401k Plan data: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST plan

FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 401k Plan overview

Plan Name	FARMERS STATE BANK OF EMDEN RETIREMENT TRUST
Plan identification number	001

FARMERS STATE BANK OF EMDEN RETIREMENT TRUST Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
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

FARMERS STATE BANK OF EMDEN has sponsored the creation of one or more 401k plans.

Company Name: FARMERS STATE BANK OF EMDEN

Employer identification number (EIN): 370269930

NAIC Classification: 522110
NAIC Description: Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FARMERS STATE BANK OF EMDEN RETIREMENT TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2018-12-01
001 2017-12-01
001 2016-12-01 KENT CROSS
001 2015-12-01 KENT CROSS
001 2014-12-01 KENT CROSS
001 2013-12-01 KENT CROSS
001 2012-12-01 KENT CROSS
001 2011-12-01 KENT CROSS
001 2009-12-01 KENT CROSS

Plan Statistics for FARMERS STATE BANK OF EMDEN RETIREMENT TRUST

401k plan membership statisitcs for FARMERS STATE BANK OF EMDEN RETIREMENT TRUST

Measure Date Value
2019: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2019 401k membership
Market value of plan assets 2019-07-31 94,291
Acturial value of plan assets 2019-07-31 94,291
Funding target for retired participants and beneficiaries receiving payment 2019-07-31 0
Number of terminated vested participants 2019-07-31 0
Fundng target for terminated vested participants 2019-07-31 0
Active participant vested funding target 2019-07-31 87,320
Number of active participants 2019-07-31 1
Total funding liabilities for active participants 2019-07-31 87,320
Total participant count 2019-07-31 1
Total funding target for all participants 2019-07-31 87,320
Balance at beginning of prior year after applicable adjustments 2019-07-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2019-07-31 133
Carryover balanced portion elected for use to offset prior years funding requirement 2019-07-31 0
Prefunding balanced used to offset prior years funding requirement 2019-07-31 0
Amount remaining of carryover balance 2019-07-31 0
Amount remaining of prefunding balance 2019-07-31 133
Present value of excess contributions 2019-07-31 41,458
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2019-07-31 43,879
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2019-07-31 0
Reductions in caryover balances due to elections or deemed elections 2019-07-31 0
Reductions in prefunding balances due to elections or deemed elections 2019-07-31 0
Balance of carryovers at beginning of current year 2019-07-31 0
Balance of prefunding at beginning of current year 2019-07-31 138
Total employer contributions 2019-07-31 0
Total employee contributions 2019-07-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2019-07-31 0
Contributions made to avoid restrictions adjusted to valuation date 2019-07-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2019-07-31 0
Unpaid minimum required contributions for all prior years 2019-07-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2019-07-31 0
Remaining amount of unpaid minimum required contributions 2019-07-31 0
Minimum required contributions for current year target normal cost 2019-07-31 0
Net shortfall amortization installment of oustanding balance 2019-07-31 0
Waiver amortization installment 2019-07-31 0
Total funding amount beforereflecting carryover/prefunding balances 2019-07-31 0
Carryover balance elected to use to offset funding requirement 2019-07-31 0
Prefunding balance elected to use to offset funding requirement 2019-07-31 0
Additional cash requirement 2019-07-31 0
Contributions allocatedtoward minimum required contributions for current year 2019-07-31 0
Unpaid minimum required contributions for current year 2019-07-31 0
Unpaid minimum required contributions for all years 2019-07-31 0
2018: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2018 401k membership
Total participants, beginning-of-year 2018-12-01 1
Total number of active participants reported on line 7a of the Form 5500 2018-12-01 0
Number of retired or separated participants receiving benefits 2018-12-01 0
Number of other retired or separated participants entitled to future benefits 2018-12-01 0
Total of all active and inactive participants 2018-12-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-12-01 0
Total participants 2018-12-01 0
Number of participants with account balances 2018-12-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-12-01 0
Market value of plan assets 2018-11-30 203,620
Acturial value of plan assets 2018-11-30 203,620
Funding target for retired participants and beneficiaries receiving payment 2018-11-30 0
Number of terminated vested participants 2018-11-30 0
Fundng target for terminated vested participants 2018-11-30 0
Active participant vested funding target 2018-11-30 198,097
Number of active participants 2018-11-30 3
Total funding liabilities for active participants 2018-11-30 198,097
