401k Plan data: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST plan

C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST
Plan identification number	001

C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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.
Life insurance

401k Sponsoring company profile

C.J.W., INC. has sponsored the creation of one or more 401k plans.

Company Name: C.J.W., INC.

Employer identification number (EIN): 391216257

NAIC Classification: 424800

Additional information about C.J.W., INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 1988-05-10

Company Identification Number: M80183

Legal Registered Office Address: 777 CURTISS PARKWAY

MIAMI SPRINGS

33166

More information about C.J.W., INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 PAUL TENUTA 2023-05-09
001 2021-01-01 GLENN MADRIGRANO 2022-05-20
001 2020-01-01 GLENN MADRIGRANO 2021-04-14
001 2019-01-01
001 2018-01-01 GLENN MADRIGRANO
001 2017-01-01 GLENN MADRIGRANO
001 2017-01-01 GLENN MADRIGRANO
001 2016-01-01 GLENN MADRIGRANO
001 2015-01-01 GLENN MADRIGRANO
001 2014-01-01 GLENN MADRIGRANO
001 2013-01-01 GLENN MADRIGRANO
001 2012-01-01 GLENN MADRIGRANO
001 2011-01-01 PAUL TENUTA
001 2010-01-01 PAUL TENUTA
001 2009-01-01 PAUL TENUTA

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	PAUL TENUTA	2023-05-09
001	2021-01-01	GLENN MADRIGRANO	2022-05-20
001	2020-01-01	GLENN MADRIGRANO	2021-04-14
001	2019-01-01
001	2018-01-01	GLENN MADRIGRANO
001	2017-01-01	GLENN MADRIGRANO
001	2017-01-01	GLENN MADRIGRANO
001	2016-01-01	GLENN MADRIGRANO
001	2015-01-01	GLENN MADRIGRANO
001	2014-01-01	GLENN MADRIGRANO
001	2013-01-01	GLENN MADRIGRANO
001	2012-01-01	GLENN MADRIGRANO
001	2011-01-01	PAUL TENUTA
001	2010-01-01	PAUL TENUTA
001	2009-01-01	PAUL TENUTA

Plan Statistics for C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST

Measure Date Value
2019: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year 2019-01-01 118
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 93
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 19
Total of all active and inactive participants 2019-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 112
Number of participants with account balances 2019-01-01 111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 9
2018: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year 2018-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 94
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 24
Total of all active and inactive participants 2018-01-01 118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 118
Number of participants with account balances 2018-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 11
2017: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year 2017-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 91
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 21
Total of all active and inactive participants 2017-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 112
Number of participants with account balances 2017-01-01 112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 3
2016: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year 2016-01-01 94
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 83
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 20
Total of all active and inactive participants 2016-01-01 103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 103
Number of participants with account balances 2016-01-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 7
2015: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2015 401k membership
Total participants, beginning-of-year 2015-01-01 94
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 78
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 16
Total of all active and inactive participants 2015-01-01 94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 94
Number of participants with account balances 2015-01-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 14
2014: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2014 401k membership
Total participants, beginning-of-year 2014-01-01 118
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 87
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 7
Total of all active and inactive participants 2014-01-01 94
Total participants 2014-01-01 94
2013: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2013 401k membership
Total participants, beginning-of-year 2013-01-01 118
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 89
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 28
Total of all active and inactive participants 2013-01-01 118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 118
Number of participants with account balances 2013-01-01 116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 9
2012: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year 2012-01-01 118
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 84
Number of retired or separated participants receiving benefits 2012-01-01 2
Number of other retired or separated participants entitled to future benefits 2012-01-01 23
Total of all active and inactive participants 2012-01-01 109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 3
Total participants 2012-01-01 112
Number of participants with account balances 2012-01-01 105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 6
2011: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 125
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 81
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 30
Total of all active and inactive participants 2011-01-01 111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 3
Total participants 2011-01-01 114
Number of participants with account balances 2011-01-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 11
2010: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year 2010-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 94
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 31
Total of all active and inactive participants 2010-01-01 125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 4
Total participants 2010-01-01 129
Number of participants with account balances 2010-01-01 123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 5
2009: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 114
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 93
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 30
Total of all active and inactive participants 2009-01-01 123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 1
Total participants 2009-01-01 124
Number of participants with account balances 2009-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2019: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	93
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	19
Total of all active and inactive participants	2019-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	112
Number of participants with account balances	2019-01-01	111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	9
2018: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	94
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	24
Total of all active and inactive participants	2018-01-01	118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	118
Number of participants with account balances	2018-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	11
2017: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year	2017-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	91
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	21
Total of all active and inactive participants	2017-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	112
Number of participants with account balances	2017-01-01	112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	3
2016: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year	2016-01-01	94
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	83
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	20
Total of all active and inactive participants	2016-01-01	103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	103
Number of participants with account balances	2016-01-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	7
2015: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2015 401k membership
Total participants, beginning-of-year	2015-01-01	94
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	78
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	16
Total of all active and inactive participants	2015-01-01	94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	94
Number of participants with account balances	2015-01-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	14
2014: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2014 401k membership
Total participants, beginning-of-year	2014-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	87
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	7
Total of all active and inactive participants	2014-01-01	94
Total participants	2014-01-01	94
2013: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2013 401k membership
Total participants, beginning-of-year	2013-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	89
