401k Plan data: THE LEE MANOR 401(K) PLAN plan

THE LEE MANOR 401(K) PLAN 401k Plan overview

Plan Name	THE LEE MANOR 401(K) PLAN
Plan identification number	001

THE LEE MANOR 401(K) 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

THE LEE MANOR has sponsored the creation of one or more 401k plans.

Company Name: THE LEE MANOR

Employer identification number (EIN): 362998136

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE LEE MANOR 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 JERRY JANUSZEWSKI
001 2016-01-01 ALLAN GABRYS
001 2015-01-01 ALLAN S. GABRYS CHRISTOPHER P VANGEL 2016-10-17
001 2014-01-01 ALLAN S GABRYS
001 2013-01-01 ZENY ENGRACIA
001 2012-01-01 ZENY ENGRACIA
001 2011-01-01 ZENY ENGRACIA
001 2009-01-01 CHESTER PLODZIEN

Plan Statistics for THE LEE MANOR 401(K) PLAN

401k plan membership statisitcs for THE LEE MANOR 401(K) PLAN

Measure Date Value
2022: THE LEE MANOR 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 226
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 189
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 38
Total of all active and inactive participants 2022-01-01 227
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 227
Number of participants with account balances 2022-01-01 101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: THE LEE MANOR 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 309
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 190
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 36
Total of all active and inactive participants 2021-01-01 226
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 226
Number of participants with account balances 2021-01-01 111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: THE LEE MANOR 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 303
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 309
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 51
Total of all active and inactive participants 2020-01-01 360
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 360
Number of participants with account balances 2020-01-01 132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: THE LEE MANOR 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 292
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 249
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 54
Total of all active and inactive participants 2019-01-01 303
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 303
Number of participants with account balances 2019-01-01 134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 2
2018: THE LEE MANOR 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 279
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 261
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 49
Total of all active and inactive participants 2018-01-01 310
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 310
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: THE LEE MANOR 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 259
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 205
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 52
Total of all active and inactive participants 2017-01-01 257
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 257
Number of participants with account balances 2017-01-01 143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: THE LEE MANOR 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 99
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 51
Total of all active and inactive participants 2016-01-01 150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 150
Number of participants with account balances 2016-01-01 134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 4
2015: THE LEE MANOR 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 141
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 97
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 46
Total of all active and inactive participants 2015-01-01 143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 143
Number of participants with account balances 2015-01-01 125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 3
2014: THE LEE MANOR 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 100
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 38
Total of all active and inactive participants 2014-01-01 138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 138
Number of participants with account balances 2014-01-01 124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: THE LEE MANOR 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 212
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 201
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 36
Total of all active and inactive participants 2013-01-01 237
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 237
Number of participants with account balances 2013-01-01 113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 2
2012: THE LEE MANOR 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 220
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 184
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 28
Total of all active and inactive participants 2012-01-01 212
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 212
Number of participants with account balances 2012-01-01 94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: THE LEE MANOR 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 209
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 200
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 20
Total of all active and inactive participants 2011-01-01 220
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 220
Number of participants with account balances 2011-01-01 96
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: THE LEE MANOR 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 190
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 24
Total of all active and inactive participants 2009-01-01 199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 199
Number of participants with account balances 2009-01-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 9

Measure	Date	Value
2022: THE LEE MANOR 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	226
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	189
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	38
Total of all active and inactive participants	2022-01-01	227
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	227
Number of participants with account balances	2022-01-01	101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: THE LEE MANOR 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	309
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	190
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	36
Total of all active and inactive participants	2021-01-01	226
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	226
Number of participants with account balances	2021-01-01	111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: THE LEE MANOR 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	303
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	309
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	51
Total of all active and inactive participants	2020-01-01	360
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	360
Number of participants with account balances	2020-01-01	132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: THE LEE MANOR 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	292
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	249
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	54
Total of all active and inactive participants	2019-01-01	303
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	303
Number of participants with account balances	2019-01-01	134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	2
2018: THE LEE MANOR 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	279
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	261
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	49
Total of all active and inactive participants	2018-01-01	310
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	310
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: THE LEE MANOR 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	259
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	205
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	52
Total of all active and inactive participants	2017-01-01	257
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	257
Number of participants with account balances	2017-01-01	143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: THE LEE MANOR 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	99
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	51
Total of all active and inactive participants	2016-01-01	150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	150
Number of participants with account balances	2016-01-01	134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	4
2015: THE LEE MANOR 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	141
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	97
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	46
Total of all active and inactive participants	2015-01-01	143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	143
Number of participants with account balances	2015-01-01	125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	3
2014: THE LEE MANOR 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	100
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	38
Total of all active and inactive participants	2014-01-01	138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	138
Number of participants with account balances	2014-01-01	124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: THE LEE MANOR 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	212
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	201
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	36
Total of all active and inactive participants	2013-01-01	237
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	237
Number of participants with account balances	2013-01-01	113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	2
2012: THE LEE MANOR 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	220
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	184
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	28
Total of all active and inactive participants	2012-01-01	212
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	212
Number of participants with account balances	2012-01-01	94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: THE LEE MANOR 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	209
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	200
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	20
Total of all active and inactive participants	2011-01-01	220
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	220
Number of participants with account balances	2011-01-01	96
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: THE LEE MANOR 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	190
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	24
Total of all active and inactive participants	2009-01-01	199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	199
Number of participants with account balances	2009-01-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	9

