401k Plan data: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST plan

DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST
Plan identification number	001

DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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

DEBEAUBIEN, SIMMONS, KNIGHT, MANTZARIS NEAL has sponsored the creation of one or more 401k plans.

Company Name: DEBEAUBIEN, SIMMONS, KNIGHT, MANTZARIS NEAL

Employer identification number (EIN): 592206392

NAIC Classification: 541110
NAIC Description: Offices of Lawyers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DBKSM&N 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 DAVID SIMMONS 2023-10-11 DAVID SIMMONS 2023-10-11
001 2021-01-01 DAVID SIMMONS 2022-10-13 DAVID SIMMONS 2022-10-13
001 2020-01-01 DAVID SIMMONS 2021-10-08 DAVID SIMMONS 2021-10-08
001 2019-01-01 DAVID SIMMONS 2020-11-25 DAVID SIMMONS 2020-11-25
001 2019-01-01 DAVID SIMMONS 2020-10-15 DAVID SIMMONS 2020-10-15
001 2018-01-01
001 2017-01-01
001 2016-01-01 DAVID SIMMONS 2017-10-16 DAVID SIMMONS 2017-10-16
001 2015-01-01 DAVID SIMMONS 2016-07-28 DAVID SIMMONS 2016-07-28
001 2014-01-01 DAVID SIMMONS 2015-04-18 DAVID SIMMONS 2015-04-18
001 2013-01-01 DAVID SIMMONS 2014-06-04 DAVID SIMMONS 2014-06-04
001 2012-01-01 DAVID SIMMONS 2013-05-09 DAVID SIMMONS 2013-05-09
001 2011-01-01 DAVID SIMMONS DAVID SIMMONS 2012-06-29
001 2010-01-01 DAVID SIMMONS DAVID SIMMONS 2011-08-15
001 2009-01-01 DAVID SIMMONS DAVID SIMMONS 2010-09-08

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	DAVID SIMMONS	2023-10-11	DAVID SIMMONS	2023-10-11
001	2021-01-01	DAVID SIMMONS	2022-10-13	DAVID SIMMONS	2022-10-13
001	2020-01-01	DAVID SIMMONS	2021-10-08	DAVID SIMMONS	2021-10-08
001	2019-01-01	DAVID SIMMONS	2020-11-25	DAVID SIMMONS	2020-11-25
001	2019-01-01	DAVID SIMMONS	2020-10-15	DAVID SIMMONS	2020-10-15
001	2018-01-01
001	2017-01-01
001	2016-01-01	DAVID SIMMONS	2017-10-16	DAVID SIMMONS	2017-10-16
001	2015-01-01	DAVID SIMMONS	2016-07-28	DAVID SIMMONS	2016-07-28
001	2014-01-01	DAVID SIMMONS	2015-04-18	DAVID SIMMONS	2015-04-18
001	2013-01-01	DAVID SIMMONS	2014-06-04	DAVID SIMMONS	2014-06-04
001	2012-01-01	DAVID SIMMONS	2013-05-09	DAVID SIMMONS	2013-05-09
001	2011-01-01	DAVID SIMMONS		DAVID SIMMONS	2012-06-29
001	2010-01-01	DAVID SIMMONS		DAVID SIMMONS	2011-08-15
001	2009-01-01	DAVID SIMMONS		DAVID SIMMONS	2010-09-08

Plan Statistics for DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST

Measure Date Value
2022: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2022 401k membership
Total participants, beginning-of-year 2022-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 85
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 39
Total of all active and inactive participants 2022-01-01 124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 124
Number of participants with account balances 2022-01-01 113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2021 401k membership
Total participants, beginning-of-year 2021-01-01 143
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 94
Number of other retired or separated participants entitled to future benefits 2021-01-01 37
Total of all active and inactive participants 2021-01-01 131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 131
Number of participants with account balances 2021-01-01 120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 136
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 95
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 38
Total of all active and inactive participants 2020-01-01 133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 133
Number of participants with account balances 2020-01-01 118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year 2019-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 95
Number of other retired or separated participants entitled to future benefits 2019-01-01 35
Total of all active and inactive participants 2019-01-01 130
Total participants 2019-01-01 130
Number of participants with account balances 2019-01-01 116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2011: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 73
Number of other retired or separated participants entitled to future benefits 2011-01-01 25
Total of all active and inactive participants 2011-01-01 98
Total participants 2011-01-01 98
Number of participants with account balances 2011-01-01 92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2010: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year 2010-01-01 111
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 87
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 16
Total of all active and inactive participants 2010-01-01 103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 103
Number of participants with account balances 2010-01-01 97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 2
2009: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 110
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 14
Total of all active and inactive participants 2009-01-01 107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 107
Number of participants with account balances 2009-01-01 99
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 3

