401k Plan data: CITIZENS STATE BANK 401(K) PLAN AND TRUST plan

CITIZENS STATE BANK 401(K) PLAN AND TRUST 401k Plan overview

Plan Name	CITIZENS STATE BANK 401(K) PLAN AND TRUST
Plan identification number	001

CITIZENS STATE BANK 401(K) PLAN AND TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

CITIZENS BANKSHARES, INC. has sponsored the creation of one or more 401k plans.

Company Name: CITIZENS BANKSHARES, INC.

Employer identification number (EIN): 731231736

NAIC Classification: 522110
NAIC Description: Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CITIZENS STATE BANK 401(K) PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01 JOHN HAYS 2020-03-27
001 2018-01-01
001 2017-01-01 JOHN HAYS
001 2016-01-01 JOHN HAYS

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2019-01-01	JOHN HAYS	2020-03-27
001	2018-01-01
001	2017-01-01	JOHN HAYS
001	2016-01-01	JOHN HAYS

Plan Statistics for CITIZENS STATE BANK 401(K) PLAN AND TRUST

401k plan membership statisitcs for CITIZENS STATE BANK 401(K) PLAN AND TRUST

Measure Date Value
2018: CITIZENS STATE BANK 401(K) PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year 2018-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 26
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 25
Total of all active and inactive participants 2018-01-01 51
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 51
Number of participants with account balances 2018-01-01 45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: CITIZENS STATE BANK 401(K) PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year 2017-01-01 274
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 28
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 128
Total of all active and inactive participants 2017-01-01 156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 156
Number of participants with account balances 2017-01-01 147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: CITIZENS STATE BANK 401(K) PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year 2016-01-01 199
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 251
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 12
Total of all active and inactive participants 2016-01-01 263
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 263
Number of participants with account balances 2016-01-01 140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0

Measure	Date	Value
2018: CITIZENS STATE BANK 401(K) PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	26
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	25
Total of all active and inactive participants	2018-01-01	51
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	51
Number of participants with account balances	2018-01-01	45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: CITIZENS STATE BANK 401(K) PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year	2017-01-01	274
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	28
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	128
Total of all active and inactive participants	2017-01-01	156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	156
Number of participants with account balances	2017-01-01	147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: CITIZENS STATE BANK 401(K) PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year	2016-01-01	199
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	251
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	12
Total of all active and inactive participants	2016-01-01	263
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	263
Number of participants with account balances	2016-01-01	140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0

Financial Data on CITIZENS STATE BANK 401(K) PLAN AND TRUST

Measure	Date	Value
2018 : CITIZENS STATE BANK 401(K) PLAN AND TRUST 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$-22,848
Total of all expenses incurred	2018-12-31	$2,016,645
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,924,199
Expenses. Certain deemed distributions of participant loans	2018-12-31	$58,984
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$107,735
Value of total assets at end of year	2018-12-31	$2,448,280
Value of total assets at beginning of year	2018-12-31	$4,487,773
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$33,462
Total interest from all sources	2018-12-31	$1,700
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$90,082
Participant contributions at end of year	2018-12-31	$11,212
Participant contributions at beginning of year	2018-12-31	$76,457
Participant contributions at end of year	2018-12-31	$3,585
Participant contributions at beginning of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Total non interest bearing cash at end of year	2018-12-31	$16,347
Total non interest bearing cash at beginning of year	2018-12-31	$50,193
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-2,039,493
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,448,280
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$4,487,773
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Investment advisory and management fees	2018-12-31	$33,462
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$2,415,081
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$4,361,123
Interest on participant loans	2018-12-31	$1,700
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-132,283
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$17,653
Employer contributions (assets) at end of year	2018-12-31	$2,055
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,924,199
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	FINLEY & COOK, PLLC
Accountancy firm EIN	2018-12-31	730604334
2017 : CITIZENS STATE BANK 401(K) PLAN AND TRUST 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$2,555,945
Total of all expenses incurred	2017-12-31	$1,760,640
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,718,405
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,703,818
Value of total assets at end of year	2017-12-31	$4,487,773
Value of total assets at beginning of year	2017-12-31	$3,692,468
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$42,235
Total interest from all sources	2017-12-31	$6,009
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
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$4,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$790,005
Participant contributions at end of year	2017-12-31	$76,457
Participant contributions at beginning of year	2017-12-31	$49,815
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$414,647
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$0
Administrative expenses (other) incurred	2017-12-31	$42,235
Total non interest bearing cash at end of year	2017-12-31	$50,193
Total non interest bearing cash at beginning of year	2017-12-31	$10,319
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	$795,305
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$4,487,773
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,692,468
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	$4,361,123
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,632,334
Interest on participant loans	2017-12-31	$6,009
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$846,118
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	Yes
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	$499,166
Employer contributions (assets) at end of year	2017-12-31	$0
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,718,405
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	No
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	FINLEY & COOK, PLLC
Accountancy firm EIN	2017-12-31	730604334
2016 : CITIZENS STATE BANK 401(K) PLAN AND TRUST 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$1,322,138
Total of all expenses incurred	2016-12-31	$134,769
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$113,646
Expenses. Certain deemed distributions of participant loans	2016-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,029,024
Value of total assets at end of year	2016-12-31	$3,692,468
Value of total assets at beginning of year	2016-12-31	$2,505,099
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$21,123
Total interest from all sources	2016-12-31	$1,565
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
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	Yes
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	$430,822
Participant contributions at end of year	2016-12-31	$49,815
Participant contributions at beginning of year	2016-12-31	$6,903
Participant contributions at end of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$287,485
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Total non interest bearing cash at end of year	2016-12-31	$10,319
Total non interest bearing cash at beginning of year	2016-12-31	$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	2016-12-31	No
Value of net income/loss	2016-12-31	$1,187,369
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,692,468
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,505,099
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
Investment advisory and management fees	2016-12-31	$21,123
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$3,632,334
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$2,430,908
Interest on participant loans	2016-12-31	$1,496
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$10,219
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$10,219
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$69
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$291,549
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	No
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	$310,717
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$57,069
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$113,646
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	Yes
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	HEARD, MCELROY AND VESTAL, LLC
Accountancy firm EIN	2016-12-31	720398470

Form 5500 Responses for CITIZENS STATE BANK 401(K) PLAN AND TRUST

2018: CITIZENS STATE BANK 401(K) PLAN AND TRUST 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: CITIZENS STATE BANK 401(K) PLAN AND TRUST 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: CITIZENS STATE BANK 401(K) PLAN AND TRUST 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	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

123029

Policy instance

Insurance contract or identification number	123029
Number of Individuals Covered	46
Total amount of commissions paid to insurance broker	USD $8,006
Total amount of fees paid to insurance company	USD $8,823
Commission paid to Insurance Broker	USD $8,006
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKERS COMMISSION
Insurance broker organization code?	3

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

Policy contract number

123029

Policy instance

Insurance contract or identification number	123029
Total amount of commissions paid to insurance broker	USD $14,730
Total amount of fees paid to insurance company	USD $10,180
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,730
Insurance broker organization code?	3
Amount paid for insurance broker fees	6307
Insurance broker name	NOVA 401(K) ASSOCIATES

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Company Name:	CITIZENS BANKSHARES, INC.
Employer identification number (EIN):	731231736
NAIC Classification:	522110
NAIC Description:	Commercial Banking