401k Plan data: KENOSHA COUNTY GIRL SCOUT COUNCIL, INC. plan

KENOSHA COUNTY GIRL SCOUT COUNCIL, INC. 401k Plan overview

Plan Name	KENOSHA COUNTY GIRL SCOUT COUNCIL, INC.
Plan identification number	001

KENOSHA COUNTY GIRL SCOUT COUNCIL, INC. Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

401k Sponsoring company profile

KENOSHA COUNTY GIRL SCOUT COUNCIL TAX DEFERRED ANNUITY PLAN has sponsored the creation of one or more 401k plans.

Company Name: KENOSHA COUNTY GIRL SCOUT COUNCIL TAX DEFERRED ANNUITY PLAN

Employer identification number (EIN): 390806282

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KENOSHA COUNTY GIRL SCOUT COUNCIL, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01 CAROL ROBINSON 2016-10-16 CAROL ROBINSON 2016-10-16
001 2014-01-01 CAROL ROBINSON 2015-10-08 CAROL ROBINSON 2015-10-08
001 2013-01-01 CAROL ROBINSON 2014-07-31 CAROL ROBINSON 2014-07-31
001 2012-01-01 CAROL ROBINSON 2013-11-22 CAROL ROBINSON 2013-11-22
001 2011-01-01 CAROL ROBINSON 2013-11-22 CAROL ROBINSON 2013-11-22
001 2010-01-01 CAROL ROBINSON 2013-11-22 CAROL ROBINSON 2013-11-22
001 2008-01-01 CAROL ROBINSON CAROL ROBINSON 2013-11-22

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2015-01-01	CAROL ROBINSON	2016-10-16	CAROL ROBINSON	2016-10-16
001	2014-01-01	CAROL ROBINSON	2015-10-08	CAROL ROBINSON	2015-10-08
001	2013-01-01	CAROL ROBINSON	2014-07-31	CAROL ROBINSON	2014-07-31
001	2012-01-01	CAROL ROBINSON	2013-11-22	CAROL ROBINSON	2013-11-22
001	2011-01-01	CAROL ROBINSON	2013-11-22	CAROL ROBINSON	2013-11-22
001	2010-01-01	CAROL ROBINSON	2013-11-22	CAROL ROBINSON	2013-11-22
001	2008-01-01	CAROL ROBINSON		CAROL ROBINSON	2013-11-22

Plan Statistics for KENOSHA COUNTY GIRL SCOUT COUNCIL, INC.

401k plan membership statisitcs for KENOSHA COUNTY GIRL SCOUT COUNCIL, INC.

Measure Date Value
2008: KENOSHA COUNTY GIRL SCOUT COUNCIL, INC. 2008 401k membership
Total participants, beginning-of-year 2008-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 0
Number of retired or separated participants receiving benefits 2008-01-01 5
Number of other retired or separated participants entitled to future benefits 2008-01-01 0
Total of all active and inactive participants 2008-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-01-01 0
Total participants 2008-01-01 5
Number of participants with account balances 2008-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-01-01 0

Measure	Date	Value
2008: KENOSHA COUNTY GIRL SCOUT COUNCIL, INC. 2008 401k membership
Total participants, beginning-of-year	2008-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	0
Number of retired or separated participants receiving benefits	2008-01-01	5
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-01-01	0
Total participants	2008-01-01	5
Number of participants with account balances	2008-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-01-01	0

Form 5500 Responses for KENOSHA COUNTY GIRL SCOUT COUNCIL, INC.

2008: KENOSHA COUNTY GIRL SCOUT COUNCIL, INC. 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – Insurance	Yes
2008-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

069491-E

Policy instance

Insurance contract or identification number	069491-E
Number of Individuals Covered	5
Insurance policy start date	2008-01-01
Insurance policy end date	2008-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for group deferred annuity?	Yes
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker name	N/A

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Company Name:	KENOSHA COUNTY GIRL SCOUT COUNCIL TAX DEFERRED ANNUITY PLAN
Employer identification number (EIN):	390806282
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations