401k Plan data: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST plan

PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 401k Plan overview

Plan Name	PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST
Plan identification number	505

PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

PEACE HAVEN ASSOCIATION has sponsored the creation of one or more 401k plans.

Company Name: PEACE HAVEN ASSOCIATION

Employer identification number (EIN): 430677632

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

Additional information about PEACE HAVEN ASSOCIATION

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities

Incorporation Date: 1959-11-02

Company Identification Number: 079829

Legal Registered Office Address: 900 ANTIQUE CITY DR

WALNUT
United States of America (USA)
51577

More information about PEACE HAVEN ASSOCIATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2022-01-01
505 2021-01-01
505 2020-01-01
505 2019-01-01
505 2018-01-01 VALERIE HICKAM
505 2017-01-01 VALERIE HICKAM

Plan Statistics for PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST

401k plan membership statisitcs for PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST

Measure Date Value
2022: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2022 401k membership
Total participants, beginning-of-year 2022-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 23
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 23
2021: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2021 401k membership
Total participants, beginning-of-year 2021-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 25
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 25
2020: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 28
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 28
2019: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2019 401k membership
Total participants, beginning-of-year 2019-01-01 27
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 23
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 0
Total of all active and inactive participants 2019-01-01 23
2018: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2018 401k membership
Total participants, beginning-of-year 2018-01-01 30
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 26
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 0
Total of all active and inactive participants 2018-01-01 26
2017: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2017 401k membership
Total participants, beginning-of-year 2017-01-01 29
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 28
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 28

Measure	Date	Value
2022: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2022 401k membership
Total participants, beginning-of-year	2022-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	23
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	23
2021: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2021 401k membership
Total participants, beginning-of-year	2021-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	25
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	25
2020: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	28
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	28
2019: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	27
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	23
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	0
Total of all active and inactive participants	2019-01-01	23
2018: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	30
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	26
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	0
Total of all active and inactive participants	2018-01-01	26
2017: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2017 401k membership
Total participants, beginning-of-year	2017-01-01	29
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	28
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	28

Financial Data on PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST

Measure	Date	Value
2022 : PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2022 401k financial data
Total income from all sources	2022-12-31	$32,306
Expenses. Total of all expenses incurred	2022-12-31	$23,648
Benefits paid (including direct rollovers)	2022-12-31	$7,429
Total plan assets at end of year	2022-12-31	$58,507
Total plan assets at beginning of year	2022-12-31	$49,849
Value of fidelity bond covering the plan	2022-12-31	$100,000
Total contributions received or receivable from participants	2022-12-31	$351
Expenses. Other expenses not covered elsewhere	2022-12-31	$16,219
Net income (gross income less expenses)	2022-12-31	$8,658
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$58,507
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$49,849
Total contributions received or receivable from employer(s)	2022-12-31	$31,955
2021 : PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2021 401k financial data
Total income from all sources	2021-12-31	$30,679
Expenses. Total of all expenses incurred	2021-12-31	$24,126
Benefits paid (including direct rollovers)	2021-12-31	$7,763
Total plan assets at end of year	2021-12-31	$49,849
Total plan assets at beginning of year	2021-12-31	$43,296
Value of fidelity bond covering the plan	2021-12-31	$100,000
Expenses. Other expenses not covered elsewhere	2021-12-31	$16,363
Net income (gross income less expenses)	2021-12-31	$6,553
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$49,849
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$43,296
Total contributions received or receivable from employer(s)	2021-12-31	$30,679
2020 : PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2020 401k financial data
Total income from all sources	2020-12-31	$28,565
Expenses. Total of all expenses incurred	2020-12-31	$21,975
Benefits paid (including direct rollovers)	2020-12-31	$5,379
Total plan assets at end of year	2020-12-31	$43,296
Total plan assets at beginning of year	2020-12-31	$36,706
Value of fidelity bond covering the plan	2020-12-31	$100,000
Expenses. Other expenses not covered elsewhere	2020-12-31	$16,596
Net income (gross income less expenses)	2020-12-31	$6,590
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$43,296
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$36,706
Total contributions received or receivable from employer(s)	2020-12-31	$28,565
2019 : PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2019 401k financial data
Total income from all sources	2019-12-31	$37,435
Expenses. Total of all expenses incurred	2019-12-31	$20,967
Benefits paid (including direct rollovers)	2019-12-31	$4,774
Total plan assets at end of year	2019-12-31	$36,706
Total plan assets at beginning of year	2019-12-31	$20,238
Value of fidelity bond covering the plan	2019-12-31	$100,000
Expenses. Other expenses not covered elsewhere	2019-12-31	$16,193
Net income (gross income less expenses)	2019-12-31	$16,468
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$36,706
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$20,238
Total contributions received or receivable from employer(s)	2019-12-31	$37,435
2018 : PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2018 401k financial data
Total income from all sources	2018-12-31	$28,794
Expenses. Total of all expenses incurred	2018-12-31	$24,971
Benefits paid (including direct rollovers)	2018-12-31	$8,134
Total plan assets at end of year	2018-12-31	$20,238
Total plan assets at beginning of year	2018-12-31	$16,415
Value of fidelity bond covering the plan	2018-12-31	$100,000
Total contributions received or receivable from participants	2018-12-31	$263
Expenses. Other expenses not covered elsewhere	2018-12-31	$16,837
Net income (gross income less expenses)	2018-12-31	$3,823
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$20,238
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$16,415
Total contributions received or receivable from employer(s)	2018-12-31	$28,531
2017 : PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2017 401k financial data
Total income from all sources	2017-12-31	$39,444
Expenses. Total of all expenses incurred	2017-12-31	$23,029
Benefits paid (including direct rollovers)	2017-12-31	$6,066
Total plan assets at end of year	2017-12-31	$16,415
Total plan assets at beginning of year	2017-12-31	$0
Value of fidelity bond covering the plan	2017-12-31	$100,000
Expenses. Other expenses not covered elsewhere	2017-12-31	$16,963
Net income (gross income less expenses)	2017-12-31	$16,415
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$16,415
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$0
Total contributions received or receivable from employer(s)	2017-12-31	$39,444

Form 5500 Responses for PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST

2022: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: PEACE HAVEN EMPLOYEE BENEFIT PLAN TRUST 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	First time form 5500 has been submitted	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	PEACE HAVEN ASSOCIATION
Employer identification number (EIN):	430677632
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	Iowa Secretary of State Business Entities
Incorporation Date:	1959-11-02
Company Identification Number:	079829
Legal Registered Office Address:	900 ANTIQUE CITY DR WALNUT United States of America (USA) 51577