401k Plan data: CREFORM CORPORATION 401(K) RETIREMENT PLAN plan

CREFORM CORPORATION 401(K) RETIREMENT PLAN 401k Plan overview

Plan Name	CREFORM CORPORATION 401(K) RETIREMENT PLAN
Plan identification number	002

CREFORM CORPORATION 401(K) RETIREMENT PLAN 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.
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.

401k Sponsoring company profile

CREFORM CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: CREFORM CORPORATION

Employer identification number (EIN): 570934092

NAIC Classification: 339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CREFORM CORPORATION 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2017-01-01 KEITH SODERLUND
002 2016-01-01 KEITH SODERLUND
002 2015-01-01 YOSHIHITO MATSUI 2016-07-26
002 2014-01-01 MOREHEAD PLAN ADMINISTRATORS 2015-07-24
002 2013-01-01 YOSHIHITO MATSUI 2014-07-29
002 2012-01-01 YOSHIHITO MATSUI 2013-07-31
002 2011-01-01 YOSHIHITO MATSUI 2012-07-30
002 2010-01-01 MARCUS JONES 2011-06-29
002 2009-01-01 YOSHIHITO MATSUI YOSHIHITO MATSUI 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2017-01-01	KEITH SODERLUND
002	2016-01-01	KEITH SODERLUND
002	2015-01-01	YOSHIHITO MATSUI	2016-07-26
002	2014-01-01	MOREHEAD PLAN ADMINISTRATORS	2015-07-24
002	2013-01-01	YOSHIHITO MATSUI	2014-07-29
002	2012-01-01	YOSHIHITO MATSUI	2013-07-31
002	2011-01-01	YOSHIHITO MATSUI	2012-07-30
002	2010-01-01	MARCUS JONES	2011-06-29
002	2009-01-01	YOSHIHITO MATSUI		YOSHIHITO MATSUI	2010-10-14

Plan Statistics for CREFORM CORPORATION 401(K) RETIREMENT PLAN

401k plan membership statisitcs for CREFORM CORPORATION 401(K) RETIREMENT PLAN

Measure Date Value
2021: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 114
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 13
Total of all active and inactive participants 2021-01-01 128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 128
Number of participants with account balances 2021-01-01 113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 162
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 135
Number of retired or separated participants receiving benefits 2020-01-01 2
Number of other retired or separated participants entitled to future benefits 2020-01-01 13
Total of all active and inactive participants 2020-01-01 150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 150
Number of participants with account balances 2020-01-01 131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 2
2019: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 144
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 14
Total of all active and inactive participants 2019-01-01 158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 158
Number of participants with account balances 2019-01-01 143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 4
2017: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 127
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 14
Total of all active and inactive participants 2017-01-01 141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 141
Number of participants with account balances 2017-01-01 125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 3
2016: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 116
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 11
Total of all active and inactive participants 2016-01-01 128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 128
Number of participants with account balances 2016-01-01 114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 2
2009: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 82
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 15
Total of all active and inactive participants 2009-01-01 97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 97
Number of participants with account balances 2009-01-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2021: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	114
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	13
Total of all active and inactive participants	2021-01-01	128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	128
Number of participants with account balances	2021-01-01	113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	162
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	135
Number of retired or separated participants receiving benefits	2020-01-01	2
Number of other retired or separated participants entitled to future benefits	2020-01-01	13
Total of all active and inactive participants	2020-01-01	150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	150
Number of participants with account balances	2020-01-01	131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	2
2019: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	144
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	14
Total of all active and inactive participants	2019-01-01	158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	158
Number of participants with account balances	2019-01-01	143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	4
2017: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	127
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	14
Total of all active and inactive participants	2017-01-01	141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	141
Number of participants with account balances	2017-01-01	125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	3
2016: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	116
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	11
Total of all active and inactive participants	2016-01-01	128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	128
Number of participants with account balances	2016-01-01	114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	2
2009: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	82
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	15
Total of all active and inactive participants	2009-01-01	97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	97
Number of participants with account balances	2009-01-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on CREFORM CORPORATION 401(K) RETIREMENT PLAN

