401k Plan data: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. plan

THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 401k Plan overview

Plan Name	THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC.
Plan identification number	002

THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 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.
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

CHEYENNE VILLAGE, INC. has sponsored the creation of one or more 401k plans.

Company Name: CHEYENNE VILLAGE, INC.

Employer identification number (EIN): 846051921

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Additional information about CHEYENNE VILLAGE, INC.

Jurisdiction of Incorporation: Colorado Department of State

Incorporation Date: 1967-11-30

Company Identification Number: 19871234097

Legal Registered Office Address: 6275 Lehman Drive

Colorado Springs
United States of America (USA)
80918

More information about CHEYENNE VILLAGE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC.

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 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 B. JEANNE SOLZE
002 2016-01-01 B. JEANNE SOLZE
002 2016-01-01
002 2016-01-01 B. JEANNE SOLZE 2017-10-11
002 2015-01-01 B JEANNE SOLZE B JEANNE SOLZE 2016-10-14
002 2014-07-01 B. JEANNE SOLZE B. JEANNE SOLZE 2015-07-20
002 2013-07-01 B. JEANNE SOLZE B. JEANNE SOLZE 2015-01-29
002 2012-07-01 B. JEANNE SOLZE B. JEANNE SOLZE 2014-01-28
002 2011-07-01 B. JEANNE SOLZE B. JEANNE SOLZE 2013-04-12
002 2010-07-01 B. JEANNE SOLZE B. JEANNE SOLZE 2012-03-28
002 2009-07-01 B. JEANNE SOLZE B. JEANNE SOLZE 2011-03-16

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	B. JEANNE SOLZE
002	2016-01-01	B. JEANNE SOLZE
002	2016-01-01
002	2016-01-01		B. JEANNE SOLZE	2017-10-11
002	2015-01-01	B JEANNE SOLZE	B JEANNE SOLZE	2016-10-14
002	2014-07-01	B. JEANNE SOLZE	B. JEANNE SOLZE	2015-07-20
002	2013-07-01	B. JEANNE SOLZE	B. JEANNE SOLZE	2015-01-29
002	2012-07-01	B. JEANNE SOLZE	B. JEANNE SOLZE	2014-01-28
002	2011-07-01	B. JEANNE SOLZE	B. JEANNE SOLZE	2013-04-12
002	2010-07-01	B. JEANNE SOLZE	B. JEANNE SOLZE	2012-03-28
002	2009-07-01	B. JEANNE SOLZE	B. JEANNE SOLZE	2011-03-16

Plan Statistics for THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC.

401k plan membership statisitcs for THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC.

Measure Date Value
2022: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 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 61
Number of retired or separated participants receiving benefits 2022-01-01 1
Number of other retired or separated participants entitled to future benefits 2022-01-01 20
Total of all active and inactive participants 2022-01-01 82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 82
Number of participants with account balances 2022-01-01 78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2021 401k membership
Total participants, beginning-of-year 2021-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 67
Number of retired or separated participants receiving benefits 2021-01-01 14
Number of other retired or separated participants entitled to future benefits 2021-01-01 49
Total of all active and inactive participants 2021-01-01 130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 130
Number of participants with account balances 2021-01-01 121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2020 401k membership
Total participants, beginning-of-year 2020-01-01 137
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 82
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 55
Total of all active and inactive participants 2020-01-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 137
Number of participants with account balances 2020-01-01 132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2019 401k membership
Total participants, beginning-of-year 2019-01-01 117
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 82
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 54
Total of all active and inactive participants 2019-01-01 136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 136
Number of participants with account balances 2019-01-01 123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2018 401k membership
Total participants, beginning-of-year 2018-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 87
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 30
Total of all active and inactive participants 2018-01-01 117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 117
Number of participants with account balances 2018-01-01 107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2017 401k membership
Total participants, beginning-of-year 2017-01-01 92
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 91
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 21
Total of all active and inactive participants 2017-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 113
Number of participants with account balances 2017-01-01 107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2016 401k membership
Total participants, beginning-of-year 2016-01-01 102
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 93
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 22
Total of all active and inactive participants 2016-01-01 115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 1
Total participants 2016-01-01 116
Number of participants with account balances 2016-01-01 92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 11
2015: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2015 401k membership
Total participants, beginning-of-year 2015-01-01 135
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 106
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 12
Total of all active and inactive participants 2015-01-01 118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 1
Total participants 2015-01-01 119
Number of participants with account balances 2015-01-01 102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 2
2014: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2014 401k membership
Total participants, beginning-of-year 2014-07-01 130
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 97
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 38
Total of all active and inactive participants 2014-07-01 135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 135
Number of participants with account balances 2014-07-01 135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 4
2013: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2013 401k membership
Total participants, beginning-of-year 2013-07-01 109
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 102
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 28
Total of all active and inactive participants 2013-07-01 130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 130
Number of participants with account balances 2013-07-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 10
2012: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2012 401k membership
Total participants, beginning-of-year 2012-07-01 106
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 104
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 18
Total of all active and inactive participants 2012-07-01 122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 122
Number of participants with account balances 2012-07-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 6
2011: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2011 401k membership
Total participants, beginning-of-year 2011-07-01 123
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 103
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 21
Total of all active and inactive participants 2011-07-01 124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 124
Number of participants with account balances 2011-07-01 106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 13
2010: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2010 401k membership
Total participants, beginning-of-year 2010-07-01 114
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 103
Number of other retired or separated participants entitled to future benefits 2010-07-01 19
Total of all active and inactive participants 2010-07-01 122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-07-01 1
Total participants 2010-07-01 123
Number of participants with account balances 2010-07-01 111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-07-01 20
2009: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2009 401k membership
Total participants, beginning-of-year 2009-07-01 106
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 96
Number of retired or separated participants receiving benefits 2009-07-01 0
Number of other retired or separated participants entitled to future benefits 2009-07-01 18
Total of all active and inactive participants 2009-07-01 114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 114
Number of participants with account balances 2009-07-01 114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 13

Measure	Date	Value
2022: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 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	61
Number of retired or separated participants receiving benefits	2022-01-01	1
Number of other retired or separated participants entitled to future benefits	2022-01-01	20
Total of all active and inactive participants	2022-01-01	82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	82
Number of participants with account balances	2022-01-01	78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2021 401k membership
Total participants, beginning-of-year	2021-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	67
Number of retired or separated participants receiving benefits	2021-01-01	14
Number of other retired or separated participants entitled to future benefits	2021-01-01	49
Total of all active and inactive participants	2021-01-01	130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	130
Number of participants with account balances	2021-01-01	121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2020 401k membership
Total participants, beginning-of-year	2020-01-01	137
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	82
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	55
Total of all active and inactive participants	2020-01-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	137
Number of participants with account balances	2020-01-01	132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2019 401k membership
Total participants, beginning-of-year	2019-01-01	117
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	82
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	54
Total of all active and inactive participants	2019-01-01	136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	136
Number of participants with account balances	2019-01-01	123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2018 401k membership
Total participants, beginning-of-year	2018-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	87
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	30
Total of all active and inactive participants	2018-01-01	117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	117
Number of participants with account balances	2018-01-01	107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2017 401k membership
Total participants, beginning-of-year	2017-01-01	92
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	91
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	21
Total of all active and inactive participants	2017-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	113
Number of participants with account balances	2017-01-01	107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2016 401k membership
Total participants, beginning-of-year	2016-01-01	102
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	93
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	22
Total of all active and inactive participants	2016-01-01	115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	1
Total participants	2016-01-01	116
Number of participants with account balances	2016-01-01	92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	11
2015: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2015 401k membership
Total participants, beginning-of-year	2015-01-01	135
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	106
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	12
Total of all active and inactive participants	2015-01-01	118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	1
Total participants	2015-01-01	119
Number of participants with account balances	2015-01-01	102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	2
2014: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2014 401k membership
Total participants, beginning-of-year	2014-07-01	130
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	97
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	38
Total of all active and inactive participants	2014-07-01	135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	135
Number of participants with account balances	2014-07-01	135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	4
2013: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2013 401k membership
Total participants, beginning-of-year	2013-07-01	109
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	102
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	28
Total of all active and inactive participants	2013-07-01	130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	130
Number of participants with account balances	2013-07-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	10
2012: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2012 401k membership
Total participants, beginning-of-year	2012-07-01	106
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	104
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	18
Total of all active and inactive participants	2012-07-01	122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	122
Number of participants with account balances	2012-07-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	6
2011: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2011 401k membership
Total participants, beginning-of-year	2011-07-01	123
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	103
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	21
Total of all active and inactive participants	2011-07-01	124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	124
Number of participants with account balances	2011-07-01	106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	13
2010: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2010 401k membership
Total participants, beginning-of-year	2010-07-01	114
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	103
Number of other retired or separated participants entitled to future benefits	2010-07-01	19
Total of all active and inactive participants	2010-07-01	122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-07-01	1
Total participants	2010-07-01	123
Number of participants with account balances	2010-07-01	111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-07-01	20
2009: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2009 401k membership
Total participants, beginning-of-year	2009-07-01	106
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	96
Number of retired or separated participants receiving benefits	2009-07-01	0
Number of other retired or separated participants entitled to future benefits	2009-07-01	18
Total of all active and inactive participants	2009-07-01	114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	114
Number of participants with account balances	2009-07-01	114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	13

Financial Data on THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC.

Measure	Date	Value
2022 : THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 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	$-153,912
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$668,340
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$654,700
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	$262,140
Value of total assets at end of year	2022-12-31	$1,955,181
Value of total assets at beginning of year	2022-12-31	$2,777,433
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$13,640
Total income from rents	2022-12-31	$0
Total interest from all sources	2022-12-31	$2,675
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$54,049
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	$54,049
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	$1,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$173,377
Participant contributions at end of year	2022-12-31	$51,185
Participant contributions at beginning of year	2022-12-31	$63,614
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	$0
Administrative expenses (other) incurred	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	$-822,252
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$1,955,181
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$2,777,433
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	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$1,669,771
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$2,410,157
Interest on participant loans	2022-12-31	$2,675
Income. Interest from loans (other than to participants)	2022-12-31	$0
Interest earned on other investments	2022-12-31	$0
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	$234,225
Value of interest in common/collective trusts at beginning of year	2022-12-31	$303,662
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
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	$-479,184
Net investment gain/loss from pooled separate accounts	2022-12-31	$0
Net investment gain or loss from common/collective trusts	2022-12-31	$6,408
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	$88,763
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	$654,700
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	$13,640
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	STOCKMAN KAST RYAN AND CO, LLP
Accountancy firm EIN	2022-12-31	841509584
2021 : THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets	2021-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2021-12-31	$0
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Expenses. Interest paid	2021-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$660,470
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,065,809
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,046,887
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Value of total corrective distributions	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$274,307
Value of total assets at end of year	2021-12-31	$2,777,433
Value of total assets at beginning of year	2021-12-31	$3,182,772
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$18,922
Total income from rents	2021-12-31	$0
Total interest from all sources	2021-12-31	$3,585
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$341,939
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	$341,939
Assets. Real estate other than employer real property at end of year	2021-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2021-12-31	$0
Administrative expenses professional fees incurred	2021-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2021-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2021-12-31	$0
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,000,000
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	$180,278
Participant contributions at end of year	2021-12-31	$63,614
Participant contributions at beginning of year	2021-12-31	$83,761
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$0
Assets. Loans (other than to participants) at end of year	2021-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$0
Other income not declared elsewhere	2021-12-31	$-34
Administrative expenses (other) incurred	2021-12-31	$0
Total non interest bearing cash at end of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Income. Non cash contributions	2021-12-31	$0
Value of net income/loss	2021-12-31	$-405,339
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,777,433
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$3,182,772
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
Assets. partnership/joint venture interests at end of year	2021-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2021-12-31	$0
Investment advisory and management fees	2021-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$2,410,157
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$2,862,221
Interest on participant loans	2021-12-31	$3,585
Income. Interest from loans (other than to participants)	2021-12-31	$0
Interest earned on other investments	2021-12-31	$0
Income. Interest from US Government securities	2021-12-31	$0
Income. Interest from corporate debt instruments	2021-12-31	$0
Value of interest in master investment trust accounts at end of year	2021-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2021-12-31	$0
Value of interest in common/collective trusts at end of year	2021-12-31	$303,662
Value of interest in common/collective trusts at beginning of year	2021-12-31	$236,790
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2021-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2021-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Asset value of US Government securities at end of year	2021-12-31	$0
Asset value of US Government securities at beginning of year	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$34,062
Net investment gain/loss from pooled separate accounts	2021-12-31	$0
Net investment gain or loss from common/collective trusts	2021-12-31	$6,611
Net gain/loss from 103.12 investment entities	2021-12-31	$0
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
Assets. Invements in employer securities at end of year	2021-12-31	$0
Assets. Invements in employer securities at beginning of year	2021-12-31	$0
Assets. Value of employer real property at end of year	2021-12-31	$0
Assets. Value of employer real property at beginning of year	2021-12-31	$0
Contributions received in cash from employer	2021-12-31	$94,029
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$0
Income. Dividends from preferred stock	2021-12-31	$0
Income. Dividends from common stock	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,046,887
Asset. Corporate debt instrument preferred debt at end of year	2021-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2021-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2021-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2021-12-31	$0
Contract administrator fees	2021-12-31	$18,922
Assets. Corporate common stocks other than exployer securities at end of year	2021-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2021-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2021-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2021-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2021-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2021-12-31	$0
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
Aggregate proceeds on sale of assets	2021-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2021-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2021-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2021-12-31	$0
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	STOCKMAN KAST RYAN AND CO, LLP
Accountancy firm EIN	2021-12-31	841509584
2020 : THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets	2020-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2020-12-31	$0