Total participant count 2018-11-30 3
Total funding target for all participants 2018-11-30 198,097
Balance at beginning of prior year after applicable adjustments 2018-11-30 0
Prefunding balance at beginning of prior year after applicable adjustments 2018-11-30 127
Carryover balanced portion elected for use to offset prior years funding requirement 2018-11-30 0
Prefunding balanced used to offset prior years funding requirement 2018-11-30 0
Amount remaining of carryover balance 2018-11-30 0
Amount remaining of prefunding balance 2018-11-30 127
Present value of excess contributions 2018-11-30 27,547
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2018-11-30 29,183
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2018-11-30 0
Reductions in caryover balances due to elections or deemed elections 2018-11-30 0
Reductions in prefunding balances due to elections or deemed elections 2018-11-30 0
Balance of carryovers at beginning of current year 2018-11-30 0
Balance of prefunding at beginning of current year 2018-11-30 133
Total employer contributions 2018-11-30 42,536
Total employee contributions 2018-11-30 0
Contributions allocated toward unpaid minimum require contributions from prior years 2018-11-30 0
Contributions made to avoid restrictions adjusted to valuation date 2018-11-30 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2018-11-30 41,458
Liquidity shortfalls end of Q1 2018-11-30 0
Liquidity shortfalls end of Q2 2018-11-30 0
Liquidity shortfalls end of Q3 2018-11-30 0
Liquidity shortfalls end of Q4 2018-11-30 0
Unpaid minimum required contributions for all prior years 2018-11-30 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2018-11-30 0
Remaining amount of unpaid minimum required contributions 2018-11-30 0
Minimum required contributions for current year target normal cost 2018-11-30 2,050
Net shortfall amortization installment of oustanding balance 2018-11-30 0
Waiver amortization installment 2018-11-30 0
Total funding amount beforereflecting carryover/prefunding balances 2018-11-30 0
Carryover balance elected to use to offset funding requirement 2018-11-30 0
Prefunding balance elected to use to offset funding requirement 2018-11-30 0
Additional cash requirement 2018-11-30 0
Contributions allocatedtoward minimum required contributions for current year 2018-11-30 41,458
Unpaid minimum required contributions for current year 2018-11-30 0
Unpaid minimum required contributions for all years 2018-11-30 0
2017: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2017 401k membership
Total participants, beginning-of-year 2017-12-01 3
Total number of active participants reported on line 7a of the Form 5500 2017-12-01 1
Number of retired or separated participants receiving benefits 2017-12-01 0
Number of other retired or separated participants entitled to future benefits 2017-12-01 0
Total of all active and inactive participants 2017-12-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-12-01 0
Total participants 2017-12-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-12-01 0
Market value of plan assets 2017-11-30 153,136
Acturial value of plan assets 2017-11-30 153,136
Funding target for retired participants and beneficiaries receiving payment 2017-11-30 86,666
Number of terminated vested participants 2017-11-30 0
Fundng target for terminated vested participants 2017-11-30 0
Active participant vested funding target 2017-11-30 98,863
Number of active participants 2017-11-30 2
Total funding liabilities for active participants 2017-11-30 98,863
Total participant count 2017-11-30 3
Total funding target for all participants 2017-11-30 185,529
Balance at beginning of prior year after applicable adjustments 2017-11-30 0
Prefunding balance at beginning of prior year after applicable adjustments 2017-11-30 123
Carryover balanced portion elected for use to offset prior years funding requirement 2017-11-30 0
Prefunding balanced used to offset prior years funding requirement 2017-11-30 0
Amount remaining of carryover balance 2017-11-30 0
Amount remaining of prefunding balance 2017-11-30 123
Present value of excess contributions 2017-11-30 12,187
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2017-11-30 12,926
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2017-11-30 0
Reductions in caryover balances due to elections or deemed elections 2017-11-30 0
Reductions in prefunding balances due to elections or deemed elections 2017-11-30 0
Balance of carryovers at beginning of current year 2017-11-30 0
Balance of prefunding at beginning of current year 2017-11-30 127
Total employer contributions 2017-11-30 45,000
Total employee contributions 2017-11-30 0
Contributions allocated toward unpaid minimum require contributions from prior years 2017-11-30 0
Contributions made to avoid restrictions adjusted to valuation date 2017-11-30 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2017-11-30 43,332
Liquidity shortfalls end of Q1 2017-11-30 0
Liquidity shortfalls end of Q2 2017-11-30 0