Financial Data on THE LEE MANOR 401(K) PLAN

Measure	Date	Value
2022 : THE LEE MANOR 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-224,947
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$397,689
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$381,709
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$252,658
Value of total assets at end of year	2022-12-31	$2,620,062
Value of total assets at beginning of year	2022-12-31	$3,242,698
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$15,980
Total interest from all sources	2022-12-31	$7,135
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$52,909
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	$52,909
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	$198,872
Participant contributions at end of year	2022-12-31	$48,113
Participant contributions at beginning of year	2022-12-31	$135,375
Other income not declared elsewhere	2022-12-31	$731
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	$-622,636
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$2,620,062
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$3,242,698
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$9,319
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$2,560,520
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$2,954,958
Interest on participant loans	2022-12-31	$7,135
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$3,269
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$3,269
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$11,429
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$106,316
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-538,380
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	$53,786
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$42,780
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$381,709
Contract administrator fees	2022-12-31	$6,661
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	PFK MUELLER
Accountancy firm EIN	2022-12-31	362658780
2021 : THE LEE MANOR 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$625,386
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$247,504
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$221,009
Value of total corrective distributions	2021-12-31	$9,933
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$261,382
Value of total assets at end of year	2021-12-31	$3,242,698
Value of total assets at beginning of year	2021-12-31	$2,864,816
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$16,562
Total interest from all sources	2021-12-31	$6,302
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$67,411
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	$67,411
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$188,882
Participant contributions at end of year	2021-12-31	$135,375
Participant contributions at beginning of year	2021-12-31	$77,044
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$14,302
Other income not declared elsewhere	2021-12-31	$1,483
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	$377,882
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$3,242,698
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,864,816
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$9,649
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$2,954,958
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$2,773,189
Interest on participant loans	2021-12-31	$6,302
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$3,269
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$106,316
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$14,583
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$288,808
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	$58,198
Employer contributions (assets) at end of year	2021-12-31	$42,780
Employer contributions (assets) at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$221,009
Contract administrator fees	2021-12-31	$6,913
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	PFK MUELLER
Accountancy firm EIN	2021-12-31	362658780
2020 : THE LEE MANOR 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$450,294
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$537,961
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$478,617
Expenses. Certain deemed distributions of participant loans	2020-12-31	$31,193
Value of total corrective distributions	2020-12-31	$21,709
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$175,488
Value of total assets at end of year	2020-12-31	$2,864,816
Value of total assets at beginning of year	2020-12-31	$2,952,483
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$6,442
Total interest from all sources	2020-12-31	$5,698
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$52,851
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	$52,851
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	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$175,488
Participant contributions at end of year	2020-12-31	$77,044
Participant contributions at beginning of year	2020-12-31	$88,845
Other income not declared elsewhere	2020-12-31	$10
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	$-87,667
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,864,816
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,952,483
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
Investment advisory and management fees	2020-12-31	$3,354
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$2,773,189
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$2,704,348
Interest on participant loans	2020-12-31	$5,698
Value of interest in common/collective trusts at end of year	2020-12-31	$0
Value of interest in common/collective trusts at beginning of year	2020-12-31	$159,290
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$14,583
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$209,960
Net investment gain or loss from common/collective trusts	2020-12-31	$6,287
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$478,617
Contract administrator fees	2020-12-31	$3,088
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	2020-12-31	Yes
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	Unqualified
Accountancy firm name	2020-12-31	PFK MUELLER
Accountancy firm EIN	2020-12-31	362658780
2019 : THE LEE MANOR 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets to this plan	2019-12-31	$0
Total transfer of assets from this plan	2019-12-31	$450,610
Total transfer of assets from this plan	2019-12-31	$450,610
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$892,206
Total income from all sources (including contributions)	2019-12-31	$892,206
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$195,651
Total of all expenses incurred	2019-12-31	$195,651
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$184,248
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$184,248
Expenses. Certain deemed distributions of participant loans	2019-12-31	$1,830
Expenses. Certain deemed distributions of participant loans	2019-12-31	$1,830
Value of total corrective distributions	2019-12-31	$8,538
Value of total corrective distributions	2019-12-31	$8,538
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$312,555
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$312,555
Value of total assets at end of year	2019-12-31	$2,952,483
Value of total assets at end of year	2019-12-31	$2,952,483
Value of total assets at beginning of year	2019-12-31	$2,706,538
Value of total assets at beginning of year	2019-12-31	$2,706,538
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$1,035
Total interest from all sources	2019-12-31	$10,155
Total interest from all sources	2019-12-31	$10,155
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$152,917
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$152,917
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	$152,917
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$152,917
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$271,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$300,727
Contributions received from participants	2019-12-31	$300,727
Participant contributions at end of year	2019-12-31	$88,845
Participant contributions at end of year	2019-12-31	$88,845
Participant contributions at beginning of year	2019-12-31	$152,600
Participant contributions at beginning of year	2019-12-31	$152,600
Administrative expenses (other) incurred	2019-12-31	$1,035
Administrative expenses (other) incurred	2019-12-31	$1,035
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	$696,555
Value of net income/loss	2019-12-31	$696,555
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,952,483
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,952,483
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,706,538
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,706,538
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$2,704,348
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$2,704,348
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$2,425,327
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$2,425,327
Interest on participant loans	2019-12-31	$10,155
Interest on participant loans	2019-12-31	$10,155
Value of interest in common/collective trusts at end of year	2019-12-31	$159,290
Value of interest in common/collective trusts at end of year	2019-12-31	$159,290
Value of interest in common/collective trusts at beginning of year	2019-12-31	$128,611
Value of interest in common/collective trusts at beginning of year	2019-12-31	$128,611
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$396,873
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$396,873
Net investment gain or loss from common/collective trusts	2019-12-31	$19,706
Net investment gain or loss from common/collective trusts	2019-12-31	$19,706
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$11,828
Contributions received in cash from employer	2019-12-31	$11,828
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$184,248
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$184,248
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	MUELLER & CO. LLP
Accountancy firm name	2019-12-31	MUELLER & CO. LLP
Accountancy firm EIN	2019-12-31	362658780
Accountancy firm EIN	2019-12-31	362658780
2018 : THE LEE MANOR 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets to this plan	2018-12-31	$0
Total transfer of assets from this plan	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$124,360
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$467,558
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$443,187
Expenses. Certain deemed distributions of participant loans	2018-12-31	$1,748
Value of total corrective distributions	2018-12-31	$21,158
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$305,235
Value of total assets at end of year	2018-12-31	$2,706,538
Value of total assets at beginning of year	2018-12-31	$3,049,736
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$1,465
Total interest from all sources	2018-12-31	$14,433
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$198,453
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	$198,453
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$305,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$261,654
Participant contributions at end of year	2018-12-31	$152,600
Participant contributions at beginning of year	2018-12-31	$224,747
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$5,137
Administrative expenses (other) incurred	2018-12-31	$1,465
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	$-343,198
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,706,538
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$3,049,736
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	$2,425,327
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$2,669,617
Interest on participant loans	2018-12-31	$14,433
Value of interest in common/collective trusts at end of year	2018-12-31	$128,611
Value of interest in common/collective trusts at beginning of year	2018-12-31	$155,372
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-391,884
Net investment gain or loss from common/collective trusts	2018-12-31	$-1,877
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	$38,444
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$443,187
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	MUELLER & CO. LLP
Accountancy firm EIN	2018-12-31	362658780
2017 : THE LEE MANOR 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	2017-12-31	$0
Total transfer of assets from this plan	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	$1,012,784
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$807,828
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$798,750
Expenses. Certain deemed distributions of participant loans	2017-12-31	$1,647
Value of total corrective distributions	2017-12-31	$5,506
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$468,523
Value of total assets at end of year	2017-12-31	$3,049,736
Value of total assets at beginning of year	2017-12-31	$2,844,780
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$1,925
Total interest from all sources	2017-12-31	$9,351
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$126,919
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	$126,919
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$285,000
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	$315,966
Participant contributions at end of year	2017-12-31	$224,747
Participant contributions at beginning of year	2017-12-31	$150,160
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$101,832
Other income not declared elsewhere	2017-12-31	$106,000
Administrative expenses (other) incurred	2017-12-31	$1,925
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	$204,956
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$3,049,736
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,844,780
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	$2,669,617
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$2,573,267
Interest on participant loans	2017-12-31	$9,351
Value of interest in common/collective trusts at end of year	2017-12-31	$155,372
Value of interest in common/collective trusts at beginning of year	2017-12-31	$121,353
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$290,702
Net investment gain or loss from common/collective trusts	2017-12-31	$11,289
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	$50,725
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$798,750
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	MUELLER & CO. LLP
Accountancy firm EIN	2017-12-31	362658780
2016 : THE LEE MANOR 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets to this plan	2016-12-31	$0
Total transfer of assets from this plan	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	$475,784
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$181,447
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$153,967
Expenses. Certain deemed distributions of participant loans	2016-12-31	$1,569
Value of total corrective distributions	2016-12-31	$24,661
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$251,313
Value of total assets at end of year	2016-12-31	$2,844,780
Value of total assets at beginning of year	2016-12-31	$2,550,443
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,250
Total interest from all sources	2016-12-31	$7,855
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$89,396
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	$89,396
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$256,000
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	$251,313
Participant contributions at end of year	2016-12-31	$150,160
Participant contributions at beginning of year	2016-12-31	$141,968
Administrative expenses (other) incurred	2016-12-31	$1,250
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	$294,337
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,844,780
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,550,443
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	$2,573,267
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$2,359,515
Interest on participant loans	2016-12-31	$7,855
Value of interest in common/collective trusts at end of year	2016-12-31	$121,353
Value of interest in common/collective trusts at beginning of year	2016-12-31	$48,960
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$122,395
Net investment gain or loss from common/collective trusts	2016-12-31	$4,825
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	$153,967
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	MUELLER & CO. LLP
Accountancy firm EIN	2016-12-31	362658780
