401k Plan data: TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN plan

TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN 401k Plan overview

Plan Name	TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN
Plan identification number	001

TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

TWIN LAKES GOLF & COUNTRY CLUB has sponsored the creation of one or more 401k plans.

Company Name: TWIN LAKES GOLF & COUNTRY CLUB

Employer identification number (EIN): 910817896

NAIC Classification: 713900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 ROSS ROBINSON 2013-12-12
001 2012-01-01 ROSS ROBINSON 2013-07-03
001 2011-01-01 ROSS ROBINSON
001 2010-01-01 ROSS ROBINSON
001 2009-01-01
001 2009-01-01 CAROL BALESTRERI CAROL BALESTRERI 2010-08-09
001 2009-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	ROSS ROBINSON	2013-12-12
001	2012-01-01	ROSS ROBINSON	2013-07-03
001	2011-01-01	ROSS ROBINSON
001	2010-01-01	ROSS ROBINSON
001	2009-01-01
001	2009-01-01	CAROL BALESTRERI		CAROL BALESTRERI	2010-08-09
001	2009-01-01

Plan Statistics for TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN

401k plan membership statisitcs for TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN

Measure Date Value
2011: TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 26
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 17
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 6
Total of all active and inactive participants 2011-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 23
Number of participants with account balances 2011-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 27
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 17
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 9
Total of all active and inactive participants 2010-01-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 26
Number of participants with account balances 2010-01-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 30
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 18
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 9
Total of all active and inactive participants 2009-01-01 27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 27
Number of participants with account balances 2009-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	26
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	17
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	6
Total of all active and inactive participants	2011-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	23
Number of participants with account balances	2011-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	27
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	17
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	9
Total of all active and inactive participants	2010-01-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	26
Number of participants with account balances	2010-01-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	30
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	18
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	9
Total of all active and inactive participants	2009-01-01	27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	27
Number of participants with account balances	2009-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN

Measure	Date	Value
2011 : TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$4,046
Expenses. Total of all expenses incurred	2011-12-31	$60,057
Benefits paid (including direct rollovers)	2011-12-31	$59,547
Total plan assets at end of year	2011-12-31	$236,060
Total plan assets at beginning of year	2011-12-31	$292,071
Value of fidelity bond covering the plan	2011-12-31	$30,000
Total contributions received or receivable from participants	2011-12-31	$15,215
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-11,169
Net income (gross income less expenses)	2011-12-31	$-56,011
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$236,060
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$292,071
Total contributions received or receivable from employer(s)	2011-12-31	$0
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$510
2010 : TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$54,056
Expenses. Total of all expenses incurred	2010-12-31	$28,486
Benefits paid (including direct rollovers)	2010-12-31	$27,186
Total plan assets at end of year	2010-12-31	$292,071
Total plan assets at beginning of year	2010-12-31	$266,501
Value of fidelity bond covering the plan	2010-12-31	$30,000
Total contributions received or receivable from participants	2010-12-31	$16,615
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$33,443
Net income (gross income less expenses)	2010-12-31	$25,570
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$292,071
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$266,501
Total contributions received or receivable from employer(s)	2010-12-31	$3,998
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$1,300

Form 5500 Responses for TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN

2011: TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: TWIN LAKES GOLF & COUNTRY CLUB 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

931233

Policy instance

Insurance contract or identification number	931233
Number of Individuals Covered	14
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,243
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

931233

Policy instance

Insurance contract or identification number	931233
Number of Individuals Covered	17
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,182
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	TWIN LAKES GOLF & COUNTRY CLUB
Employer identification number (EIN):	910817896
NAIC Classification:	713900