401k Plan data: COWBOY STATE BANCORP 401(K) PLAN plan

COWBOY STATE BANCORP 401(K) PLAN 401k Plan overview

Plan Name	COWBOY STATE BANCORP 401(K) PLAN
Plan identification number	001

COWBOY STATE BANCORP 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

COWBOY STATE BANCORP has sponsored the creation of one or more 401k plans.

Company Name: COWBOY STATE BANCORP

Employer identification number (EIN): 830332645

NAIC Classification: 522110
NAIC Description: Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COWBOY STATE BANCORP 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01 KERRIE L. BOHLER 2019-07-23
001 2018-01-01
001 2017-01-01
001 2017-01-01
001 2016-01-01 SAM T SUMMERS
001 2015-01-01 SAM T SUMMERS
001 2014-01-01 SAM T SUMMERS
001 2013-01-01 SAM T SUMMERS
001 2012-01-01 SAM T SUMMERS
001 2011-01-01 SAM T SUMMERS
001 2009-01-01 SAM T SUMMERS
001 2009-01-01 SAM T. SUMMERS SAM T. SUMMERS 2010-07-29

Plan Statistics for COWBOY STATE BANCORP 401(K) PLAN

401k plan membership statisitcs for COWBOY STATE BANCORP 401(K) PLAN

Measure Date Value
2022: COWBOY STATE BANCORP 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 16
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 0
Total of all active and inactive participants 2022-01-01 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 16
Number of participants with account balances 2022-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: COWBOY STATE BANCORP 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 14
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 15
Number of participants with account balances 2021-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: COWBOY STATE BANCORP 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 19
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 14
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 1
Total of all active and inactive participants 2020-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 15
Number of participants with account balances 2020-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1
2019: COWBOY STATE BANCORP 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 18
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 15
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 2
Total of all active and inactive participants 2019-01-01 17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 17
Number of participants with account balances 2019-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: COWBOY STATE BANCORP 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 18
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 15
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 3
Total of all active and inactive participants 2018-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 18
Number of participants with account balances 2018-01-01 16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 1
2017: COWBOY STATE BANCORP 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 18
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 17
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 1
Total of all active and inactive participants 2017-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 18
Number of participants with account balances 2017-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: COWBOY STATE BANCORP 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 15
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 2
Total of all active and inactive participants 2016-01-01 17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 17
Number of participants with account balances 2016-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: COWBOY STATE BANCORP 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 14
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 4
Total of all active and inactive participants 2015-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 18
Number of participants with account balances 2015-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 1
2014: COWBOY STATE BANCORP 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 10
Number of retired or separated participants receiving benefits 2014-01-01 5
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 15
Number of participants with account balances 2014-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 2
2013: COWBOY STATE BANCORP 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 15
Number of retired or separated participants receiving benefits 2013-01-01 6
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 21
Number of participants with account balances 2013-01-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: COWBOY STATE BANCORP 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 20
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 13
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 9
Total of all active and inactive participants 2012-01-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 22
Number of participants with account balances 2012-01-01 20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 2
2011: COWBOY STATE BANCORP 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 21
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 13
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 7
Total of all active and inactive participants 2011-01-01 20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 20
Number of participants with account balances 2011-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2009: COWBOY STATE BANCORP 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 16
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 6
Total of all active and inactive participants 2009-01-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 22
Number of participants with account balances 2009-01-01 22

Measure	Date	Value
2022: COWBOY STATE BANCORP 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	16
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	0
Total of all active and inactive participants	2022-01-01	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	16
Number of participants with account balances	2022-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: COWBOY STATE BANCORP 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	14
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	15
Number of participants with account balances	2021-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: COWBOY STATE BANCORP 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	19
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	14
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	1
Total of all active and inactive participants	2020-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	15
Number of participants with account balances	2020-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1
2019: COWBOY STATE BANCORP 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	18
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	15
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	2
Total of all active and inactive participants	2019-01-01	17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	17
Number of participants with account balances	2019-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: COWBOY STATE BANCORP 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	18
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	15
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	3
Total of all active and inactive participants	2018-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	18
Number of participants with account balances	2018-01-01	16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	1
2017: COWBOY STATE BANCORP 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	18
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	17
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	1
Total of all active and inactive participants	2017-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	18
Number of participants with account balances	2017-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: COWBOY STATE BANCORP 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	15
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	2
Total of all active and inactive participants	2016-01-01	17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	17
Number of participants with account balances	2016-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: COWBOY STATE BANCORP 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	14
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	4
Total of all active and inactive participants	2015-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	18
Number of participants with account balances	2015-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	1
2014: COWBOY STATE BANCORP 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	10
Number of retired or separated participants receiving benefits	2014-01-01	5
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	15
Number of participants with account balances	2014-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	2
2013: COWBOY STATE BANCORP 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	15
Number of retired or separated participants receiving benefits	2013-01-01	6
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	21
Number of participants with account balances	2013-01-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: COWBOY STATE BANCORP 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	20
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	13
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	9
Total of all active and inactive participants	2012-01-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	22
Number of participants with account balances	2012-01-01	20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	2
2011: COWBOY STATE BANCORP 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	21
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	13
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	7
Total of all active and inactive participants	2011-01-01	20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	20
Number of participants with account balances	2011-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2009: COWBOY STATE BANCORP 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	16
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	6
Total of all active and inactive participants	2009-01-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	22
Number of participants with account balances	2009-01-01	22