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Expenses. Interest paid	2020-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$687,050
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$259,859
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$241,966
Expenses. Certain deemed distributions of participant loans	2020-12-31	$1,872
Value of total corrective distributions	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$272,608
Value of total assets at end of year	2020-12-31	$3,182,772
Value of total assets at beginning of year	2020-12-31	$2,755,581
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$16,021
Total income from rents	2020-12-31	$0
Total interest from all sources	2020-12-31	$3,730
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$100,938
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$100,938
Assets. Real estate other than employer real property at end of year	2020-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2020-12-31	$0
Administrative expenses professional fees incurred	2020-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2020-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2020-12-31	$0
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$169,180
Participant contributions at end of year	2020-12-31	$83,761
Participant contributions at beginning of year	2020-12-31	$65,312
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$3,763
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Assets. Loans (other than to participants) at end of year	2020-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$0
Other income not declared elsewhere	2020-12-31	$68
Administrative expenses (other) incurred	2020-12-31	$0
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$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	2020-12-31	No
Income. Non cash contributions	2020-12-31	$0
Value of net income/loss	2020-12-31	$427,191
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$3,182,772
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,755,581
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Assets. partnership/joint venture interests at end of year	2020-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2020-12-31	$0
Investment advisory and management fees	2020-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$2,862,221
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$2,451,548
Interest on participant loans	2020-12-31	$3,730
Income. Interest from loans (other than to participants)	2020-12-31	$0
Interest earned on other investments	2020-12-31	$0
Income. Interest from US Government securities	2020-12-31	$0
Income. Interest from corporate debt instruments	2020-12-31	$0
Value of interest in master investment trust accounts at end of year	2020-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2020-12-31	$0
Value of interest in common/collective trusts at end of year	2020-12-31	$236,790
Value of interest in common/collective trusts at beginning of year	2020-12-31	$238,721
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2020-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2020-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Asset value of US Government securities at end of year	2020-12-31	$0
Asset value of US Government securities at beginning of year	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$301,546
Net investment gain/loss from pooled separate accounts	2020-12-31	$0
Net investment gain or loss from common/collective trusts	2020-12-31	$8,160
Net gain/loss from 103.12 investment entities	2020-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Assets. Invements in employer securities at end of year	2020-12-31	$0
Assets. Invements in employer securities at beginning of year	2020-12-31	$0
Assets. Value of employer real property at end of year	2020-12-31	$0
Assets. Value of employer real property at beginning of year	2020-12-31	$0
Contributions received in cash from employer	2020-12-31	$99,665
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$0
Income. Dividends from preferred stock	2020-12-31	$0
Income. Dividends from common stock	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$241,966
Asset. Corporate debt instrument preferred debt at end of year	2020-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2020-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2020-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2020-12-31	$0
Contract administrator fees	2020-12-31	$16,021
Assets. Corporate common stocks other than exployer securities at end of year	2020-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2020-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2020-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2020-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2020-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2020-12-31	$0
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Aggregate proceeds on sale of assets	2020-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2020-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2020-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2020-12-31	$0
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	STOCKMAN KAST RYAN AND CO, LLP
Accountancy firm EIN	2020-12-31	841509584
2019 : THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets	2019-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Expenses. Interest paid	2019-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$772,513
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$244,407
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$223,216
Expenses. Certain deemed distributions of participant loans	2019-12-31	$7,121
Value of total corrective distributions	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$289,866
Value of total assets at end of year	2019-12-31	$2,755,581
Value of total assets at beginning of year	2019-12-31	$2,227,475
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$14,070
Total income from rents	2019-12-31	$0
Total interest from all sources	2019-12-31	$3,840
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$71,362
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$71,362
Assets. Real estate other than employer real property at end of year	2019-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2019-12-31	$0
Administrative expenses professional fees incurred	2019-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2019-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$140,721
Participant contributions at end of year	2019-12-31	$65,312
Participant contributions at beginning of year	2019-12-31	$85,767
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Assets. Loans (other than to participants) at end of year	2019-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$100
Administrative expenses (other) incurred	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$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	2019-12-31	No
Income. Non cash contributions	2019-12-31	$0
Value of net income/loss	2019-12-31	$528,106
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,755,581
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,227,475
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Assets. partnership/joint venture interests at end of year	2019-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2019-12-31	$0
Investment advisory and management fees	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$2,451,548
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,894,858
Interest on participant loans	2019-12-31	$3,840
Income. Interest from loans (other than to participants)	2019-12-31	$0
Interest earned on other investments	2019-12-31	$0
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from corporate debt instruments	2019-12-31	$0
Value of interest in master investment trust accounts at end of year	2019-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2019-12-31	$0
Value of interest in common/collective trusts at end of year	2019-12-31	$238,721
Value of interest in common/collective trusts at beginning of year	2019-12-31	$246,850
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2019-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Asset value of US Government securities at end of year	2019-12-31	$0
Asset value of US Government securities at beginning of year	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$401,400
Net investment gain/loss from pooled separate accounts	2019-12-31	$0
Net investment gain or loss from common/collective trusts	2019-12-31	$5,945
Net gain/loss from 103.12 investment entities	2019-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Assets. Invements in employer securities at end of year	2019-12-31	$0
Assets. Invements in employer securities at beginning of year	2019-12-31	$0
Assets. Value of employer real property at end of year	2019-12-31	$0
Assets. Value of employer real property at beginning of year	2019-12-31	$0
Contributions received in cash from employer	2019-12-31	$149,145
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Income. Dividends from preferred stock	2019-12-31	$0
Income. Dividends from common stock	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$223,216
Asset. Corporate debt instrument preferred debt at end of year	2019-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2019-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2019-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2019-12-31	$0
Contract administrator fees	2019-12-31	$14,070
Assets. Corporate common stocks other than exployer securities at end of year	2019-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2019-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2019-12-31	$0
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Aggregate proceeds on sale of assets	2019-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	STOCKMAN KAST RYAN AND CO, LLP
Accountancy firm EIN	2019-12-31	841509584
2018 : THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets	2018-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2018-12-31	$0
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Expenses. Interest paid	2018-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$178,028
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$153,395
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$129,864
Expenses. Certain deemed distributions of participant loans	2018-12-31	$6,908
Value of total corrective distributions	2018-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$302,825
Value of total assets at end of year	2018-12-31	$2,227,475
Value of total assets at beginning of year	2018-12-31	$2,202,842
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$16,623
Total income from rents	2018-12-31	$0
Total interest from all sources	2018-12-31	$4,129
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$73,281
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	$73,281
Assets. Real estate other than employer real property at end of year	2018-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2018-12-31	$0
Administrative expenses professional fees incurred	2018-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2018-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$161,115
Participant contributions at end of year	2018-12-31	$85,767
Participant contributions at beginning of year	2018-12-31	$78,466
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2018-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	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
Assets. Loans (other than to participants) at end of year	2018-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Other income not declared elsewhere	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$0
Total non interest bearing cash at end of year	2018-12-31	$0
Total non interest bearing cash at beginning of year	2018-12-31	$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	2018-12-31	No
Income. Non cash contributions	2018-12-31	$0
Value of net income/loss	2018-12-31	$24,633
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,227,475
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,202,842
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
Assets. partnership/joint venture interests at end of year	2018-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2018-12-31	$0
Investment advisory and management fees	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$1,894,858
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$1,898,072
Interest on participant loans	2018-12-31	$4,129
Income. Interest from loans (other than to participants)	2018-12-31	$0
Interest earned on other investments	2018-12-31	$0
Income. Interest from US Government securities	2018-12-31	$0
Income. Interest from corporate debt instruments	2018-12-31	$0
Value of interest in master investment trust accounts at end of year	2018-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2018-12-31	$0
Value of interest in common/collective trusts at end of year	2018-12-31	$246,850
Value of interest in common/collective trusts at beginning of year	2018-12-31	$226,304
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2018-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2018-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Asset value of US Government securities at end of year	2018-12-31	$0
Asset value of US Government securities at beginning of year	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-209,653
Net investment gain/loss from pooled separate accounts	2018-12-31	$0
Net investment gain or loss from common/collective trusts	2018-12-31	$7,446
Net gain/loss from 103.12 investment entities	2018-12-31	$0
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	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Assets. Invements in employer securities at end of year	2018-12-31	$0
Assets. Invements in employer securities at beginning of year	2018-12-31	$0
Assets. Value of employer real property at end of year	2018-12-31	$0
Assets. Value of employer real property at beginning of year	2018-12-31	$0
Contributions received in cash from employer	2018-12-31	$141,710
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$0
Income. Dividends from preferred stock	2018-12-31	$0
Income. Dividends from common stock	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$129,864
Asset. Corporate debt instrument preferred debt at end of year	2018-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2018-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2018-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2018-12-31	$0
Contract administrator fees	2018-12-31	$16,623
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	2018-12-31	No
Assets. Corporate common stocks other than exployer securities at end of year	2018-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2018-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2018-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2018-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2018-12-31	$0
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
Aggregate proceeds on sale of assets	2018-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2018-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2018-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2018-12-31	$0
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	STOCKMAN KAST RYAN AND CO, LLP
Accountancy firm EIN	2018-12-31	841509584
2017 : THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$589,144