2015 : THE LEE MANOR 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets to this plan	2015-12-31	$0
Total transfer of assets from this plan	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	$308,036
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$385,203
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$321,875
Expenses. Certain deemed distributions of participant loans	2015-12-31	$29,996
Value of total corrective distributions	2015-12-31	$32,357
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$324,519
Value of total assets at end of year	2015-12-31	$2,550,443
Value of total assets at beginning of year	2015-12-31	$2,627,610
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$975
Total interest from all sources	2015-12-31	$8,417
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$112,432
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$112,432
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$263,000
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	$277,083
Participant contributions at end of year	2015-12-31	$141,968
Participant contributions at beginning of year	2015-12-31	$217,848
Administrative expenses (other) incurred	2015-12-31	$975
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	$-77,167
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$2,550,443
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$2,627,610
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	$2,359,515
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$2,375,758
Interest on participant loans	2015-12-31	$8,417
Value of interest in common/collective trusts at end of year	2015-12-31	$48,960
Value of interest in common/collective trusts at beginning of year	2015-12-31	$34,004
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-137,618
Net investment gain or loss from common/collective trusts	2015-12-31	$286
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	$47,436
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$321,875
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	MUELLER & CO. LLP
Accountancy firm EIN	2015-12-31	362658780
2014 : THE LEE MANOR 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$1,100
Total transfer of assets from this plan	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	$452,152
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$234,753
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$212,537
Expenses. Certain deemed distributions of participant loans	2014-12-31	$19,766
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$324,036
Value of total assets at end of year	2014-12-31	$2,627,610
Value of total assets at beginning of year	2014-12-31	$2,409,111
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$2,450
Total interest from all sources	2014-12-31	$5,564
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$103,032
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	$103,032
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$241,000
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	$277,150
Participant contributions at end of year	2014-12-31	$217,848
Participant contributions at beginning of year	2014-12-31	$111,939
Administrative expenses (other) incurred	2014-12-31	$2,450
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	$217,399
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$2,627,610
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$2,409,111
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$2,375,758
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$2,282,305
Interest on participant loans	2014-12-31	$5,564
Value of interest in common/collective trusts at end of year	2014-12-31	$34,004
Value of interest in common/collective trusts at beginning of year	2014-12-31	$14,867
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$16,651
Net investment gain or loss from common/collective trusts	2014-12-31	$2,869
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$46,886
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$212,537
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	MUELLER & CO. LLP
Accountancy firm EIN	2014-12-31	362658780
2013 : THE LEE MANOR 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$645,811
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$72,038
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$55,415
Expenses. Certain deemed distributions of participant loans	2013-12-31	$15,902
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$334,194
Value of total assets at end of year	2013-12-31	$2,409,111
Value of total assets at beginning of year	2013-12-31	$1,835,338
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$721
Total interest from all sources	2013-12-31	$3,046
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$105,836
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$105,836
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$184,000
If this is an individual account plan, was there a blackout period	2013-12-31	Yes
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	$255,750
Participant contributions at end of year	2013-12-31	$111,939
Participant contributions at beginning of year	2013-12-31	$59,749
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$39,535
Administrative expenses (other) incurred	2013-12-31	$721
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	$573,773
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$2,409,111
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,835,338
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$2,282,305
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,767,890
Interest on participant loans	2013-12-31	$3,046
Value of interest in common/collective trusts at end of year	2013-12-31	$14,867
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$7,699
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$7,699
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$202,365
Net investment gain or loss from common/collective trusts	2013-12-31	$370
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$38,909
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$55,415
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	2013-12-31	Yes
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	MUELLER & CO. LLP
Accountancy firm EIN	2013-12-31	362658780
2012 : THE LEE MANOR 401(K) PLAN 2012 401k financial data
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	$451,737
Total of all expenses incurred	2012-12-31	$145,581
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$125,350
Value of total corrective distributions	2012-12-31	$19,237
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$282,730
Value of total assets at end of year	2012-12-31	$1,835,338
Value of total assets at beginning of year	2012-12-31	$1,529,182
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$994
Total interest from all sources	2012-12-31	$3,415
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$38,096
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$38,096
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$195,000
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	$216,738
Participant contributions at end of year	2012-12-31	$59,749
Participant contributions at beginning of year	2012-12-31	$73,146
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$14,347
Administrative expenses (other) incurred	2012-12-31	$994
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	$306,156
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,835,338
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,529,182
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 registered invesment companies (eg mutual funds) at end of year	2012-12-31	$1,767,890
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$1,282,887
Interest on participant loans	2012-12-31	$2,616
Interest earned on other investments	2012-12-31	$799
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$7,699
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$23
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$23
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$173,126
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$127,496
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$51,645
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$125,350
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	2012-12-31	No
