401k Plan data: UBG 401(K) - EQUITY EXCHANGE plan

UBG 401(K) - EQUITY EXCHANGE 401k Plan overview

Plan Name	UBG 401(K) - EQUITY EXCHANGE
Plan identification number	002

UBG 401(K) - EQUITY EXCHANGE 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

PERRYTON EQUITY EXCHANGE has sponsored the creation of one or more 401k plans.

Company Name: PERRYTON EQUITY EXCHANGE

Employer identification number (EIN): 750491660

NAIC Classification: 115110

Additional information about PERRYTON EQUITY EXCHANGE

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1921-03-30

Company Identification Number: 0003618801

Legal Registered Office Address: PO BOX 889

PERRYTON
United States of America (USA)
79070

More information about PERRYTON EQUITY EXCHANGE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UBG 401(K) - EQUITY EXCHANGE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01 KELLY SEEMANN 2021-09-30 KELLY SEEMANN 2021-09-30
002 2019-01-01 KELLY SEEMANN 2020-07-29
002 2018-01-01 KELLY SEEMANN 2019-10-07
002 2017-01-01 KELLY SEEMANN 2018-08-31 KELLY SEEMANN 2018-08-31
002 2016-01-01 KELLY SEEMANN 2017-07-26 KELLY SEEMANN 2017-07-26
002 2015-01-01 KELLY SEEMANN 2016-08-17
002 2014-01-01 KELLY SEEMANN 2015-10-07
002 2013-01-01 KELLY SEEMANN 2014-10-06
002 2012-01-01 KELLY SEEMANN 2013-07-09 KELLY SEEMANN 2013-07-09
002 2011-01-01 KELLY SEEMANN 2012-07-16
002 2009-01-01 KELLY SEEMANN
002 2009-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01	KELLY SEEMANN	2021-09-30	KELLY SEEMANN	2021-09-30
002	2019-01-01	KELLY SEEMANN	2020-07-29
002	2018-01-01	KELLY SEEMANN	2019-10-07
002	2017-01-01	KELLY SEEMANN	2018-08-31	KELLY SEEMANN	2018-08-31
002	2016-01-01	KELLY SEEMANN	2017-07-26	KELLY SEEMANN	2017-07-26
002	2015-01-01	KELLY SEEMANN	2016-08-17
002	2014-01-01	KELLY SEEMANN	2015-10-07
002	2013-01-01	KELLY SEEMANN	2014-10-06
002	2012-01-01	KELLY SEEMANN	2013-07-09	KELLY SEEMANN	2013-07-09
002	2011-01-01	KELLY SEEMANN	2012-07-16
002	2009-01-01	KELLY SEEMANN
002	2009-01-01

Plan Statistics for UBG 401(K) - EQUITY EXCHANGE

401k plan membership statisitcs for UBG 401(K) - EQUITY EXCHANGE

Measure Date Value
2022: UBG 401(K) - EQUITY EXCHANGE 2022 401k membership
Total participants, beginning-of-year 2022-01-01 130
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 121
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 6
Total of all active and inactive participants 2022-01-01 127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 127
Number of participants with account balances 2022-01-01 24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 29
2009: UBG 401(K) - EQUITY EXCHANGE 2009 401k membership
Total participants, beginning-of-year 2009-01-01 54
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 62
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 3
Total of all active and inactive participants 2009-01-01 65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 65
Number of participants with account balances 2009-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2022: UBG 401(K) - EQUITY EXCHANGE 2022 401k membership
Total participants, beginning-of-year	2022-01-01	130
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	121
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	6
Total of all active and inactive participants	2022-01-01	127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	127
Number of participants with account balances	2022-01-01	24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	29
2009: UBG 401(K) - EQUITY EXCHANGE 2009 401k membership
Total participants, beginning-of-year	2009-01-01	54
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	62
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	3
Total of all active and inactive participants	2009-01-01	65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	65
Number of participants with account balances	2009-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on UBG 401(K) - EQUITY EXCHANGE

Measure	Date	Value
2022 : UBG 401(K) - EQUITY EXCHANGE 2022 401k financial data
Unrealized appreciation/depreciation of real estate assets	2022-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$0
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Expenses. Interest paid	2022-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-68,558
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$81,189
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$74,142
Expenses. Certain deemed distributions of participant loans	2022-12-31	$0
Value of total corrective distributions	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$40,537
Value of total assets at end of year	2022-12-31	$575,674
Value of total assets at beginning of year	2022-12-31	$725,421
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$7,047
Total income from rents	2022-12-31	$0
Total interest from all sources	2022-12-31	$1,554
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$11,411
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$11,411
Assets. Real estate other than employer real property at end of year	2022-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2022-12-31	$0
Administrative expenses professional fees incurred	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-12-31	$0
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	Yes
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$40,537
Participant contributions at end of year	2022-12-31	$17,627
Participant contributions at beginning of year	2022-12-31	$27,678
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Assets. Loans (other than to participants) at end of year	2022-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$0
Other income not declared elsewhere	2022-12-31	$119
Administrative expenses (other) incurred	2022-12-31	$0
Liabilities. Value of operating payables at end of year	2022-12-31	$0
Liabilities. Value of operating payables at beginning of year	2022-12-31	$0
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning 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
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$-149,747
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$575,674
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$725,421
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
Assets. partnership/joint venture interests at end of year	2022-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2022-12-31	$0
Investment advisory and management fees	2022-12-31	$42
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$347,047
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$697,743
Value of interest in pooled separate accounts at end of year	2022-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$0
Interest on participant loans	2022-12-31	$1,445
Income. Interest from loans (other than to participants)	2022-12-31	$0
Interest earned on other investments	2022-12-31	$109
Income. Interest from US Government securities	2022-12-31	$0
Income. Interest from corporate debt instruments	2022-12-31	$0
Value of interest in master investment trust accounts at end of year	2022-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2022-12-31	$0
Value of interest in common/collective trusts at end of year	2022-12-31	$159,558
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$51,442
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Asset value of US Government securities at end of year	2022-12-31	$0
Asset value of US Government securities at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-133,583
Net investment gain/loss from pooled separate accounts	2022-12-31	$0
Net investment gain or loss from common/collective trusts	2022-12-31	$11,404
Net gain/loss from 103.12 investment entities	2022-12-31	$0
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
Assets. Invements in employer securities at end of year	2022-12-31	$0
Assets. Invements in employer securities at beginning of year	2022-12-31	$0
Assets. Value of employer real property at end of year	2022-12-31	$0
Assets. Value of employer real property at beginning of year	2022-12-31	$0
Contributions received in cash from employer	2022-12-31	$0
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Income. Dividends from preferred stock	2022-12-31	$0
Income. Dividends from common stock	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$74,142
Asset. Corporate debt instrument preferred debt at end of year	2022-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$0
Contract administrator fees	2022-12-31	$7,005
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	2022-12-31	Yes
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2022-12-31	$0
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
Aggregate proceeds on sale of assets	2022-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2022-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2022-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning 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	EIDE BAILLY, LLP
Accountancy firm EIN	2022-12-31	450250958
2021 : UBG 401(K) - EQUITY EXCHANGE 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total transfer of assets to this plan	2021-12-31	$107,234
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$44
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	$114,697
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$48,442
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$38,984
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$34,504
Value of total assets at end of year	2021-12-31	$728,073
Value of total assets at beginning of year	2021-12-31	$554,540
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$9,458
Total interest from all sources	2021-12-31	$2,133
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$28,105
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	$28,105
Administrative expenses professional fees incurred	2021-12-31	$9,369
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	$34,504
Participant contributions at end of year	2021-12-31	$28,066
Participant contributions at beginning of year	2021-12-31	$37,413
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$44
Other income not declared elsewhere	2021-12-31	$3,010
Administrative expenses (other) incurred	2021-12-31	$89
Total non interest bearing cash at end of year	2021-12-31	$1,704
Total non interest bearing cash at beginning of year	2021-12-31	$1,938
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	$66,255
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$728,029
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$554,540
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	$643,880
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$473,450
Interest on participant loans	2021-12-31	$2,133
Value of interest in common/collective trusts at end of year	2021-12-31	$2,339
Value of interest in common/collective trusts at beginning of year	2021-12-31	$41,739
Asset value of US Government securities at end of year	2021-12-31	$22,613
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$46,944
Net investment gain or loss from common/collective trusts	2021-12-31	$1
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$38,984
Asset. Corporate debt instrument preferred debt at end of year	2021-12-31	$9,953
Asset. Corporate debt instrument debt (other) at end of year	2021-12-31	$19,518
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	EIDE BAILLY LLP
Accountancy firm EIN	2021-12-31	450250958
2010 : UBG 401(K) - EQUITY EXCHANGE 2010 401k financial data
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$13,375
Expenses. Total of all expenses incurred	2010-12-31	$11,743
Benefits paid (including direct rollovers)	2010-12-31	$11,020
Total plan assets at end of year	2010-12-31	$69,104
Total plan assets at beginning of year	2010-12-31	$67,472
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$5,652
Expenses. Other expenses not covered elsewhere	2010-12-31	$723
Other income received	2010-12-31	$7,723
Net income (gross income less expenses)	2010-12-31	$1,632
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$69,104
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$67,472
Total contributions received or receivable from employer(s)	2010-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : UBG 401(K) - EQUITY EXCHANGE 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 UBG 401(K) - EQUITY EXCHANGE

2022: UBG 401(K) - EQUITY EXCHANGE 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	Yes
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
2009: UBG 401(K) - EQUITY EXCHANGE 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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

517883-01

Policy instance

Insurance contract or identification number	517883-01
Number of Individuals Covered	18
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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

AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )

Policy contract number

1666920

Policy instance

Insurance contract or identification number	1666920
Number of Individuals Covered	116
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 $0
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

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

G-027795

Policy instance

Insurance contract or identification number	G-027795
Number of Individuals Covered	116
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 $0
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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

062491

Policy instance

Insurance contract or identification number	062491
Number of Individuals Covered	116
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 $0
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

MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 )

Policy contract number

MDA01360TR

Policy instance

Insurance contract or identification number	MDA01360TR
Number of Individuals Covered	116
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 $0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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

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Company Name:	PERRYTON EQUITY EXCHANGE
Employer identification number (EIN):	750491660
NAIC Classification:	115110

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1921-03-30
Company Identification Number:	0003618801
Legal Registered Office Address:	PO BOX 889 PERRYTON United States of America (USA) 79070