Liquidity shortfalls end of Q3 2017-11-30 0
Liquidity shortfalls end of Q4 2017-11-30 0
Unpaid minimum required contributions for all prior years 2017-11-30 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2017-11-30 0
Remaining amount of unpaid minimum required contributions 2017-11-30 0
Minimum required contributions for current year target normal cost 2017-11-30 0
Net shortfall amortization installment of oustanding balance 2017-11-30 32,520
Waiver amortization installment 2017-11-30 0
Total funding amount beforereflecting carryover/prefunding balances 2017-11-30 15,785
Additional cash requirement 2017-11-30 15,785
Contributions allocatedtoward minimum required contributions for current year 2017-11-30 43,332
Unpaid minimum required contributions for current year 2017-11-30 0
Unpaid minimum required contributions for all years 2017-11-30 0
2016: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2016 401k membership
Total participants, beginning-of-year 2016-12-01 3
Total number of active participants reported on line 7a of the Form 5500 2016-12-01 3
Number of retired or separated participants receiving benefits 2016-12-01 0
Number of other retired or separated participants entitled to future benefits 2016-12-01 0
Total of all active and inactive participants 2016-12-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-12-01 0
Total participants 2016-12-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-12-01 0
2015: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2015 401k membership
Total participants, beginning-of-year 2015-12-01 3
Total number of active participants reported on line 7a of the Form 5500 2015-12-01 3
Number of retired or separated participants receiving benefits 2015-12-01 0
Number of other retired or separated participants entitled to future benefits 2015-12-01 0
Total of all active and inactive participants 2015-12-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-12-01 0
Total participants 2015-12-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-12-01 0
2014: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2014 401k membership
Total participants, beginning-of-year 2014-12-01 3
Total number of active participants reported on line 7a of the Form 5500 2014-12-01 3
Number of retired or separated participants receiving benefits 2014-12-01 0
Number of other retired or separated participants entitled to future benefits 2014-12-01 0
Total of all active and inactive participants 2014-12-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-12-01 0
Total participants 2014-12-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-12-01 0
2013: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2013 401k membership
Total participants, beginning-of-year 2013-12-01 3
Total number of active participants reported on line 7a of the Form 5500 2013-12-01 3
Number of retired or separated participants receiving benefits 2013-12-01 0
Number of other retired or separated participants entitled to future benefits 2013-12-01 0
Total of all active and inactive participants 2013-12-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-12-01 0
Total participants 2013-12-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-12-01 0
2012: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2012 401k membership
Total participants, beginning-of-year 2012-12-01 3
Total number of active participants reported on line 7a of the Form 5500 2012-12-01 3
Number of retired or separated participants receiving benefits 2012-12-01 0
Number of other retired or separated participants entitled to future benefits 2012-12-01 0
Total of all active and inactive participants 2012-12-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-12-01 0
Total participants 2012-12-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-12-01 0
2011: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2011 401k membership
Total participants, beginning-of-year 2011-12-01 3
Total number of active participants reported on line 7a of the Form 5500 2011-12-01 3
Number of retired or separated participants receiving benefits 2011-12-01 0
Number of other retired or separated participants entitled to future benefits 2011-12-01 0
Total of all active and inactive participants 2011-12-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-12-01 0
Total participants 2011-12-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-12-01 0
2009: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2009 401k membership
Total participants, beginning-of-year 2009-12-01 3
Total number of active participants reported on line 7a of the Form 5500 2009-12-01 3
Number of retired or separated participants receiving benefits 2009-12-01 0
Number of other retired or separated participants entitled to future benefits 2009-12-01 0
Total of all active and inactive participants 2009-12-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-12-01 0
Total participants 2009-12-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-12-01 0

Measure	Date	Value
2019: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2019 401k membership
Market value of plan assets	2019-07-31	94,291
Acturial value of plan assets	2019-07-31	94,291
Funding target for retired participants and beneficiaries receiving payment	2019-07-31	0
Number of terminated vested participants	2019-07-31	0
Fundng target for terminated vested participants	2019-07-31	0
Active participant vested funding target	2019-07-31	87,320
Number of active participants	2019-07-31	1
Total funding liabilities for active participants	2019-07-31	87,320
Total participant count	2019-07-31	1
Total funding target for all participants	2019-07-31	87,320
Balance at beginning of prior year after applicable adjustments	2019-07-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2019-07-31	133
Carryover balanced portion elected for use to offset prior years funding requirement	2019-07-31	0
Prefunding balanced used to offset prior years funding requirement	2019-07-31	0
Amount remaining of carryover balance	2019-07-31	0
Amount remaining of prefunding balance	2019-07-31	133
Present value of excess contributions	2019-07-31	41,458
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2019-07-31	43,879
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2019-07-31	0
Reductions in caryover balances due to elections or deemed elections	2019-07-31	0
Reductions in prefunding balances due to elections or deemed elections	2019-07-31	0
Balance of carryovers at beginning of current year	2019-07-31	0
Balance of prefunding at beginning of current year	2019-07-31	138
Total employer contributions	2019-07-31	0
Total employee contributions	2019-07-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2019-07-31	0
Contributions made to avoid restrictions adjusted to valuation date	2019-07-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2019-07-31	0
Unpaid minimum required contributions for all prior years	2019-07-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2019-07-31	0
Remaining amount of unpaid minimum required contributions	2019-07-31	0
Minimum required contributions for current year target normal cost	2019-07-31	0
Net shortfall amortization installment of oustanding balance	2019-07-31	0
Waiver amortization installment	2019-07-31	0
Total funding amount beforereflecting carryover/prefunding balances	2019-07-31	0
Carryover balance elected to use to offset funding requirement	2019-07-31	0
Prefunding balance elected to use to offset funding requirement	2019-07-31	0
Additional cash requirement	2019-07-31	0
Contributions allocatedtoward minimum required contributions for current year	2019-07-31	0
Unpaid minimum required contributions for current year	2019-07-31	0
Unpaid minimum required contributions for all years	2019-07-31	0
2018: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2018 401k membership
Total participants, beginning-of-year	2018-12-01	1
Total number of active participants reported on line 7a of the Form 5500	2018-12-01	0
Number of retired or separated participants receiving benefits	2018-12-01	0
Number of other retired or separated participants entitled to future benefits	2018-12-01	0
Total of all active and inactive participants	2018-12-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-12-01	0
Total participants	2018-12-01	0
Number of participants with account balances	2018-12-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-12-01	0
Market value of plan assets	2018-11-30	203,620
Acturial value of plan assets	2018-11-30	203,620
Funding target for retired participants and beneficiaries receiving payment	2018-11-30	0
Number of terminated vested participants	2018-11-30	0
Fundng target for terminated vested participants	2018-11-30	0
Active participant vested funding target	2018-11-30	198,097
Number of active participants	2018-11-30	3
Total funding liabilities for active participants	2018-11-30	198,097
Total participant count	2018-11-30	3
Total funding target for all participants	2018-11-30	198,097
Balance at beginning of prior year after applicable adjustments	2018-11-30	0
Prefunding balance at beginning of prior year after applicable adjustments	2018-11-30	127
Carryover balanced portion elected for use to offset prior years funding requirement	2018-11-30	0
Prefunding balanced used to offset prior years funding requirement	2018-11-30	0
Amount remaining of carryover balance	2018-11-30	0
Amount remaining of prefunding balance	2018-11-30	127
Present value of excess contributions	2018-11-30	27,547
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2018-11-30	29,183
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2018-11-30	0
Reductions in caryover balances due to elections or deemed elections	2018-11-30	0
Reductions in prefunding balances due to elections or deemed elections	2018-11-30	0
Balance of carryovers at beginning of current year	2018-11-30	0
Balance of prefunding at beginning of current year	2018-11-30	133
Total employer contributions	2018-11-30	42,536
Total employee contributions	2018-11-30	0
Contributions allocated toward unpaid minimum require contributions from prior years	2018-11-30	0
Contributions made to avoid restrictions adjusted to valuation date	2018-11-30	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2018-11-30	41,458
Liquidity shortfalls end of Q1	2018-11-30	0
Liquidity shortfalls end of Q2	2018-11-30	0
Liquidity shortfalls end of Q3	2018-11-30	0
Liquidity shortfalls end of Q4	2018-11-30	0
Unpaid minimum required contributions for all prior years	2018-11-30	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2018-11-30	0
Remaining amount of unpaid minimum required contributions	2018-11-30	0
Minimum required contributions for current year target normal cost	2018-11-30	2,050
Net shortfall amortization installment of oustanding balance	2018-11-30	0
Waiver amortization installment	2018-11-30	0
Total funding amount beforereflecting carryover/prefunding balances	2018-11-30	0
Carryover balance elected to use to offset funding requirement	2018-11-30	0
Prefunding balance elected to use to offset funding requirement	2018-11-30	0
Additional cash requirement	2018-11-30	0
Contributions allocatedtoward minimum required contributions for current year	2018-11-30	41,458
Unpaid minimum required contributions for current year	2018-11-30	0
Unpaid minimum required contributions for all years	2018-11-30	0
2017: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2017 401k membership
Total participants, beginning-of-year	2017-12-01	3
Total number of active participants reported on line 7a of the Form 5500	2017-12-01	1
Number of retired or separated participants receiving benefits	2017-12-01	0
Number of other retired or separated participants entitled to future benefits	2017-12-01	0
Total of all active and inactive participants	2017-12-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-12-01	0
Total participants	2017-12-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-12-01	0
Market value of plan assets	2017-11-30	153,136
Acturial value of plan assets	2017-11-30	153,136
Funding target for retired participants and beneficiaries receiving payment	2017-11-30	86,666
Number of terminated vested participants	2017-11-30	0
Fundng target for terminated vested participants	2017-11-30	0
Active participant vested funding target	2017-11-30	98,863
Number of active participants	2017-11-30	2
Total funding liabilities for active participants	2017-11-30	98,863
Total participant count	2017-11-30	3
Total funding target for all participants	2017-11-30	185,529
Balance at beginning of prior year after applicable adjustments	2017-11-30	0
Prefunding balance at beginning of prior year after applicable adjustments	2017-11-30	123
Carryover balanced portion elected for use to offset prior years funding requirement	2017-11-30	0
Prefunding balanced used to offset prior years funding requirement	2017-11-30	0
Amount remaining of carryover balance	2017-11-30	0
Amount remaining of prefunding balance	2017-11-30	123
Present value of excess contributions	2017-11-30	12,187
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2017-11-30	12,926
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2017-11-30	0
Reductions in caryover balances due to elections or deemed elections	2017-11-30	0
Reductions in prefunding balances due to elections or deemed elections	2017-11-30	0
Balance of carryovers at beginning of current year	2017-11-30	0
Balance of prefunding at beginning of current year	2017-11-30	127
Total employer contributions	2017-11-30	45,000
Total employee contributions	2017-11-30	0
Contributions allocated toward unpaid minimum require contributions from prior years	2017-11-30	0
Contributions made to avoid restrictions adjusted to valuation date	2017-11-30	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2017-11-30	43,332
Liquidity shortfalls end of Q1	2017-11-30	0
Liquidity shortfalls end of Q2	2017-11-30	0
Liquidity shortfalls end of Q3	2017-11-30	0
Liquidity shortfalls end of Q4	2017-11-30	0
Unpaid minimum required contributions for all prior years	2017-11-30	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2017-11-30	0
Remaining amount of unpaid minimum required contributions	2017-11-30	0
Minimum required contributions for current year target normal cost	2017-11-30	0
Net shortfall amortization installment of oustanding balance	2017-11-30	32,520
Waiver amortization installment	2017-11-30	0
Total funding amount beforereflecting carryover/prefunding balances	2017-11-30	15,785
Additional cash requirement	2017-11-30	15,785
Contributions allocatedtoward minimum required contributions for current year	2017-11-30	43,332
Unpaid minimum required contributions for current year	2017-11-30	0
Unpaid minimum required contributions for all years	2017-11-30	0
2016: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2016 401k membership
Total participants, beginning-of-year	2016-12-01	3
Total number of active participants reported on line 7a of the Form 5500	2016-12-01	3
Number of retired or separated participants receiving benefits	2016-12-01	0
Number of other retired or separated participants entitled to future benefits	2016-12-01	0
Total of all active and inactive participants	2016-12-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-12-01	0
Total participants	2016-12-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-12-01	0
2015: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2015 401k membership
Total participants, beginning-of-year	2015-12-01	3
Total number of active participants reported on line 7a of the Form 5500	2015-12-01	3
Number of retired or separated participants receiving benefits	2015-12-01	0
Number of other retired or separated participants entitled to future benefits	2015-12-01	0
Total of all active and inactive participants	2015-12-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-12-01	0
Total participants	2015-12-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-12-01	0
2014: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2014 401k membership
Total participants, beginning-of-year	2014-12-01	3
Total number of active participants reported on line 7a of the Form 5500	2014-12-01	3
Number of retired or separated participants receiving benefits	2014-12-01	0
Number of other retired or separated participants entitled to future benefits	2014-12-01	0
Total of all active and inactive participants	2014-12-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-12-01	0
Total participants	2014-12-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-12-01	0
2013: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2013 401k membership
Total participants, beginning-of-year	2013-12-01	3
Total number of active participants reported on line 7a of the Form 5500	2013-12-01	3
Number of retired or separated participants receiving benefits	2013-12-01	0
Number of other retired or separated participants entitled to future benefits	2013-12-01	0
Total of all active and inactive participants	2013-12-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-12-01	0
Total participants	2013-12-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-12-01	0
2012: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2012 401k membership
Total participants, beginning-of-year	2012-12-01	3
Total number of active participants reported on line 7a of the Form 5500	2012-12-01	3
Number of retired or separated participants receiving benefits	2012-12-01	0
Number of other retired or separated participants entitled to future benefits	2012-12-01	0
Total of all active and inactive participants	2012-12-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-12-01	0
Total participants	2012-12-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-12-01	0
2011: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2011 401k membership
Total participants, beginning-of-year	2011-12-01	3
Total number of active participants reported on line 7a of the Form 5500	2011-12-01	3
Number of retired or separated participants receiving benefits	2011-12-01	0
Number of other retired or separated participants entitled to future benefits	2011-12-01	0
Total of all active and inactive participants	2011-12-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-12-01	0
Total participants	2011-12-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-12-01	0
2009: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2009 401k membership
Total participants, beginning-of-year	2009-12-01	3
Total number of active participants reported on line 7a of the Form 5500	2009-12-01	3
Number of retired or separated participants receiving benefits	2009-12-01	0
Number of other retired or separated participants entitled to future benefits	2009-12-01	0
Total of all active and inactive participants	2009-12-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-12-01	0
Total participants	2009-12-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-12-01	0

Financial Data on FARMERS STATE BANK OF EMDEN RETIREMENT TRUST

Measure	Date	Value
2019 : FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2019 401k financial data
Transfers to/from the plan	2019-07-31	$0
Total plan liabilities at end of year	2019-07-31	$0
Total plan liabilities at beginning of year	2019-07-31	$0
Total income from all sources	2019-07-31	$0
Expenses. Total of all expenses incurred	2019-07-31	$94,291
Benefits paid (including direct rollovers)	2019-07-31	$94,291
Total plan assets at end of year	2019-07-31	$0
Total plan assets at beginning of year	2019-07-31	$94,291
Value of fidelity bond covering the plan	2019-07-31	$50,000
Total contributions received or receivable from participants	2019-07-31	$0
Expenses. Other expenses not covered elsewhere	2019-07-31	$0
Contributions received from other sources (not participants or employers)	2019-07-31	$0
Other income received	2019-07-31	$0
Noncash contributions received	2019-07-31	$0
Net income (gross income less expenses)	2019-07-31	$-94,291
Net plan assets at end of year (total assets less liabilities)	2019-07-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2019-07-31	$94,291
Total contributions received or receivable from employer(s)	2019-07-31	$0
Value of certain deemed distributions of participant loans	2019-07-31	$0
Value of corrective distributions	2019-07-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-07-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-07-31	$0
2018 : FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2018 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-11-30	$0
2017 : FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2017 401k financial data
Transfers to/from the plan	2017-11-30	$0
Total plan liabilities at end of year	2017-11-30	$0
Total plan liabilities at beginning of year	2017-11-30	$0
Total income from all sources	2017-11-30	$51,745
Expenses. Total of all expenses incurred	2017-11-30	$1,261
Benefits paid (including direct rollovers)	2017-11-30	$0
Total plan assets at end of year	2017-11-30	$203,620
Total plan assets at beginning of year	2017-11-30	$153,136
Value of fidelity bond covering the plan	2017-11-30	$50,000
Total contributions received or receivable from participants	2017-11-30	$0
Expenses. Other expenses not covered elsewhere	2017-11-30	$0
Contributions received from other sources (not participants or employers)	2017-11-30	$0
Other income received	2017-11-30	$6,745
Noncash contributions received	2017-11-30	$0
Net income (gross income less expenses)	2017-11-30	$50,484
Net plan assets at end of year (total assets less liabilities)	2017-11-30	$203,620
Net plan assets at beginning of year (total assets less liabilities)	2017-11-30	$153,136
Total contributions received or receivable from employer(s)	2017-11-30	$45,000
Value of certain deemed distributions of participant loans	2017-11-30	$0
Value of corrective distributions	2017-11-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-11-30	$1,261
2016 : FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2016 401k financial data
Transfers to/from the plan	2016-11-30	$0
Total plan liabilities at end of year	2016-11-30	$0
Total plan liabilities at beginning of year	2016-11-30	$0
Total income from all sources	2016-11-30	$36,167
Expenses. Total of all expenses incurred	2016-11-30	$1,124
Benefits paid (including direct rollovers)	2016-11-30	$0
Total plan assets at end of year	2016-11-30	$153,136
Total plan assets at beginning of year	2016-11-30	$118,093
Value of fidelity bond covering the plan	2016-11-30	$50,000
Total contributions received or receivable from participants	2016-11-30	$0
Expenses. Other expenses not covered elsewhere	2016-11-30	$1,124
Contributions received from other sources (not participants or employers)	2016-11-30	$0
Other income received	2016-11-30	$5,737
Noncash contributions received	2016-11-30	$0
Net income (gross income less expenses)	2016-11-30	$35,043
Net plan assets at end of year (total assets less liabilities)	2016-11-30	$153,136
Net plan assets at beginning of year (total assets less liabilities)	2016-11-30	$118,093
Total contributions received or receivable from employer(s)	2016-11-30	$30,430
Value of certain deemed distributions of participant loans	2016-11-30	$0
Value of corrective distributions	2016-11-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-11-30	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-11-30	$0
2015 : FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2015 401k financial data
Transfers to/from the plan	2015-11-30	$0
Total plan liabilities at end of year	2015-11-30	$0
Total plan liabilities at beginning of year	2015-11-30	$0
Total income from all sources	2015-11-30	$34,827
Expenses. Total of all expenses incurred	2015-11-30	$1,813
Benefits paid (including direct rollovers)	2015-11-30	$0
Total plan assets at end of year	2015-11-30	$118,093
Total plan assets at beginning of year	2015-11-30	$85,079
Value of fidelity bond covering the plan	2015-11-30	$50,000
Total contributions received or receivable from participants	2015-11-30	$0
Expenses. Other expenses not covered elsewhere	2015-11-30	$0
Contributions received from other sources (not participants or employers)	2015-11-30	$0
Other income received	2015-11-30	$4,397
Noncash contributions received	2015-11-30	$0
Net income (gross income less expenses)	2015-11-30	$33,014
Net plan assets at end of year (total assets less liabilities)	2015-11-30	$118,093
Net plan assets at beginning of year (total assets less liabilities)	2015-11-30	$85,079
Total contributions received or receivable from employer(s)	2015-11-30	$30,430
Value of certain deemed distributions of participant loans	2015-11-30	$0
Value of corrective distributions	2015-11-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-11-30	$1,813
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-11-30	$0
2014 : FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2014 401k financial data
Transfers to/from the plan	2014-11-30	$0
Total plan liabilities at end of year	2014-11-30	$0
Total plan liabilities at beginning of year	2014-11-30	$0
Total income from all sources	2014-11-30	$27,475
Expenses. Total of all expenses incurred	2014-11-30	$302,073
Benefits paid (including direct rollovers)	2014-11-30	$300,000
Total plan assets at end of year	2014-11-30	$85,079
Total plan assets at beginning of year	2014-11-30	$359,677
Value of fidelity bond covering the plan	2014-11-30	$50,000
Total contributions received or receivable from participants	2014-11-30	$0
Expenses. Other expenses not covered elsewhere	2014-11-30	$0
Contributions received from other sources (not participants or employers)	2014-11-30	$0
Other income received	2014-11-30	$7,040
Noncash contributions received	2014-11-30	$0
Net income (gross income less expenses)	2014-11-30	$-274,598
Net plan assets at end of year (total assets less liabilities)	2014-11-30	$85,079
Net plan assets at beginning of year (total assets less liabilities)	2014-11-30	$359,677
Total contributions received or receivable from employer(s)	2014-11-30	$20,435
Value of certain deemed distributions of participant loans	2014-11-30	$0
Value of corrective distributions	2014-11-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-11-30	$2,073
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-11-30	$0
2013 : FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2013 401k financial data
Transfers to/from the plan	2013-11-30	$0
Total plan liabilities at end of year	2013-11-30	$0
Total plan liabilities at beginning of year	2013-11-30	$0
Total income from all sources	2013-11-30	$37,824
Expenses. Total of all expenses incurred	2013-11-30	$1,930
Benefits paid (including direct rollovers)	2013-11-30	$0
Total plan assets at end of year	2013-11-30	$359,677
Total plan assets at beginning of year	2013-11-30	$323,783
Value of fidelity bond covering the plan	2013-11-30	$50,000
Total contributions received or receivable from participants	2013-11-30	$0
Expenses. Other expenses not covered elsewhere	2013-11-30	$1,930
Contributions received from other sources (not participants or employers)	2013-11-30	$0
Other income received	2013-11-30	$13,608
Noncash contributions received	2013-11-30	$0
Net income (gross income less expenses)	2013-11-30	$35,894
Net plan assets at end of year (total assets less liabilities)	2013-11-30	$359,677
Net plan assets at beginning of year (total assets less liabilities)	2013-11-30	$323,783
Total contributions received or receivable from employer(s)	2013-11-30	$24,216
Value of certain deemed distributions of participant loans	2013-11-30	$0
Value of corrective distributions	2013-11-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-11-30	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-11-30	$0
2012 : FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2012 401k financial data
Transfers to/from the plan	2012-11-30	$0
Total plan liabilities at end of year	2012-11-30	$0
Total plan liabilities at beginning of year	2012-11-30	$0
Total income from all sources	2012-11-30	$45,437
Expenses. Total of all expenses incurred	2012-11-30	$1,754
Benefits paid (including direct rollovers)	2012-11-30	$0
Total plan assets at end of year	2012-11-30	$323,783
Total plan assets at beginning of year	2012-11-30	$280,100
Value of fidelity bond covering the plan	2012-11-30	$50,000
Total contributions received or receivable from participants	2012-11-30	$0
Expenses. Other expenses not covered elsewhere	2012-11-30	$1,754
Contributions received from other sources (not participants or employers)	2012-11-30	$0
Other income received	2012-11-30	$12,165
Noncash contributions received	2012-11-30	$0
Net income (gross income less expenses)	2012-11-30	$43,683
Net plan assets at end of year (total assets less liabilities)	2012-11-30	$323,783
Net plan assets at beginning of year (total assets less liabilities)	2012-11-30	$280,100
Total contributions received or receivable from employer(s)	2012-11-30	$33,272
Value of certain deemed distributions of participant loans	2012-11-30	$0
Value of corrective distributions	2012-11-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-11-30	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-11-30	$0
2011 : FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2011 401k financial data
Transfers to/from the plan	2011-11-30	$0
Total plan liabilities at end of year	2011-11-30	$0
Total plan liabilities at beginning of year	2011-11-30	$0
Total income from all sources	2011-11-30	$47,372
Expenses. Total of all expenses incurred	2011-11-30	$1,561
Benefits paid (including direct rollovers)	2011-11-30	$0
Total plan assets at end of year	2011-11-30	$280,100
Total plan assets at beginning of year	2011-11-30	$234,289
Value of fidelity bond covering the plan	2011-11-30	$50,000
Total contributions received or receivable from participants	2011-11-30	$0
Expenses. Other expenses not covered elsewhere	2011-11-30	$1,561
Contributions received from other sources (not participants or employers)	2011-11-30	$0
Other income received	2011-11-30	$10,686
Noncash contributions received	2011-11-30	$0
Net income (gross income less expenses)	2011-11-30	$45,811
Net plan assets at end of year (total assets less liabilities)	2011-11-30	$280,100
Net plan assets at beginning of year (total assets less liabilities)	2011-11-30	$234,289
Total contributions received or receivable from employer(s)	2011-11-30	$36,686
Value of certain deemed distributions of participant loans	2011-11-30	$0
Value of corrective distributions	2011-11-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-11-30	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-11-30	$0
2010 : FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-11-30	$0

Form 5500 Responses for FARMERS STATE BANK OF EMDEN RETIREMENT TRUST

2018: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2018 form 5500 responses
2018-12-01	Type of plan entity	Single employer plan
2018-12-01	Submission has been amended	No
2018-12-01	This submission is the final filing	Yes
2018-12-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2018-12-01	Plan is a collectively bargained plan	No
2018-12-01	Plan funding arrangement – Insurance	Yes
2018-12-01	Plan funding arrangement – Trust	Yes
2018-12-01	Plan benefit arrangement – Insurance	Yes
2018-12-01	Plan benefit arrangement - Trust	Yes
2017: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2017 form 5500 responses
2017-12-01	Type of plan entity	Single employer plan
2017-12-01	Submission has been amended	No
2017-12-01	This submission is the final filing	No
2017-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-12-01	Plan is a collectively bargained plan	No
2017-12-01	Plan funding arrangement – Insurance	Yes
2017-12-01	Plan funding arrangement – Trust	Yes
2017-12-01	Plan benefit arrangement – Insurance	Yes
2017-12-01	Plan benefit arrangement - Trust	Yes
2016: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2016 form 5500 responses
2016-12-01	Type of plan entity	Single employer plan
2016-12-01	Submission has been amended	No
2016-12-01	This submission is the final filing	No
2016-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-12-01	Plan is a collectively bargained plan	No
2016-12-01	Plan funding arrangement – Insurance	Yes
2016-12-01	Plan funding arrangement – Trust	Yes
2016-12-01	Plan benefit arrangement – Insurance	Yes
2016-12-01	Plan benefit arrangement - Trust	Yes
2015: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2015 form 5500 responses
2015-12-01	Type of plan entity	Single employer plan
2015-12-01	Submission has been amended	No
2015-12-01	This submission is the final filing	No
2015-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-12-01	Plan is a collectively bargained plan	No
2015-12-01	Plan funding arrangement – Insurance	Yes
2015-12-01	Plan funding arrangement – Trust	Yes
2015-12-01	Plan benefit arrangement – Insurance	Yes
2015-12-01	Plan benefit arrangement - Trust	Yes
2014: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2014 form 5500 responses
2014-12-01	Type of plan entity	Single employer plan
2014-12-01	Submission has been amended	No
2014-12-01	This submission is the final filing	No
2014-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-12-01	Plan is a collectively bargained plan	No
2014-12-01	Plan funding arrangement – Insurance	Yes
2014-12-01	Plan funding arrangement – Trust	Yes
2014-12-01	Plan benefit arrangement – Insurance	Yes
2014-12-01	Plan benefit arrangement - Trust	Yes
2013: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2013 form 5500 responses
2013-12-01	Type of plan entity	Single employer plan
2013-12-01	Submission has been amended	No
2013-12-01	This submission is the final filing	No
2013-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-12-01	Plan is a collectively bargained plan	No
2013-12-01	Plan funding arrangement – Insurance	Yes
2013-12-01	Plan funding arrangement – Trust	Yes
2013-12-01	Plan benefit arrangement – Insurance	Yes
2013-12-01	Plan benefit arrangement - Trust	Yes
2012: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2012 form 5500 responses
2012-12-01	Type of plan entity	Single employer plan
2012-12-01	Submission has been amended	No
2012-12-01	This submission is the final filing	No
2012-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-12-01	Plan is a collectively bargained plan	No
2012-12-01	Plan funding arrangement – Insurance	Yes
2012-12-01	Plan funding arrangement – Trust	Yes
2012-12-01	Plan benefit arrangement – Insurance	Yes
2012-12-01	Plan benefit arrangement - Trust	Yes
2011: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2011 form 5500 responses
2011-12-01	Type of plan entity	Single employer plan
2011-12-01	Submission has been amended	No
2011-12-01	This submission is the final filing	No
2011-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-12-01	Plan is a collectively bargained plan	No
2011-12-01	Plan funding arrangement – Insurance	Yes
2011-12-01	Plan funding arrangement – Trust	Yes
2011-12-01	Plan benefit arrangement – Insurance	Yes
2011-12-01	Plan benefit arrangement - Trust	Yes
2009: FARMERS STATE BANK OF EMDEN RETIREMENT TRUST 2009 form 5500 responses
2009-12-01	Type of plan entity	Single employer plan
2009-12-01	Submission has been amended	No
2009-12-01	This submission is the final filing	No
2009-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-12-01	Plan is a collectively bargained plan	No
2009-12-01	Plan funding arrangement – Insurance	Yes
2009-12-01	Plan funding arrangement – Trust	Yes
2009-12-01	Plan benefit arrangement – Insurance	Yes
2009-12-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

CONTINTAL ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62413 )

Policy contract number

12220-004

Policy instance

Insurance contract or identification number	12220-004
Number of Individuals Covered	0
Insurance policy start date	2018-12-01
Insurance policy end date	2019-07-31
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?	Yes
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CONTINTAL ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62413 )

Policy contract number

12220-004

Policy instance

Insurance contract or identification number	12220-004
Number of Individuals Covered	0
Insurance policy start date	2017-12-01
Insurance policy end date	2018-11-30
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?	Yes
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	FARMERS STATE BANK OF EMDEN
Employer identification number (EIN):	370269930
NAIC Classification:	522110
NAIC Description:	Commercial Banking