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	MUELLER & CO., LLP
Accountancy firm EIN	2012-12-31	362658780
2011 : THE LEE MANOR 401(K) PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$327,221
Total of all expenses incurred	2011-12-31	$136,609
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$127,915
Expenses. Certain deemed distributions of participant loans	2011-12-31	$5,298
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$337,089
Value of total assets at end of year	2011-12-31	$1,529,182
Value of total assets at beginning of year	2011-12-31	$1,338,570
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$3,396
Total interest from all sources	2011-12-31	$7,710
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$35,835
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$35,835
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$195,000
If this is an individual account plan, was there a blackout period	2011-12-31	Yes
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	$208,764
Participant contributions at end of year	2011-12-31	$73,146
Participant contributions at beginning of year	2011-12-31	$76,497
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$93,268
Administrative expenses (other) incurred	2011-12-31	$344
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	$190,612
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,529,182
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,338,570
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 registered invesment companies (eg mutual funds) at end of year	2011-12-31	$1,282,887
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$0
Value of interest in pooled separate accounts at end of year	2011-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$977,844
Interest on participant loans	2011-12-31	$2,985
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$23
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$4,725
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$173,126
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$284,229
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-124,299
Net investment gain/loss from pooled separate accounts	2011-12-31	$70,886
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	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$35,057
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$127,915
Contract administrator fees	2011-12-31	$3,052
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	Yes
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	MUELLER & CO., LLP
Accountancy firm EIN	2011-12-31	362658780
2010 : THE LEE MANOR 401(K) PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets	2010-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$0
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets to this plan	2010-12-31	$0
Total transfer of assets from this plan	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Expenses. Interest paid	2010-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$443,907
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$30,459
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$25,823
Expenses. Certain deemed distributions of participant loans	2010-12-31	$0
Value of total corrective distributions	2010-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$335,674
Value of total assets at end of year	2010-12-31	$1,338,570
Value of total assets at beginning of year	2010-12-31	$925,122
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$4,636
Total income from rents	2010-12-31	$0
Total interest from all sources	2010-12-31	$8,484
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Assets. Real estate other than employer real property at end of year	2010-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2010-12-31	$0
Administrative expenses professional fees incurred	2010-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2010-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2010-12-31	$0
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$195,000
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	$172,165
Participant contributions at end of year	2010-12-31	$76,497
Participant contributions at beginning of year	2010-12-31	$7,905
Participant contributions at end of year	2010-12-31	$0
Participant contributions at beginning of year	2010-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$121,289
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$0
Assets. Loans (other than to participants) at end of year	2010-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$0
Other income not declared elsewhere	2010-12-31	$0
Administrative expenses (other) incurred	2010-12-31	$0
Total non interest bearing cash at end of year	2010-12-31	$0
Total non interest bearing cash at beginning of year	2010-12-31	$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	2010-12-31	No
Income. Non cash contributions	2010-12-31	$0
Value of net income/loss	2010-12-31	$413,448
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,338,570
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$925,122
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
Assets. partnership/joint venture interests at end of year	2010-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2010-12-31	$0
Investment advisory and management fees	2010-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$0
Value of interest in pooled separate accounts at end of year	2010-12-31	$977,844
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$740,767
Interest on participant loans	2010-12-31	$2,150
Income. Interest from loans (other than to participants)	2010-12-31	$0
Interest earned on other investments	2010-12-31	$6,334
Income. Interest from US Government securities	2010-12-31	$0
Income. Interest from corporate debt instruments	2010-12-31	$0
Value of interest in master investment trust accounts at end of year	2010-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2010-12-31	$0
Value of interest in common/collective trusts at end of year	2010-12-31	$0
Value of interest in common/collective trusts at beginning of year	2010-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2010-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$284,229
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$176,450
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$0
Asset value of US Government securities at end of year	2010-12-31	$0
Asset value of US Government securities at beginning of year	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$0
Net investment gain/loss from pooled separate accounts	2010-12-31	$99,749
Net investment gain or loss from common/collective trusts	2010-12-31	$0
Net gain/loss from 103.12 investment entities	2010-12-31	$0
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	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Assets. Invements in employer securities at end of year	2010-12-31	$0
Assets. Invements in employer securities at beginning of year	2010-12-31	$0
Assets. Value of employer real property at end of year	2010-12-31	$0
Assets. Value of employer real property at beginning of year	2010-12-31	$0
Contributions received in cash from employer	2010-12-31	$42,220
Employer contributions (assets) at end of year	2010-12-31	$0
Employer contributions (assets) at beginning of year	2010-12-31	$0
Income. Dividends from preferred stock	2010-12-31	$0
Income. Dividends from common stock	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$25,823
Asset. Corporate debt instrument preferred debt at end of year	2010-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2010-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$0
Contract administrator fees	2010-12-31	$4,636
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
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2010-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2010-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2010-12-31	$0
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
Aggregate proceeds on sale of assets	2010-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2010-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2010-12-31	$0
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	MUELLER & CO., LLP
Accountancy firm EIN	2010-12-31	362658780
2009 : THE LEE MANOR 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for THE LEE MANOR 401(K) PLAN

2022: THE LEE MANOR 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	Yes
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: THE LEE MANOR 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: THE LEE MANOR 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: THE LEE MANOR 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: THE LEE MANOR 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: THE LEE MANOR 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: THE LEE MANOR 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: THE LEE MANOR 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: THE LEE MANOR 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: THE LEE MANOR 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: THE LEE MANOR 401(K) 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 funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: THE LEE MANOR 401(K) 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 funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: THE LEE MANOR 401(K) 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 benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

LE0502

Policy instance

Insurance contract or identification number	LE0502
Number of Individuals Covered	101
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

LE0502

Policy instance

Insurance contract or identification number	LE0502
Number of Individuals Covered	111
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

LE0502

Policy instance

Insurance contract or identification number	LE0502
Number of Individuals Covered	2
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

513562-01

Policy instance

Insurance contract or identification number	513562-01
Number of Individuals Covered	0
Insurance policy start date	2012-01-01
Insurance policy end date	2012-04-26
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

513562-01

Policy instance

Insurance contract or identification number	513562-01
Number of Individuals Covered	63
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $3,244
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

513562-01

Policy instance

Insurance contract or identification number	513562-01
Number of Individuals Covered	103
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $5,910
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $5,910
Insurance broker organization code?	3
Insurance broker name	WOODBURY FINANCIAL SERVICES INC

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Company Name:	THE LEE MANOR
Employer identification number (EIN):	362998136
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities