401k Plan data: SCREEN-IT GRAPHICS OF LAWRENCE, INC. VISION PLAN plan

SCREEN-IT GRAPHICS OF LAWRENCE, INC. VISION PLAN 401k Plan overview

Plan Name	SCREEN-IT GRAPHICS OF LAWRENCE, INC. VISION PLAN
Plan identification number	504

SCREEN-IT GRAPHICS OF LAWRENCE, INC. VISION PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Vision

401k Sponsoring company profile

SCREEN-IT GRAPHICS OF LAWRENCE, has sponsored the creation of one or more 401k plans.

Company Name: SCREEN-IT GRAPHICS OF LAWRENCE,

Employer identification number (EIN): 481053811

NAIC Classification: 323100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SCREEN-IT GRAPHICS OF LAWRENCE, INC. VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2018-01-01 BRANDON PETZ

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
504	2018-01-01	BRANDON PETZ

Plan Statistics for SCREEN-IT GRAPHICS OF LAWRENCE, INC. VISION PLAN

401k plan membership statisitcs for SCREEN-IT GRAPHICS OF LAWRENCE, INC. VISION PLAN

Measure Date Value
2018: SCREEN-IT GRAPHICS OF LAWRENCE, INC. VISION PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 126
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 122
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 2018-01-01 122

Measure	Date	Value
2018: SCREEN-IT GRAPHICS OF LAWRENCE, INC. VISION PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	126
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	122
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	122

Form 5500 Responses for SCREEN-IT GRAPHICS OF LAWRENCE, INC. VISION PLAN

2018: SCREEN-IT GRAPHICS OF LAWRENCE, INC. VISION PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	First time form 5500 has been submitted	Yes
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30052419

Policy instance

Insurance contract or identification number	30052419
Number of Individuals Covered	126
Insurance policy start date	2018-01-01
Insurance policy end date	2018-02-28
Total amount of commissions paid to insurance broker	USD $148
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $148
Insurance broker name	INTEGRITY MIDWEST INSURANCE LLC

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Company Name:	SCREEN-IT GRAPHICS OF LAWRENCE,
Employer identification number (EIN):	481053811
NAIC Classification:	323100