Financial Data on COWBOY STATE BANCORP 401(K) PLAN

Measure	Date	Value
2022 : COWBOY STATE BANCORP 401(K) PLAN 2022 401k financial data
Total plan liabilities at beginning of year	2022-12-31	$0
Total income from all sources	2022-12-31	$-20,541
Expenses. Total of all expenses incurred	2022-12-31	$8,939
Benefits paid (including direct rollovers)	2022-12-31	$141
Total plan assets at end of year	2022-12-31	$632,890
Total plan assets at beginning of year	2022-12-31	$662,370
Value of fidelity bond covering the plan	2022-12-31	$500,000
Total contributions received or receivable from participants	2022-12-31	$22,357
Contributions received from other sources (not participants or employers)	2022-12-31	$7,134
Other income received	2022-12-31	$-68,142
Net income (gross income less expenses)	2022-12-31	$-29,480
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$632,890
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$662,370
Assets. Value of participant loans	2022-12-31	$42,190
Assets. Value of employer securities	2022-12-31	$176,725
Total contributions received or receivable from employer(s)	2022-12-31	$18,110
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$8,798
2021 : COWBOY STATE BANCORP 401(K) PLAN 2021 401k financial data
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$130,616
Expenses. Total of all expenses incurred	2021-12-31	$99,968
Benefits paid (including direct rollovers)	2021-12-31	$89,809
Total plan assets at end of year	2021-12-31	$662,370
Total plan assets at beginning of year	2021-12-31	$631,722
Value of fidelity bond covering the plan	2021-12-31	$500,000
Total contributions received or receivable from participants	2021-12-31	$27,469
Other income received	2021-12-31	$85,808
Net income (gross income less expenses)	2021-12-31	$30,648
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$662,370
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$631,722
Assets. Value of participant loans	2021-12-31	$23,416
Assets. Value of employer securities	2021-12-31	$178,955
Total contributions received or receivable from employer(s)	2021-12-31	$17,339
Value of certain deemed distributions of participant loans	2021-12-31	$10,159
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : COWBOY STATE BANCORP 401(K) PLAN 2020 401k financial data
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$104,799
Expenses. Total of all expenses incurred	2020-12-31	$134,149
Benefits paid (including direct rollovers)	2020-12-31	$119,103
Total plan assets at end of year	2020-12-31	$631,722
Total plan assets at beginning of year	2020-12-31	$661,072
Value of fidelity bond covering the plan	2020-12-31	$500,000
Total contributions received or receivable from participants	2020-12-31	$22,491
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$0
Other income received	2020-12-31	$64,297
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$-29,350
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$631,722
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$661,072
Assets. Value of participant loans	2020-12-31	$27,836
Assets. Value of employer securities	2020-12-31	$150,765
Total contributions received or receivable from employer(s)	2020-12-31	$18,011
Value of certain deemed distributions of participant loans	2020-12-31	$6,701
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$8,345
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : COWBOY STATE BANCORP 401(K) PLAN 2019 401k financial data
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$145,103
Expenses. Total of all expenses incurred	2019-12-31	$117,982
Benefits paid (including direct rollovers)	2019-12-31	$107,350
Total plan assets at end of year	2019-12-31	$661,072
Total plan assets at beginning of year	2019-12-31	$633,951
Value of fidelity bond covering the plan	2019-12-31	$500,000
Total contributions received or receivable from participants	2019-12-31	$23,867
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$0
Other income received	2019-12-31	$101,865
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$27,121
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$661,072
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$633,951
Assets. Value of participant loans	2019-12-31	$32,557
Assets. Value of employer securities	2019-12-31	$143,450
Total contributions received or receivable from employer(s)	2019-12-31	$19,371
Value of certain deemed distributions of participant loans	2019-12-31	$1,822
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$8,810
2018 : COWBOY STATE BANCORP 401(K) PLAN 2018 401k financial data
Total plan liabilities at end of year	2018-12-31	$0
Total plan liabilities at beginning of year	2018-12-31	$0
Total income from all sources	2018-12-31	$39,412
Expenses. Total of all expenses incurred	2018-12-31	$8,830
Benefits paid (including direct rollovers)	2018-12-31	$80
Total plan assets at end of year	2018-12-31	$633,951
Total plan assets at beginning of year	2018-12-31	$603,369
Value of fidelity bond covering the plan	2018-12-31	$500,000
Total contributions received or receivable from participants	2018-12-31	$33,002
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$20,682
Other income received	2018-12-31	$-35,583
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$30,582
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$633,951
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$603,369
Assets. Value of participant loans	2018-12-31	$30,281
Assets. Value of employer securities	2018-12-31	$121,950
Total contributions received or receivable from employer(s)	2018-12-31	$21,311
Value of certain deemed distributions of participant loans	2018-12-31	$0
Value of corrective distributions	2018-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$8,750
2017 : COWBOY STATE BANCORP 401(K) PLAN 2017 401k financial data
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$105,396
Expenses. Total of all expenses incurred	2017-12-31	$65,997
Benefits paid (including direct rollovers)	2017-12-31	$57,777
Total plan assets at end of year	2017-12-31	$603,369
Total plan assets at beginning of year	2017-12-31	$563,970
Value of fidelity bond covering the plan	2017-12-31	$500,000
Total contributions received or receivable from participants	2017-12-31	$27,494
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$187
Other income received	2017-12-31	$56,991
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$39,399
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$603,369
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$563,970
Assets. Value of participant loans	2017-12-31	$25,402
Assets. Value of employer securities	2017-12-31	$135,242