Measure	Date	Value
2022: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2022 401k membership
Total participants, beginning-of-year	2022-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	85
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	39
Total of all active and inactive participants	2022-01-01	124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	124
Number of participants with account balances	2022-01-01	113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2021 401k membership
Total participants, beginning-of-year	2021-01-01	143
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	94
Number of other retired or separated participants entitled to future benefits	2021-01-01	37
Total of all active and inactive participants	2021-01-01	131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	131
Number of participants with account balances	2021-01-01	120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	136
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	95
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	38
Total of all active and inactive participants	2020-01-01	133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	133
Number of participants with account balances	2020-01-01	118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	95
Number of other retired or separated participants entitled to future benefits	2019-01-01	35
Total of all active and inactive participants	2019-01-01	130
Total participants	2019-01-01	130
Number of participants with account balances	2019-01-01	116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2011: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	73
Number of other retired or separated participants entitled to future benefits	2011-01-01	25
Total of all active and inactive participants	2011-01-01	98
Total participants	2011-01-01	98
Number of participants with account balances	2011-01-01	92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2010: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year	2010-01-01	111
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	87
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	16
Total of all active and inactive participants	2010-01-01	103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	103
Number of participants with account balances	2010-01-01	97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	2
2009: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	110
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	14
Total of all active and inactive participants	2009-01-01	107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	107
Number of participants with account balances	2009-01-01	99
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	3

Financial Data on DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2022 : DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-1,505,039
Total of all expenses incurred	2022-12-31	$511,240
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$420,528
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$720,319
Value of total assets at end of year	2022-12-31	$11,901,694
Value of total assets at beginning of year	2022-12-31	$13,917,973
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$90,712
Total interest from all sources	2022-12-31	$7,650
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$473,744
Participant contributions at end of year	2022-12-31	$127,563
Participant contributions at beginning of year	2022-12-31	$211,304
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$13,048
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Total non interest bearing cash at end of year	2022-12-31	$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	2022-12-31	No
Value of net income/loss	2022-12-31	$-2,016,279
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$11,901,694
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$13,917,973
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$3,300
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$0
Value of interest in pooled separate accounts at end of year	2022-12-31	$11,774,131
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$13,706,669
Interest on participant loans	2022-12-31	$7,650
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Net investment gain/loss from pooled separate accounts	2022-12-31	$-2,233,008
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$233,527
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$420,528
Contract administrator fees	2022-12-31	$87,412
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Liabilities. Value of acquisition indebtedness at end of year	2022-12-31	$0
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	WITHUM
Accountancy firm EIN	2022-12-31	222027092
2021 : DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2021 401k financial data
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	$2,600,715
Total of all expenses incurred	2021-12-31	$292,898
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$195,252
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$796,972
Value of total assets at end of year	2021-12-31	$13,917,973
Value of total assets at beginning of year	2021-12-31	$11,610,156
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$97,646
Total interest from all sources	2021-12-31	$7,906
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Administrative expenses professional fees incurred	2021-12-31	$1,900
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	$497,582
Participant contributions at end of year	2021-12-31	$211,304
Participant contributions at beginning of year	2021-12-31	$154,175
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$38,908
Liabilities. Value of operating payables at beginning of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	2021-12-31	$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	2021-12-31	No
Value of net income/loss	2021-12-31	$2,307,817
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$13,917,973
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$11,610,156
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
Investment advisory and management fees	2021-12-31	$38,619
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$0
Value of interest in pooled separate accounts at end of year	2021-12-31	$13,706,669
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$11,455,981
Interest on participant loans	2021-12-31	$7,906
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$0
Net investment gain/loss from pooled separate accounts	2021-12-31	$1,795,837
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	$260,482
Employer contributions (assets) at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$195,252
Contract administrator fees	2021-12-31	$57,127
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	WITHUM
Accountancy firm EIN	2021-12-31	222027092
2020 : DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k financial data
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	$2,332,711
Total of all expenses incurred	2020-12-31	$375,478
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$338,457
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$693,097
Value of total assets at end of year	2020-12-31	$11,610,156
Value of total assets at beginning of year	2020-12-31	$9,652,923
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$37,021
Total interest from all sources	2020-12-31	$8,721
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$2,050
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	$459,947
Participant contributions at end of year	2020-12-31	$154,175
Participant contributions at beginning of year	2020-12-31	$186,504
Liabilities. Value of operating payables at end of year	2020-12-31	$0
Liabilities. Value of operating payables at beginning of year	2020-12-31	$0
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$6,251
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	$1,957,233
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$11,610,156
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$9,652,923
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
Investment advisory and management fees	2020-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$0
Value of interest in pooled separate accounts at end of year	2020-12-31	$11,455,981
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$9,460,168
Interest on participant loans	2020-12-31	$8,721
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$0
Net investment gain/loss from pooled separate accounts	2020-12-31	$1,630,893
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	$233,150
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$338,457
Contract administrator fees	2020-12-31	$34,971
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	WITHUM
Accountancy firm EIN	2020-12-31	222027092
2019 : DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	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 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	$2,326,135
Total income from all sources (including contributions)	2019-12-31	$2,326,135
Total of all expenses incurred	2019-12-31	$121,816
Total of all expenses incurred	2019-12-31	$121,816
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$102,933
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$102,933
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$644,635
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$644,635
Value of total assets at end of year	2019-12-31	$9,653,808
Value of total assets at end of year	2019-12-31	$9,653,808
Value of total assets at beginning of year	2019-12-31	$7,449,489
Value of total assets at beginning of year	2019-12-31	$7,449,489
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$18,883
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$18,883
Total interest from all sources	2019-12-31	$9,974
Total interest from all sources	2019-12-31	$9,974
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$2,100
Administrative expenses professional fees incurred	2019-12-31	$2,100
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
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
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$427,392
Contributions received from participants	2019-12-31	$427,392
Participant contributions at end of year	2019-12-31	$186,504
Participant contributions at end of year	2019-12-31	$186,504
Participant contributions at beginning of year	2019-12-31	$207,002
Participant contributions at beginning of year	2019-12-31	$207,002
Other income not declared elsewhere	2019-12-31	$2,663
Liabilities. Value of operating payables at end of year	2019-12-31	$0
Liabilities. Value of operating payables at end of year	2019-12-31	$0
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$6,251
Total non interest bearing cash at end of year	2019-12-31	$6,251
Total non interest bearing cash at beginning of year	2019-12-31	$3,589
Total non interest bearing cash at beginning of year	2019-12-31	$3,589
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
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	$2,204,319
Value of net income/loss	2019-12-31	$2,204,319
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$9,653,808
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$9,653,808
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$7,449,489
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$7,449,489
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
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 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
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	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$0
Value of interest in pooled separate accounts at end of year	2019-12-31	$9,457,910
Value of interest in pooled separate accounts at end of year	2019-12-31	$9,457,910
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$7,238,385
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$7,238,385
Interest on participant loans	2019-12-31	$9,964
Interest on participant loans	2019-12-31	$9,964
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$2,259
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$2,259
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$10
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$10
Net investment gain/loss from pooled separate accounts	2019-12-31	$1,671,526
Net investment gain/loss from pooled separate accounts	2019-12-31	$1,671,526
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
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
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
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	$217,243
Contributions received in cash from employer	2019-12-31	$217,243
Employer contributions (assets) at end of year	2019-12-31	$884
Employer contributions (assets) at end of year	2019-12-31	$884
Employer contributions (assets) at beginning of year	2019-12-31	$513
Employer contributions (assets) at beginning of year	2019-12-31	$513
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$102,933
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$102,933
Contract administrator fees	2019-12-31	$16,783
Contract administrator fees	2019-12-31	$16,783
Did the plan have assets held for investment	2019-12-31	Yes
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
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
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
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	WITHUM
Accountancy firm name	2019-12-31	WITHUM
Accountancy firm EIN	2019-12-31	593214308
Accountancy firm EIN	2019-12-31	593214308
2011 : DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2011 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$4,789
Total income from all sources (including contributions)	2011-12-31	$160,069
Total of all expenses incurred	2011-12-31	$301,933
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$281,791
Expenses. Certain deemed distributions of participant loans	2011-12-31	$5,239
Value of total corrective distributions	2011-12-31	$362
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$277,786
Value of total assets at end of year	2011-12-31	$4,400,962
Value of total assets at beginning of year	2011-12-31	$4,547,615
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$14,541
Total interest from all sources	2011-12-31	$2,133
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
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
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$277,786
Participant contributions at end of year	2011-12-31	$45,773
Participant contributions at beginning of year	2011-12-31	$48,230
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$4,789
Total non interest bearing cash at end of year	2011-12-31	$1,655
Total non interest bearing cash at beginning of year	2011-12-31	$751
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	$-141,864
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,400,962
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,542,826
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
Value of interest in pooled separate accounts at end of year	2011-12-31	$4,353,534
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$4,493,794
Interest on participant loans	2011-12-31	$2,126
Interest earned on other investments	2011-12-31	$7
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$4,840
Net investment gain/loss from pooled separate accounts	2011-12-31	$-119,850
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$281,791
Contract administrator fees	2011-12-31	$14,541
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
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	AVERETT WARMUS DURKEE OSBURN HENNIN
Accountancy firm EIN	2011-12-31	593214308
2010 : DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$4,789
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$8,323
Total income from all sources (including contributions)	2010-12-31	$846,511
Total of all expenses incurred	2010-12-31	$260,874
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$247,300
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$301,243
Value of total assets at end of year	2010-12-31	$4,547,615
Value of total assets at beginning of year	2010-12-31	$3,965,512
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$13,574
Total interest from all sources	2010-12-31	$2,558
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$301,243
Participant contributions at end of year	2010-12-31	$48,230
Participant contributions at beginning of year	2010-12-31	$49,156
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$4,789
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$8,323
Total non interest bearing cash at end of year	2010-12-31	$751
Total non interest bearing cash at beginning of year	2010-12-31	$621
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	$585,637
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,542,826
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,957,189
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
Value of interest in pooled separate accounts at end of year	2010-12-31	$4,493,794
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$3,912,447
Interest on participant loans	2010-12-31	$2,479
Interest earned on other investments	2010-12-31	$79
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$4,840
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$3,288
Net investment gain/loss from pooled separate accounts	2010-12-31	$542,710
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$247,300
Contract administrator fees	2010-12-31	$13,574
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
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	AVERETT, WAMUS, DURKEE
Accountancy firm EIN	2010-12-31	593214308

Form 5500 Responses for DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST

2022: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 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: DBKSM&N 401(K) PROFIT SHARING PLAN AND TRUST 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: DBKSM&N 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	Yes
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
2011: DBKSM&N 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: DBKSM&N 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: DBKSM&N 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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

Policy instance

Number of Individuals Covered	126
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $9,526
Insurance broker organization code?	1
Amount paid for insurance broker fees	9526
Additional information about fees paid to insurance broker	TPA COMPENSATION AND FEES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

Policy instance

Number of Individuals Covered	128
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $8,368
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	1
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	8368
Additional information about fees paid to insurance broker	TPA COMPENSATION AND FEES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

Policy instance

Number of Individuals Covered	130
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $4,815
Total amount of fees paid to insurance company	USD $2,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	1
Commission paid to Insurance Broker	USD $4,815
Amount paid for insurance broker fees	2050
Additional information about fees paid to insurance broker	TPA COMPENSATION & FEES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

Policy instance

Number of Individuals Covered	121
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $21,907
Total amount of fees paid to insurance company	USD $5,729
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,611
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	1
Amount paid for insurance broker fees	5729

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

46606

Policy instance

Insurance contract or identification number	46606
Number of Individuals Covered	96
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $11,702
Total amount of fees paid to insurance company	USD $2,918
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

46606

Policy instance

Insurance contract or identification number	46606
Number of Individuals Covered	102
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $10,356
Total amount of fees paid to insurance company	USD $2,702
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $10,356
Insurance broker organization code?	3
Amount paid for insurance broker fees	2702
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker name	BATES AND COMPANY, INC.

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Company Name:	DEBEAUBIEN, SIMMONS, KNIGHT, MANTZARIS NEAL
Employer identification number (EIN):	592206392
NAIC Classification:	541110
NAIC Description:	Offices of Lawyers