Measure	Date	Value
2021 : CREFORM CORPORATION 401(K) RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$3,723,120
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$3,134,025
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$3,063,343
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$906,412
Value of total assets at end of year	2021-12-31	$20,121,099
Value of total assets at beginning of year	2021-12-31	$19,532,004
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$70,682
Total interest from all sources	2021-12-31	$24,146
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$1,156,400
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$1,156,400
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$545,234
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$589,095
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$20,121,099
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$19,532,004
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$17,111,480
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$16,684,323
Interest earned on other investments	2021-12-31	$24,146
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$3,009,619
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$2,847,681
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,636,162
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$361,178
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$3,063,343
Contract administrator fees	2021-12-31	$70,682
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	ELLIOTT DAVIS
Accountancy firm EIN	2021-12-31	570381582
2020 : CREFORM CORPORATION 401(K) RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$3,712,664
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$989,412
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$940,486
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$939,065
Value of total assets at end of year	2020-12-31	$19,532,004
Value of total assets at beginning of year	2020-12-31	$16,808,752
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$48,926
Total interest from all sources	2020-12-31	$32,367
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$735,456
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$735,456
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$549,618
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$-5,189
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$2,723,252
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$19,532,004
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$16,808,752
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$16,684,323
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$14,045,540
Interest earned on other investments	2020-12-31	$32,367
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$2,847,681
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$2,772,372
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$2,005,776
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$389,447
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$-3,971
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$940,486
Contract administrator fees	2020-12-31	$48,926
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	ELLIOTT DAVIS
Accountancy firm EIN	2020-12-31	570381582
2019 : CREFORM CORPORATION 401(K) RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$3,813,175
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,241,428
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,216,722
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$899,529
Value of total assets at end of year	2019-12-31	$16,808,752
Value of total assets at beginning of year	2019-12-31	$14,237,005
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$24,706
Total interest from all sources	2019-12-31	$6,486
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$380,646
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$380,646
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$515,095
Participant contributions at end of year	2019-12-31	$-5,189
Participant contributions at beginning of year	2019-12-31	$12,884
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$2,571,747
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$16,808,752
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$14,237,005
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$14,045,540
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$14,181,640
Interest earned on other investments	2019-12-31	$6,486
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$38,819
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$38,819
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$2,772,372
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$2,526,514
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$384,434
Employer contributions (assets) at end of year	2019-12-31	$-3,971
Employer contributions (assets) at beginning of year	2019-12-31	$3,662
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,216,722
Contract administrator fees	2019-12-31	$24,706
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	ELLIOTT DAVIS
Accountancy firm EIN	2019-12-31	570381582
2017 : CREFORM CORPORATION 401(K) RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$2,981
Total income from all sources (including contributions)	2017-12-31	$3,069,694
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$103,214
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$93,218
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$784,316
Value of total assets at end of year	2017-12-31	$14,069,678
Value of total assets at beginning of year	2017-12-31	$11,106,179
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$9,996
Total interest from all sources	2017-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$460,926
Participant contributions at end of year	2017-12-31	$14,769
Participant contributions at beginning of year	2017-12-31	$12,167
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$2,966,480
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$14,069,678
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$11,103,198
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$12,767,478
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$9,865,881
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$1,287,126
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$1,223,614
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$1,223,614
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$2,285,378
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$323,390
Employer contributions (assets) at end of year	2017-12-31	$305
Employer contributions (assets) at beginning of year	2017-12-31	$4,517
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$93,218
Contract administrator fees	2017-12-31	$9,996
Liabilities. Value of benefit claims payable at end of year	2017-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$2,981
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	ELLIOTT DAVIS DECOSIMO
Accountancy firm EIN	2017-12-31	570381582
2016 : CREFORM CORPORATION 401(K) RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$2,981
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,345,439
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$290,410
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$290,260
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$710,974
Value of total assets at end of year	2016-12-31	$11,106,179
Value of total assets at beginning of year	2016-12-31	$10,048,169
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$150
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$389,571
Participant contributions at end of year	2016-12-31	$12,167
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$39,372
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$1,055,029
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$11,103,198
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$10,048,169
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$9,865,881
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$10,048,169
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$1,223,614
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$634,465
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$282,031
Employer contributions (assets) at end of year	2016-12-31	$4,517
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$290,260
Contract administrator fees	2016-12-31	$150
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$2,981
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$0
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	ELLIOTT DAVIS DECOSIMO
Accountancy firm EIN	2016-12-31	570381582
2009 : CREFORM CORPORATION 401(K) RETIREMENT PLAN 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 CREFORM CORPORATION 401(K) RETIREMENT PLAN

2021: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: CREFORM CORPORATION 401(K) RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: CREFORM CORPORATION 401(K) RETIREMENT PLAN 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
2017: CREFORM CORPORATION 401(K) RETIREMENT PLAN 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 – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: CREFORM CORPORATION 401(K) RETIREMENT PLAN 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 – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2009: CREFORM CORPORATION 401(K) RETIREMENT PLAN 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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

1260704-01

Policy instance

Insurance contract or identification number	1260704-01
Number of Individuals Covered	56
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	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?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

1260704-01

Policy instance

Insurance contract or identification number	1260704-01
Number of Individuals Covered	65
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	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?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

1260704-01

Policy instance

Insurance contract or identification number	1260704-01
Number of Individuals Covered	71
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	CREFORM CORPORATION
Employer identification number (EIN):	570934092
NAIC Classification:	339900