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$168,896
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$163,383
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$339,669
Value of total assets at end of year	2017-12-31	$2,202,842
Value of total assets at beginning of year	2017-12-31	$1,782,594
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$5,513
Total interest from all sources	2017-12-31	$50,032
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$148,743
Participant contributions at end of year	2017-12-31	$78,466
Participant contributions at beginning of year	2017-12-31	$88,735
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$42,833
Other income not declared elsewhere	2017-12-31	$60
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	$420,248
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,202,842
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,782,594
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
Investment advisory and management fees	2017-12-31	$336
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$1,898,072
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$0
Value of interest in pooled separate accounts at end of year	2017-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$1,290,135
Interest on participant loans	2017-12-31	$3,124
Interest earned on other investments	2017-12-31	$46,908
Value of interest in common/collective trusts at end of year	2017-12-31	$226,304
Value of interest in common/collective trusts at beginning of year	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$403,724
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$131,718
Net investment gain/loss from pooled separate accounts	2017-12-31	$67,665
Net investment gain or loss from common/collective trusts	2017-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$148,093
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$163,383
Contract administrator fees	2017-12-31	$5,177
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	Yes
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	STOCKMAN KAST RYAN AND CO, LLP
Accountancy firm EIN	2017-12-31	841509584
2016 : THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$286,942
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$45,684
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$42,658
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	$192,675
Value of total assets at end of year	2016-12-31	$1,782,594
Value of total assets at beginning of year	2016-12-31	$1,541,336
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$3,026
Total interest from all sources	2016-12-31	$8,610
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$119,714
Participant contributions at end of year	2016-12-31	$88,735
Participant contributions at beginning of year	2016-12-31	$69,805
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$991
Other income not declared elsewhere	2016-12-31	$0
Administrative expenses (other) incurred	2016-12-31	$3,026
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	$241,258
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,782,594
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,541,336
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$1,290,135
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$869,963
Value of interest in pooled separate accounts at end of year	2016-12-31	$1,290,135
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$869,963
Interest on participant loans	2016-12-31	$3,095
Interest earned on other investments	2016-12-31	$5,515
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$403,724
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$601,568
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Net investment gain/loss from pooled separate accounts	2016-12-31	$85,657
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	$71,970
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$42,658
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	STOCKMAN KAST RYAN AND CO, LLP
Accountancy firm EIN	2016-12-31	841509584
2015 : THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$247,439
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$204,686
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$203,128
Expenses. Certain deemed distributions of participant loans	2015-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$252,188
Value of total assets at end of year	2015-12-31	$1,541,336
Value of total assets at beginning of year	2015-12-31	$1,498,583
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,558
Total interest from all sources	2015-12-31	$9,202
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$122,127
Participant contributions at end of year	2015-12-31	$69,805
Participant contributions at beginning of year	2015-12-31	$81,256
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$64,940
Other income not declared elsewhere	2015-12-31	$0
Administrative expenses (other) incurred	2015-12-31	$1,558
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$42,753
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,541,336
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,498,583
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$869,963
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$824,131
Interest on participant loans	2015-12-31	$3,295
Interest earned on other investments	2015-12-31	$5,907
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$601,568
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$593,196
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$0
Net investment gain/loss from pooled separate accounts	2015-12-31	$-13,951
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$65,121
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$203,128
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	STOCKMAN KAST RYAN AND CO, LLP
Accountancy firm EIN	2015-12-31	841509584
2014 : THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$106,526
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$63,511
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$58,623
Expenses. Certain deemed distributions of participant loans	2014-12-31	$4,046
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$92,693
Value of total assets at end of year	2014-12-31	$1,498,583
Value of total assets at beginning of year	2014-12-31	$1,455,568
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$842
Total interest from all sources	2014-12-31	$3,095
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$36,541
Participant contributions at end of year	2014-12-31	$81,256
Participant contributions at beginning of year	2014-12-31	$79,642
Administrative expenses (other) incurred	2014-12-31	$842
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$43,015
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,498,583
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,455,568
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in pooled separate accounts at end of year	2014-12-31	$824,131
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$809,506
Interest on participant loans	2014-12-31	$1,691
Interest earned on other investments	2014-12-31	$1,404
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$593,196
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$566,420
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$0
Net investment gain/loss from pooled separate accounts	2014-12-31	$10,738
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$56,152
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$58,623
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total income from all sources (including contributions)	2014-06-30	$274,912
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$164,522
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$154,825
Expenses. Certain deemed distributions of participant loans	2014-06-30	$7,603
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$142,247
Value of total assets at end of year	2014-06-30	$1,455,568
Value of total assets at beginning of year	2014-06-30	$1,345,178
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$2,094
Total interest from all sources	2014-06-30	$9,539
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$500,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$80,869
Participant contributions at end of year	2014-06-30	$79,642
Participant contributions at beginning of year	2014-06-30	$84,273
Administrative expenses (other) incurred	2014-06-30	$2,094
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Value of net income/loss	2014-06-30	$110,390
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$1,455,568
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$1,345,178
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of interest in pooled separate accounts at end of year	2014-06-30	$809,506
Value of interest in pooled separate accounts at beginning of year	2014-06-30	$624,644
Interest on participant loans	2014-06-30	$3,235
Interest earned on other investments	2014-06-30	$6,304
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$566,420
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$636,261
Expenses. Payments to insurance carriers foe the provision of benefits	2014-06-30	$0
Net investment gain/loss from pooled separate accounts	2014-06-30	$123,126
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Contributions received in cash from employer	2014-06-30	$61,378
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$154,825
Did the plan have assets held for investment	2014-06-30	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	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	STOCKMAN KAST RYAN AND CO, LLP
Accountancy firm EIN	2014-06-30	841509584
2013 : THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total income from all sources (including contributions)	2013-06-30	$223,685
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$94,092
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$91,962
Expenses. Certain deemed distributions of participant loans	2013-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$135,426
Value of total assets at end of year	2013-06-30	$1,345,178
Value of total assets at beginning of year	2013-06-30	$1,215,585
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$2,130
Total interest from all sources	2013-06-30	$11,146
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$500,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$80,764
Participant contributions at end of year	2013-06-30	$84,273
Participant contributions at beginning of year	2013-06-30	$88,489
Income. Received or receivable in cash from other sources (including rollovers)	2013-06-30	$905
Administrative expenses (other) incurred	2013-06-30	$2,130
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$129,593
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$1,345,178
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$1,215,585
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Value of interest in pooled separate accounts at end of year	2013-06-30	$624,644
Value of interest in pooled separate accounts at beginning of year	2013-06-30	$601,122
Interest on participant loans	2013-06-30	$3,378
Interest earned on other investments	2013-06-30	$7,768
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$636,261
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$525,974
Expenses. Payments to insurance carriers foe the provision of benefits	2013-06-30	$0
Net investment gain/loss from pooled separate accounts	2013-06-30	$77,113
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	No
Was there a failure to transmit to the plan any participant contributions	2013-06-30	No
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Contributions received in cash from employer	2013-06-30	$53,757
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$91,962
Did the plan have assets held for investment	2013-06-30	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	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	STOCKMAN KAST RYAN & COMPANY, LLP
Accountancy firm EIN	2013-06-30	841509584
2012 : THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total income from all sources (including contributions)	2012-06-30	$152,710
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$35,026
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$31,535
Expenses. Certain deemed distributions of participant loans	2012-06-30	$1,258
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$141,537
Value of total assets at end of year	2012-06-30	$1,215,585
Value of total assets at beginning of year	2012-06-30	$1,097,901
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$2,233
Total interest from all sources	2012-06-30	$11,839
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$500,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$80,581
Participant contributions at end of year	2012-06-30	$88,489
Participant contributions at beginning of year	2012-06-30	$51,054
Income. Received or receivable in cash from other sources (including rollovers)	2012-06-30	$29,752
Other income not declared elsewhere	2012-06-30	$0
Administrative expenses (other) incurred	2012-06-30	$2,233
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$117,684
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$1,215,585
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$1,097,901
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest in pooled separate accounts at end of year	2012-06-30	$601,122
Value of interest in pooled separate accounts at beginning of year	2012-06-30	$604,823
Interest on participant loans	2012-06-30	$2,389
Interest earned on other investments	2012-06-30	$9,450
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$525,974
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$442,024
Expenses. Payments to insurance carriers foe the provision of benefits	2012-06-30	$0
Net investment gain/loss from pooled separate accounts	2012-06-30	$-666
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Contributions received in cash from employer	2012-06-30	$31,204
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$31,535
Did the plan have assets held for investment	2012-06-30	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	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	STOCKMAN KAST RYAN & CO., LLP
Accountancy firm EIN	2012-06-30	841509584
2011 : THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2011 401k financial data
Total income from all sources	2011-06-30	$358,402
Expenses. Total of all expenses incurred	2011-06-30	$134,492
Benefits paid (including direct rollovers)	2011-06-30	$88,542
Total plan assets at end of year	2011-06-30	$1,097,901
Total plan assets at beginning of year	2011-06-30	$873,991
Value of fidelity bond covering the plan	2011-06-30	$1,000,000
Total contributions received or receivable from participants	2011-06-30	$78,329
Expenses. Other expenses not covered elsewhere	2011-06-30	$45,950
Contributions received from other sources (not participants or employers)	2011-06-30	$48,605
Other income received	2011-06-30	$131,832
Net income (gross income less expenses)	2011-06-30	$223,910
Net plan assets at end of year (total assets less liabilities)	2011-06-30	$1,097,901
Net plan assets at beginning of year (total assets less liabilities)	2011-06-30	$873,991
Assets. Value of participant loans	2011-06-30	$51,055
Total contributions received or receivable from employer(s)	2011-06-30	$99,636
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-06-30	$0
2010 : THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0

Form 5500 Responses for THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC.

2022: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 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 – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 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: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
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 – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 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
2015: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 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 – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2013: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2012: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2011: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2010: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	Submission has been amended	No
2010-07-01	This submission is the final filing	No
2010-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-07-01	Plan is a collectively bargained plan	No
2010-07-01	Plan funding arrangement – Insurance	Yes
2010-07-01	Plan funding arrangement – Trust	Yes
2010-07-01	Plan benefit arrangement – Insurance	Yes
2009: THE SAFE HARBOR 401(K) PROFIT SHARING PLAN OF CHEYENNE VILLAGE, INC. 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

007905-D

Policy instance

Insurance contract or identification number	007905-D
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $338
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	1
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
Amount paid for insurance broker fees	338
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?	3
Insurance broker name	DENVER REGIONAL OFFICE

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

Policy contract number

007905D

Policy instance

Insurance contract or identification number	007905D
Number of Individuals Covered	102
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $129
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	1
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 $0
Amount paid for insurance broker fees	129
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	DENVER REGIONAL OFFICE

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

Policy contract number

007905D

Policy instance

Insurance contract or identification number	007905D
Number of Individuals Covered	135
Insurance policy start date	2014-07-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $152
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	1
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 $0
Amount paid for insurance broker fees	152
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	DENVER REGIONAL OFFICE

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

Policy contract number

007905D

Policy instance

Insurance contract or identification number	007905D
Number of Individuals Covered	130
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $0
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	1
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 $0
Amount paid for insurance broker fees	88
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	DENVER REGIONAL OFFICE

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

Policy contract number

007905D

Policy instance

Insurance contract or identification number	007905D
Number of Individuals Covered	109
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $104
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	1
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 $0
Amount paid for insurance broker fees	39
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	KEITH BERSTLER

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

Policy contract number

007905D

Policy instance

Insurance contract or identification number	007905D
Number of Individuals Covered	106
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $416
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	1
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

007905D

Policy instance

Insurance contract or identification number	007905D
Number of Individuals Covered	112
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $165
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	1
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

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Company Name:	CHEYENNE VILLAGE, INC.
Employer identification number (EIN):	846051921
NAIC Classification:	624100
NAIC Description:	Individual and Family Services

Jurisdiction of Incorporation:	Colorado Department of State
Incorporation Date:	1967-11-30
Company Identification Number:	19871234097
Legal Registered Office Address:	6275 Lehman Drive Colorado Springs United States of America (USA) 80918