Total contributions received or receivable from employer(s)	2017-12-31	$20,724
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$8,220
2016 : COWBOY STATE BANCORP 401(K) PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$91,470
Expenses. Total of all expenses incurred	2016-12-31	$53,528
Benefits paid (including direct rollovers)	2016-12-31	$53,075
Total plan assets at end of year	2016-12-31	$563,970
Total plan assets at beginning of year	2016-12-31	$526,028
Value of fidelity bond covering the plan	2016-12-31	$500,000
Total contributions received or receivable from participants	2016-12-31	$37,031
Expenses. Other expenses not covered elsewhere	2016-12-31	$453
Contributions received from other sources (not participants or employers)	2016-12-31	$352
Other income received	2016-12-31	$36,747
Net income (gross income less expenses)	2016-12-31	$37,942
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$563,970
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$526,028
Total contributions received or receivable from employer(s)	2016-12-31	$17,340
2015 : COWBOY STATE BANCORP 401(K) PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$32,985
Expenses. Total of all expenses incurred	2015-12-31	$26,102
Benefits paid (including direct rollovers)	2015-12-31	$25,736
Total plan assets at end of year	2015-12-31	$526,028
Total plan assets at beginning of year	2015-12-31	$519,145
Value of fidelity bond covering the plan	2015-12-31	$500,000
Total contributions received or receivable from participants	2015-12-31	$28,988
Other income received	2015-12-31	$-13,331
Net income (gross income less expenses)	2015-12-31	$6,883
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$526,028
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$519,145
Total contributions received or receivable from employer(s)	2015-12-31	$17,328
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$366
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : COWBOY STATE BANCORP 401(K) PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$54,367
Expenses. Total of all expenses incurred	2014-12-31	$14,908
Benefits paid (including direct rollovers)	2014-12-31	$14,147
Total plan assets at end of year	2014-12-31	$519,145
Total plan assets at beginning of year	2014-12-31	$479,686
Total contributions received or receivable from participants	2014-12-31	$25,662
Other income received	2014-12-31	$12,308
Net income (gross income less expenses)	2014-12-31	$39,459
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$519,145
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$479,686
Total contributions received or receivable from employer(s)	2014-12-31	$16,397
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$761
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : COWBOY STATE BANCORP 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$63,606
Expenses. Total of all expenses incurred	2013-12-31	$65,404
Benefits paid (including direct rollovers)	2013-12-31	$65,149
Total plan assets at end of year	2013-12-31	$479,686
Total plan assets at beginning of year	2013-12-31	$481,484
Total contributions received or receivable from participants	2013-12-31	$23,569
Other income received	2013-12-31	$24,527
Net income (gross income less expenses)	2013-12-31	$-1,798
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$479,686
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$481,484
Total contributions received or receivable from employer(s)	2013-12-31	$15,510
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$255
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : COWBOY STATE BANCORP 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$83,644
Expenses. Total of all expenses incurred	2012-12-31	$11,109
Benefits paid (including direct rollovers)	2012-12-31	$10,939
Total plan assets at end of year	2012-12-31	$481,484
Total plan assets at beginning of year	2012-12-31	$408,949
Total contributions received or receivable from participants	2012-12-31	$33,396
Contributions received from other sources (not participants or employers)	2012-12-31	$15,189
Other income received	2012-12-31	$18,767
Net income (gross income less expenses)	2012-12-31	$72,535
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$481,484
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$408,949
Assets. Value of employer securities	2012-12-31	$357,657
Total contributions received or receivable from employer(s)	2012-12-31	$16,292
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$170
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : COWBOY STATE BANCORP 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$86,712
Expenses. Total of all expenses incurred	2011-12-31	$47,958
Benefits paid (including direct rollovers)	2011-12-31	$47,595
Total plan assets at end of year	2011-12-31	$408,949
Total plan assets at beginning of year	2011-12-31	$370,195
Total contributions received or receivable from participants	2011-12-31	$42,367
Contributions received from other sources (not participants or employers)	2011-12-31	$12,419
Other income received	2011-12-31	$13,620
Net income (gross income less expenses)	2011-12-31	$38,754
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$408,949
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$370,195
Assets. Value of employer securities	2011-12-31	$278,214
Total contributions received or receivable from employer(s)	2011-12-31	$18,306
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$363
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : COWBOY STATE BANCORP 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$77,656
Expenses. Total of all expenses incurred	2010-12-31	$54,874
Benefits paid (including direct rollovers)	2010-12-31	$54,566
Total plan assets at end of year	2010-12-31	$364,949
Total plan assets at beginning of year	2010-12-31	$342,167
Value of fidelity bond covering the plan	2010-12-31	$27,500
Total contributions received or receivable from participants	2010-12-31	$35,884
Contributions received from other sources (not participants or employers)	2010-12-31	$1,502
Other income received	2010-12-31	$21,028
Net income (gross income less expenses)	2010-12-31	$22,782
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$364,949
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$342,167
Assets. Value of employer securities	2010-12-31	$114,333
Total contributions received or receivable from employer(s)	2010-12-31	$19,242
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$308
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : COWBOY STATE BANCORP 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for COWBOY STATE BANCORP 401(K) PLAN

2022: COWBOY STATE BANCORP 401(K) PLAN 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 – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: COWBOY STATE BANCORP 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: COWBOY STATE BANCORP 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	Yes
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 – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: COWBOY STATE BANCORP 401(K) PLAN 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 – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: COWBOY STATE BANCORP 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	Yes
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: COWBOY STATE BANCORP 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	Yes
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: COWBOY STATE BANCORP 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: COWBOY STATE BANCORP 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: COWBOY STATE BANCORP 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: COWBOY STATE BANCORP 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: COWBOY STATE BANCORP 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: COWBOY STATE BANCORP 401(K) PLAN 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: COWBOY STATE BANCORP 401(K) PLAN 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 – 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

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-824398

Policy instance

Insurance contract or identification number	GA-824398
Number of Individuals Covered	15
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,439
Total amount of fees paid to insurance company	USD $180
Are there contracts with allocated funds for individual policies?	No
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?	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,439
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Insurance broker name	THE RETIREMENT ADVANTAGE INC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-824398

Policy instance

Insurance contract or identification number	GA-824398
Number of Individuals Covered	16
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,308
Total amount of fees paid to insurance company	USD $163
Are there contracts with allocated funds for individual policies?	No
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?	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,308
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Insurance broker name	THE RETIREMENT ADVANTAGE INC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-824398

Policy instance

Insurance contract or identification number	GA-824398
Number of Individuals Covered	19
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,302
Total amount of fees paid to insurance company	USD $163
Are there contracts with allocated funds for individual policies?	No
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?	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,302
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Insurance broker name	DONALD ESHBACH

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

057135-K

Policy instance

Insurance contract or identification number	057135-K
Number of Individuals Covered	20
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,226
Total amount of fees paid to insurance company	USD $153
Are there contracts with allocated funds for individual policies?	No
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?	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,226
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Insurance broker name	DONALD ESHBACH

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

057135-K

Policy instance

Insurance contract or identification number	057135-K
Number of Individuals Covered	0
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Are there contracts with allocated funds for individual policies?	No
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?	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

824398

Policy instance

Insurance contract or identification number	824398
Number of Individuals Covered	18
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $706
Total amount of fees paid to insurance company	USD $88
Are there contracts with allocated funds for individual policies?	No
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?	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

057135-K

Policy instance

Insurance contract or identification number	057135-K
Number of Individuals Covered	20
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $47
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	COWBOY STATE BANCORP
Employer identification number (EIN):	830332645
NAIC Classification:	522110
NAIC Description:	Commercial Banking