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	28
Total of all active and inactive participants	2013-01-01	118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	118
Number of participants with account balances	2013-01-01	116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	9
2012: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year	2012-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	84
Number of retired or separated participants receiving benefits	2012-01-01	2
Number of other retired or separated participants entitled to future benefits	2012-01-01	23
Total of all active and inactive participants	2012-01-01	109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	3
Total participants	2012-01-01	112
Number of participants with account balances	2012-01-01	105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	6
2011: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	125
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	81
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	30
Total of all active and inactive participants	2011-01-01	111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	3
Total participants	2011-01-01	114
Number of participants with account balances	2011-01-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	11
2010: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year	2010-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	94
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	31
Total of all active and inactive participants	2010-01-01	125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	4
Total participants	2010-01-01	129
Number of participants with account balances	2010-01-01	123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	5
2009: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	114
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	93
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	30
Total of all active and inactive participants	2009-01-01	123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	1
Total participants	2009-01-01	124
Number of participants with account balances	2009-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2019 : C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k financial data
Total income from all sources	2019-12-31	$2,705,907
Expenses. Total of all expenses incurred	2019-12-31	$438,278
Benefits paid (including direct rollovers)	2019-12-31	$437,963
Total plan assets at end of year	2019-12-31	$11,978,397
Total plan assets at beginning of year	2019-12-31	$9,710,768
Value of fidelity bond covering the plan	2019-12-31	$500,000
Total contributions received or receivable from participants	2019-12-31	$364,493
Contributions received from other sources (not participants or employers)	2019-12-31	$1,053
Other income received	2019-12-31	$2,036,171
Net income (gross income less expenses)	2019-12-31	$2,267,629
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$11,978,397
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$9,710,768
Assets. Value of participant loans	2019-12-31	$179,672
Total contributions received or receivable from employer(s)	2019-12-31	$304,190
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$315
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2018 401k financial data
Total income from all sources	2018-12-31	$-77,451
Expenses. Total of all expenses incurred	2018-12-31	$79,861
Benefits paid (including direct rollovers)	2018-12-31	$79,452
Total plan assets at end of year	2018-12-31	$9,710,768
Total plan assets at beginning of year	2018-12-31	$9,868,080
Value of fidelity bond covering the plan	2018-12-31	$500,000
Total contributions received or receivable from participants	2018-12-31	$373,181
Other income received	2018-12-31	$-707,172
Net income (gross income less expenses)	2018-12-31	$-157,312
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$9,710,768
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$9,868,080
Assets. Value of participant loans	2018-12-31	$172,596
Total contributions received or receivable from employer(s)	2018-12-31	$256,540
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$409
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2017 401k financial data
Total income from all sources	2017-12-31	$1,968,733
Expenses. Total of all expenses incurred	2017-12-31	$624,604
Benefits paid (including direct rollovers)	2017-12-31	$624,294
Total plan assets at end of year	2017-12-31	$9,714,907
Total plan assets at beginning of year	2017-12-31	$8,523,951
Value of fidelity bond covering the plan	2017-12-31	$500,000
Total contributions received or receivable from participants	2017-12-31	$332,885
Contributions received from other sources (not participants or employers)	2017-12-31	$21,303
Other income received	2017-12-31	$1,355,833
Net income (gross income less expenses)	2017-12-31	$1,344,129
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$9,714,907
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$8,523,951
Assets. Value of participant loans	2017-12-31	$146,906
Total contributions received or receivable from employer(s)	2017-12-31	$105,539
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$310
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2016 401k financial data
Total income from all sources	2016-12-31	$1,199,306
Expenses. Total of all expenses incurred	2016-12-31	$933,373
Benefits paid (including direct rollovers)	2016-12-31	$933,036
Total plan assets at end of year	2016-12-31	$8,523,951
Total plan assets at beginning of year	2016-12-31	$8,258,018
Value of fidelity bond covering the plan	2016-12-31	$500,000
Total contributions received or receivable from participants	2016-12-31	$297,206
Contributions received from other sources (not participants or employers)	2016-12-31	$223
Other income received	2016-12-31	$648,022
Net income (gross income less expenses)	2016-12-31	$265,933
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$8,523,951
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$8,258,018
Assets. Value of participant loans	2016-12-31	$145,984
Total contributions received or receivable from employer(s)	2016-12-31	$253,855
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$337
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$2,494
Total unrealized appreciation/depreciation of assets	2015-12-31	$2,494
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	$334,185
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$424,546
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$402,420
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$495,824
Value of total assets at end of year	2015-12-31	$8,258,018
Value of total assets at beginning of year	2015-12-31	$8,348,379
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$22,126
Total interest from all sources	2015-12-31	$7,585
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Administrative expenses professional fees incurred	2015-12-31	$8,973
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	Yes
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	$280,069
Participant contributions at end of year	2015-12-31	$167,515
Participant contributions at beginning of year	2015-12-31	$131,470
Participant contributions at end of year	2015-12-31	$453
Participant contributions at beginning of year	2015-12-31	$549
Other income not declared elsewhere	2015-12-31	$518
Total non interest bearing cash at end of year	2015-12-31	$3,243
Total non interest bearing cash at beginning of year	2015-12-31	$12,356
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	$-90,361
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$8,258,018
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$8,348,379
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
Investment advisory and management fees	2015-12-31	$120
Interest on participant loans	2015-12-31	$7,585
Value of interest in master investment trust accounts at end of year	2015-12-31	$7,908,769
Value of interest in master investment trust accounts at beginning of year	2015-12-31	$7,942,704
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$34,358
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$101,921
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	$215,755
Employer contributions (assets) at end of year	2015-12-31	$143,680
Employer contributions (assets) at beginning of year	2015-12-31	$159,379
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$402,420
Contract administrator fees	2015-12-31	$13,033
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	2015-12-31	Yes
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	VRAKAS & BLUM
Accountancy firm EIN	2015-12-31	391453055
2014 : C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$10,020
Total unrealized appreciation/depreciation of assets	2014-12-31	$10,020
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	$116
Total income from all sources (including contributions)	2014-12-31	$1,148,380
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$305,331
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$272,950
Expenses. Certain deemed distributions of participant loans	2014-12-31	$19,280
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$563,422
Value of total assets at end of year	2014-12-31	$8,348,379
Value of total assets at beginning of year	2014-12-31	$7,505,446
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$13,101
Total interest from all sources	2014-12-31	$5,959
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$283,144
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	$283,144
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	Yes
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	$245,238
Participant contributions at end of year	2014-12-31	$131,470
Participant contributions at beginning of year	2014-12-31	$121,693
Participant contributions at end of year	2014-12-31	$549
Participant contributions at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$84,058
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$116
Other income not declared elsewhere	2014-12-31	$2,097
Total non interest bearing cash at end of year	2014-12-31	$12,356
Total non interest bearing cash at beginning of year	2014-12-31	$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	2014-12-31	No
Value of net income/loss	2014-12-31	$843,049
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$8,348,379
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$7,505,330
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	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$7,138,498
Interest on participant loans	2014-12-31	$5,959
Value of interest in master investment trust accounts at end of year	2014-12-31	$7,942,704
Value of interest in master investment trust accounts at beginning of year	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$101,921
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$91,901
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$334,416
Net investment gain/loss from pooled separate accounts	2014-12-31	$-50,678
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	$234,126
Employer contributions (assets) at end of year	2014-12-31	$159,379
Employer contributions (assets) at beginning of year	2014-12-31	$153,354
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$272,950
Contract administrator fees	2014-12-31	$13,101
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	2014-12-31	Yes
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	VRAKAS & BLUM
Accountancy firm EIN	2014-12-31	391453055
2013 : C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 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	$116
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	$1,447,388
Total loss/gain on sale of assets	2013-12-31	$18,081
Total of all expenses incurred	2013-12-31	$187,445
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$175,299
Expenses. Certain deemed distributions of participant loans	2013-12-31	$4,097
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$462,690
Value of total assets at end of year	2013-12-31	$7,505,446
Value of total assets at beginning of year	2013-12-31	$6,245,387
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$8,049
Total interest from all sources	2013-12-31	$12,641
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$196,824
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	$196,824
Assets. Real estate other than employer real property at end of year	2013-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2013-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2013-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$227,577
Participant contributions at end of year	2013-12-31	$121,693
Participant contributions at beginning of year	2013-12-31	$141,052
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Assets. Loans (other than to participants) at end of year	2013-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$116
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$0
Liabilities. Value of operating payables at end of year	2013-12-31	$0
Liabilities. Value of operating payables at beginning of year	2013-12-31	$0
Total non interest bearing cash at end of year	2013-12-31	$0
Total non interest bearing cash at beginning of year	2013-12-31	$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	2013-12-31	No
Value of net income/loss	2013-12-31	$1,259,943
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$7,505,330
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$6,245,387
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
Assets. partnership/joint venture interests at end of year	2013-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2013-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$7,138,498
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$5,875,395
Interest on participant loans	2013-12-31	$6,322
Interest earned on other investments	2013-12-31	$6,319
Value of interest in master investment trust accounts at end of year	2013-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2013-12-31	$0
Value of interest in common/collective trusts at end of year	2013-12-31	$0
Value of interest in common/collective trusts at beginning of year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2013-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$91,901
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$86,202
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$684
Asset value of US Government securities at end of year	2013-12-31	$0
Asset value of US Government securities at beginning of year	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$757,152
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
Assets. Invements in employer securities at end of year	2013-12-31	$0
Assets. Invements in employer securities at beginning of year	2013-12-31	$0
Assets. Value of employer real property at end of year	2013-12-31	$0
Assets. Value of employer real property at beginning of year	2013-12-31	$0
Contributions received in cash from employer	2013-12-31	$235,113
Employer contributions (assets) at end of year	2013-12-31	$153,354
Employer contributions (assets) at beginning of year	2013-12-31	$142,738
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$174,615
Asset. Corporate debt instrument preferred debt at end of year	2013-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2013-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2013-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2013-12-31	$0
Contract administrator fees	2013-12-31	$8,049
Assets. Corporate common stocks other than exployer securities at end of year	2013-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2013-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2013-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2013-12-31	$0
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
Aggregate proceeds on sale of assets	2013-12-31	$421,394
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$403,313
Liabilities. Value of acquisition indebtedness at end of year	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2013-12-31	$0
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	ADAMS, BROWN, BERAN & BALL CHTD.
Accountancy firm EIN	2013-12-31	481040139
2012 : C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$1,225,351
Total loss/gain on sale of assets	2012-12-31	$56,828
Total of all expenses incurred	2012-12-31	$1,430,402
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,409,154
Expenses. Certain deemed distributions of participant loans	2012-12-31	$13,347
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$423,808
Value of total assets at end of year	2012-12-31	$6,245,387
Value of total assets at beginning of year	2012-12-31	$6,450,438
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$7,901
Total interest from all sources	2012-12-31	$10,220
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$124,671
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	$124,671
Assets. Real estate other than employer real property at end of year	2012-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2012-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2012-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
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	$209,045
Participant contributions at end of year	2012-12-31	$141,052
Participant contributions at beginning of year	2012-12-31	$156,181
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$3,259
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$103
Assets. Loans (other than to participants) at end of year	2012-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$800
Liabilities. Value of operating payables at end of year	2012-12-31	$0
Liabilities. Value of operating payables at beginning of year	2012-12-31	$0
Total non interest bearing cash at end of year	2012-12-31	$0
Total non interest bearing cash at beginning of year	2012-12-31	$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	2012-12-31	No
Value of net income/loss	2012-12-31	$-205,051
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$6,245,387
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$6,450,438
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
Assets. partnership/joint venture interests at end of year	2012-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2012-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$5,875,395
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$6,070,276
Interest on participant loans	2012-12-31	$6,021
Interest earned on other investments	2012-12-31	$4,199
Value of interest in master investment trust accounts at end of year	2012-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2012-12-31	$0
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Value of interest in common/collective trusts at beginning of year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2012-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$86,202
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$82,003
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$684
Asset value of US Government securities at end of year	2012-12-31	$0
Asset value of US Government securities at beginning of year	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$609,824
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
Assets. Invements in employer securities at end of year	2012-12-31	$0
Assets. Invements in employer securities at beginning of year	2012-12-31	$0
Assets. Value of employer real property at end of year	2012-12-31	$0
Assets. Value of employer real property at beginning of year	2012-12-31	$0
Contributions received in cash from employer	2012-12-31	$214,763
Employer contributions (assets) at end of year	2012-12-31	$142,738
Employer contributions (assets) at beginning of year	2012-12-31	$138,616
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$1,408,470
Asset. Corporate debt instrument preferred debt at end of year	2012-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$0
Contract administrator fees	2012-12-31	$7,101
Assets. Corporate common stocks other than exployer securities at end of year	2012-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2012-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2012-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2012-12-31	$0
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
Aggregate proceeds on sale of assets	2012-12-31	$1,577,868
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$1,521,040
Liabilities. Value of acquisition indebtedness at end of year	2012-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2012-12-31	$0
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	ADAMS, BROWN, BERAN & BALL CHTD.
Accountancy firm EIN	2012-12-31	481040139
2011 : C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
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	$292,942
Total loss/gain on sale of assets	2011-12-31	$-8,415
Total of all expenses incurred	2011-12-31	$352,391
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$351,624
Value of total corrective distributions	2011-12-31	$95
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$452,107
Value of total assets at end of year	2011-12-31	$6,450,438
Value of total assets at beginning of year	2011-12-31	$6,509,887
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$672
Total interest from all sources	2011-12-31	$15,432
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$120,602
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	$120,602
Assets. Real estate other than employer real property at end of year	2011-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2011-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2011-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$231,515
Participant contributions at end of year	2011-12-31	$156,181
Participant contributions at beginning of year	2011-12-31	$114,099
Participant contributions at end of year	2011-12-31	$3,259
Participant contributions at beginning of year	2011-12-31	$3,636
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$103
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$105
Assets. Loans (other than to participants) at end of year	2011-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$0
Liabilities. Value of operating payables at end of year	2011-12-31	$0
Liabilities. Value of operating payables at beginning of year	2011-12-31	$0
Total non interest bearing cash at end of year	2011-12-31	$0
Total non interest bearing cash at beginning of year	2011-12-31	$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	2011-12-31	No
Value of net income/loss	2011-12-31	$-59,449
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$6,450,438
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$6,509,887
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
Assets. partnership/joint venture interests at end of year	2011-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2011-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$6,070,276
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$6,143,882
Interest on participant loans	2011-12-31	$5,273
Interest earned on other investments	2011-12-31	$10,159
Value of interest in master investment trust accounts at end of year	2011-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2011-12-31	$0
Value of interest in common/collective trusts at end of year	2011-12-31	$0
Value of interest in common/collective trusts at beginning of year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$0
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
Assets. Value of investments in 103.12 investment entities at end of year	2011-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$82,003
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$101,351
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$684
Asset value of US Government securities at end of year	2011-12-31	$0
Asset value of US Government securities at beginning of year	2011-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-286,784
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
Assets. Invements in employer securities at end of year	2011-12-31	$0
Assets. Invements in employer securities at beginning of year	2011-12-31	$0
Assets. Value of employer real property at end of year	2011-12-31	$0
Assets. Value of employer real property at beginning of year	2011-12-31	$0
Contributions received in cash from employer	2011-12-31	$220,592
Employer contributions (assets) at end of year	2011-12-31	$138,616
Employer contributions (assets) at beginning of year	2011-12-31	$146,814
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$350,940
Asset. Corporate debt instrument preferred debt at end of year	2011-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2011-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2011-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$0
Contract administrator fees	2011-12-31	$672
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2011-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2011-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2011-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2011-12-31	$0
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
Aggregate proceeds on sale of assets	2011-12-31	$652,640
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$661,055
Liabilities. Value of acquisition indebtedness at end of year	2011-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2011-12-31	$0
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	ADAMS, BROWN, BERAN & BALL CHTD.
Accountancy firm EIN	2011-12-31	481040139
2010 : C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2010 401k financial data
Total unrealized appreciation/depreciation of assets	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
Total income from all sources (including contributions)	2010-12-31	$1,095,733
Total loss/gain on sale of assets	2010-12-31	$495,850
Total of all expenses incurred	2010-12-31	$40,791
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$40,480
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$507,920
Value of total assets at end of year	2010-12-31	$6,509,887
Value of total assets at beginning of year	2010-12-31	$5,454,945
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$311
Total interest from all sources	2010-12-31	$43,573
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$15,647
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$15,647
Assets. Real estate other than employer real property at end of year	2010-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end 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	$470,000
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	$267,568
Participant contributions at end of year	2010-12-31	$114,099
Participant contributions at beginning of year	2010-12-31	$111,267
Participant contributions at end of year	2010-12-31	$3,636
Participant contributions at beginning of year	2010-12-31	$4,014
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$105
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$117
Assets. Loans (other than to participants) at end of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$0
Liabilities. Value of operating payables at end of year	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
Value of net income/loss	2010-12-31	$1,054,942
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$6,509,887
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$5,454,945
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$6,143,882
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$5,047,592
Interest on participant loans	2010-12-31	$5,820
Interest earned on other investments	2010-12-31	$37,753
Value of interest in master investment trust accounts at end of year	2010-12-31	$0
Value of interest in common/collective trusts at end 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
Assets. Value of investments in 103.12 investment entities at end of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$101,351
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$142,713
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$684
Asset value of US Government securities at end of year	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$32,743
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. Value of employer real property at end of year	2010-12-31	$0
Contributions received in cash from employer	2010-12-31	$240,352
Employer contributions (assets) at end of year	2010-12-31	$146,814
Employer contributions (assets) at beginning of year	2010-12-31	$149,242
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$39,796
Asset. Corporate debt instrument preferred debt at end of year	2010-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$0
Contract administrator fees	2010-12-31	$311
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$0
Liabilities. Value of benefit claims payable at end 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
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	$6,891,122
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$6,395,272
Liabilities. Value of acquisition indebtedness at end 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	ADAMS, BROWN, BERAN & BALL CHTD.
Accountancy firm EIN	2010-12-31	481040139
2009 : C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 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 C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST

2019: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 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 – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 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 – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 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 – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: C.J.W., INC. 401(K) PROFIT SHARING PLAN AND TRUST 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

E416490000

Policy instance

Insurance contract or identification number	E416490000
Number of Individuals Covered	1
Insurance policy start date	2018-04-01
Insurance policy end date	2019-03-31
Are there contracts with allocated funds for individual policies?	1
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?	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?	Yes

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

18236

Policy instance

Insurance contract or identification number	18236
Number of Individuals Covered	1
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	1
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

18236

Policy instance

Insurance contract or identification number	18236
Number of Individuals Covered	1
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	1
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

E416490000

Policy instance

Insurance contract or identification number	E416490000
Number of Individuals Covered	1
Insurance policy start date	2017-04-01
Insurance policy end date	2018-03-31
Are there contracts with allocated funds for individual policies?	1
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?	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

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

E416490000

Policy instance

Insurance contract or identification number	E416490000
Number of Individuals Covered	1
Insurance policy start date	2016-04-01
Insurance policy end date	2017-03-31
Are there contracts with allocated funds for individual policies?	1
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?	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

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

18236

Policy instance

Insurance contract or identification number	18236
Number of Individuals Covered	1
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	1
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	STEVEN H KOSNICK

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

E416490000

Policy instance

Insurance contract or identification number	E416490000
Number of Individuals Covered	1
Insurance policy start date	2015-04-01
Insurance policy end date	2016-03-31
Are there contracts with allocated funds for individual policies?	Yes
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?	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

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

18236

Policy instance

Insurance contract or identification number	18236
Number of Individuals Covered	1
Insurance policy start date	2016-01-01
Insurance policy end date	2016-12-31
Are there contracts with allocated funds for individual policies?	Yes
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	STEVEN H KOSNICK

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

18236

Policy instance

Insurance contract or identification number	18236
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	Yes
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
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?	Yes
Insurance broker organization code?	3
Insurance broker name	STEVEN H KOSNICK

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

18236

Policy instance

Insurance contract or identification number	18236
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	STEVEN H KOSNICK

SECURITY LIFE OF DENVER INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68713 )

Policy contract number

911538896

Policy instance

Insurance contract or identification number	911538896
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $14
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14
Insurance broker organization code?	3
Insurance broker name	WILLIAM H TARROLLY

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

18236

Policy instance

Insurance contract or identification number	18236
Number of Individuals Covered	1
Insurance policy start date	2013-04-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $20
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20
Insurance broker organization code?	3
Insurance broker name	STEVEN HOWARD KOSNICK

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

18236

Policy instance

Insurance contract or identification number	18236
Number of Individuals Covered	1
Insurance policy start date	2012-04-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $38
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $38
Insurance broker organization code?	3
Insurance broker name	STEVEN H KOSNICK

SECURITY LIFE OF DENVER INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68713 )

Policy contract number

911538896

Policy instance

Insurance contract or identification number	911538896
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	WILLIAM H TARROLLY

SECURITY LIFE OF DENVER INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68713 )

Policy contract number

911538896

Policy instance

Insurance contract or identification number	911538896
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $14
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
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

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

18236

Policy instance

Insurance contract or identification number	18236
Number of Individuals Covered	1
Insurance policy start date	2011-04-01
Insurance policy end date	2012-03-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $27
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
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

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

18236

Policy instance

Insurance contract or identification number	18236
Number of Individuals Covered	5
Insurance policy start date	2009-04-01
Insurance policy end date	2010-03-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $61
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
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

SECURITY LIFE OF DENVER INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68713 )

Policy contract number

911538896

Policy instance

Insurance contract or identification number	911538896
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $14
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
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:	C.J.W., INC.
Employer identification number (EIN):	391216257
NAIC Classification:	424800

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	1988-05-10
Company Identification Number:	M80183
Legal Registered Office Address:	777 CURTISS PARKWAY MIAMI SPRINGS 33166