
2016: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 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 benefit arrangement – Insurance	Yes
2011: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: TAX DEFERRED ANNUITY PLAN OF GOODWILL INDUSTRIES OF NORTHERN ILLINOIS, INC. 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

050791-J

Policy instance

Insurance contract or identification number	050791-J
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	CHICAGO REGIONAL OFFICE

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

050791-J

Policy instance

Insurance contract or identification number	050791-J
Number of Individuals Covered	66
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 $315
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	315
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?	3
Insurance broker name	CHICAGO REGIONAL OFFICE

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

050791-J

Policy instance

Insurance contract or identification number	050791-J
Number of Individuals Covered	62
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $189
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $189
Insurance broker organization code?	3
Insurance broker name	CHICAGO REGIONAL OFFICE

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

050791-J

Policy instance

Insurance contract or identification number	050791-J
Number of Individuals Covered	53
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $90
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $90
Insurance broker organization code?	3
Insurance broker name	CHICAGO REGIONAL OFFICE

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

050791-J

Policy instance

Insurance contract or identification number	050791-J
Number of Individuals Covered	44
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $85
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26
Insurance broker organization code?	3
Insurance broker name	RAFAEL J. AMGLADA

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

050791-J

Policy instance

Insurance contract or identification number	050791-J
Number of Individuals Covered	47
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $173
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

050791-J

Policy instance

Insurance contract or identification number	050791-J
Number of Individuals Covered	28
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $37
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	19
Additional information about fees paid to insurance broker	COMPENSATION
Insurance broker organization code?	3
Insurance broker name	ANTHONY B PERRIN

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Company Name:	GOODWILL INDUSTRIES OF NORTHERN ILLINOIS AND WISCONSIN STATELINE AREA
Employer identification number (EIN):	362167846
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations