401k Plan data: JERRY & CAROLE FARMS, INC. 401K PLAN plan

JERRY & CAROLE FARMS, INC. 401K PLAN 401k Plan overview

Plan Name	JERRY & CAROLE FARMS, INC. 401K PLAN
Plan identification number	002

JERRY & CAROLE FARMS, INC. 401K PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
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.
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

JERRY & CAROLE FARMS, INC. has sponsored the creation of one or more 401k plans.

Company Name: JERRY & CAROLE FARMS, INC.

Employer identification number (EIN): 942312600

NAIC Classification: 111900
NAIC Description: Other Crop Farming

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JERRY & CAROLE FARMS, INC. 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-03-01
002 2015-03-01 CAROLE SOUTHAM 2016-04-29
002 2014-03-01 CAROLE SOUTHAM 2015-04-30
002 2013-03-01 CAROLE SOUTHAM
002 2012-03-01 CAROLE SOUTHAM
002 2011-03-01 CAROLE SOUTHAM
002 2010-03-01 CAROLE SOUTHAM
002 2009-03-01 CAROLE SOUTHAM
002 2009-03-01 CAROLE SOUTHAM
002 2008-03-01 CAROLE SOUTHAM
002 2007-03-01 CAROLE SOUTHAM

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2016-03-01
002	2015-03-01	CAROLE SOUTHAM	2016-04-29
002	2014-03-01	CAROLE SOUTHAM	2015-04-30
002	2013-03-01	CAROLE SOUTHAM
002	2012-03-01	CAROLE SOUTHAM
002	2011-03-01	CAROLE SOUTHAM
002	2010-03-01	CAROLE SOUTHAM
002	2009-03-01	CAROLE SOUTHAM
002	2009-03-01	CAROLE SOUTHAM
002	2008-03-01	CAROLE SOUTHAM
002	2007-03-01	CAROLE SOUTHAM

Plan Statistics for JERRY & CAROLE FARMS, INC. 401K PLAN

401k plan membership statisitcs for JERRY & CAROLE FARMS, INC. 401K PLAN

Measure Date Value
2013: JERRY & CAROLE FARMS, INC. 401K PLAN 2013 401k membership
Total participants, beginning-of-year 2013-03-01 8
Total number of active participants reported on line 7a of the Form 5500 2013-03-01 6
Number of retired or separated participants receiving benefits 2013-03-01 0
Number of other retired or separated participants entitled to future benefits 2013-03-01 1
Total of all active and inactive participants 2013-03-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-03-01 0
Total participants 2013-03-01 7
Number of participants with account balances 2013-03-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-03-01 0
2012: JERRY & CAROLE FARMS, INC. 401K PLAN 2012 401k membership
Total participants, beginning-of-year 2012-03-01 8
Total number of active participants reported on line 7a of the Form 5500 2012-03-01 6
Number of retired or separated participants receiving benefits 2012-03-01 0
Number of other retired or separated participants entitled to future benefits 2012-03-01 2
Total of all active and inactive participants 2012-03-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-03-01 0
Total participants 2012-03-01 8
Number of participants with account balances 2012-03-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-03-01 0
2011: JERRY & CAROLE FARMS, INC. 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-03-01 7
Total number of active participants reported on line 7a of the Form 5500 2011-03-01 5
Number of retired or separated participants receiving benefits 2011-03-01 0
Number of other retired or separated participants entitled to future benefits 2011-03-01 2
Total of all active and inactive participants 2011-03-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-03-01 0
Total participants 2011-03-01 7
Number of participants with account balances 2011-03-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-03-01 0
2010: JERRY & CAROLE FARMS, INC. 401K PLAN 2010 401k membership
Total participants, beginning-of-year 2010-03-01 6
Total number of active participants reported on line 7a of the Form 5500 2010-03-01 5
Number of retired or separated participants receiving benefits 2010-03-01 0
Number of other retired or separated participants entitled to future benefits 2010-03-01 1
Total of all active and inactive participants 2010-03-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-03-01 0
Total participants 2010-03-01 6
Number of participants with account balances 2010-03-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-03-01 0
2009: JERRY & CAROLE FARMS, INC. 401K PLAN 2009 401k membership
Total participants, beginning-of-year 2009-03-01 6
Total number of active participants reported on line 7a of the Form 5500 2009-03-01 6
Number of retired or separated participants receiving benefits 2009-03-01 0
Number of other retired or separated participants entitled to future benefits 2009-03-01 0
Total of all active and inactive participants 2009-03-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-03-01 0
Total participants 2009-03-01 6
Number of participants with account balances 2009-03-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-03-01 0
2008: JERRY & CAROLE FARMS, INC. 401K PLAN 2008 401k membership
Total participants, beginning-of-year 2008-03-01 6
Total number of active participants reported on line 7a of the Form 5500 2008-03-01 6
Number of retired or separated participants receiving benefits 2008-03-01 0
Number of other retired or separated participants entitled to future benefits 2008-03-01 0
Total of all active and inactive participants 2008-03-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-03-01 0
Total participants 2008-03-01 6
Number of participants with account balances 2008-03-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-03-01 0
2007: JERRY & CAROLE FARMS, INC. 401K PLAN 2007 401k membership
Total participants, beginning-of-year 2007-03-01 6
Total number of active participants reported on line 7a of the Form 5500 2007-03-01 6
Number of retired or separated participants receiving benefits 2007-03-01 0
Number of other retired or separated participants entitled to future benefits 2007-03-01 0
Total of all active and inactive participants 2007-03-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2007-03-01 0
Total participants 2007-03-01 6
Number of participants with account balances 2007-03-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2007-03-01 0

Measure	Date	Value
2013: JERRY & CAROLE FARMS, INC. 401K PLAN 2013 401k membership
Total participants, beginning-of-year	2013-03-01	8
Total number of active participants reported on line 7a of the Form 5500	2013-03-01	6
Number of retired or separated participants receiving benefits	2013-03-01	0
Number of other retired or separated participants entitled to future benefits	2013-03-01	1
Total of all active and inactive participants	2013-03-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-03-01	0
Total participants	2013-03-01	7
Number of participants with account balances	2013-03-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-03-01	0
2012: JERRY & CAROLE FARMS, INC. 401K PLAN 2012 401k membership
Total participants, beginning-of-year	2012-03-01	8
Total number of active participants reported on line 7a of the Form 5500	2012-03-01	6
Number of retired or separated participants receiving benefits	2012-03-01	0
Number of other retired or separated participants entitled to future benefits	2012-03-01	2
Total of all active and inactive participants	2012-03-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-03-01	0
Total participants	2012-03-01	8
Number of participants with account balances	2012-03-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-03-01	0
2011: JERRY & CAROLE FARMS, INC. 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-03-01	7
Total number of active participants reported on line 7a of the Form 5500	2011-03-01	5
Number of retired or separated participants receiving benefits	2011-03-01	0
Number of other retired or separated participants entitled to future benefits	2011-03-01	2
Total of all active and inactive participants	2011-03-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-03-01	0
Total participants	2011-03-01	7
Number of participants with account balances	2011-03-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-03-01	0
2010: JERRY & CAROLE FARMS, INC. 401K PLAN 2010 401k membership
Total participants, beginning-of-year	2010-03-01	6
Total number of active participants reported on line 7a of the Form 5500	2010-03-01	5
Number of retired or separated participants receiving benefits	2010-03-01	0
Number of other retired or separated participants entitled to future benefits	2010-03-01	1
Total of all active and inactive participants	2010-03-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-03-01	0
Total participants	2010-03-01	6
Number of participants with account balances	2010-03-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-03-01	0
2009: JERRY & CAROLE FARMS, INC. 401K PLAN 2009 401k membership
Total participants, beginning-of-year	2009-03-01	6
Total number of active participants reported on line 7a of the Form 5500	2009-03-01	6
Number of retired or separated participants receiving benefits	2009-03-01	0
Number of other retired or separated participants entitled to future benefits	2009-03-01	0
Total of all active and inactive participants	2009-03-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-03-01	0
Total participants	2009-03-01	6
Number of participants with account balances	2009-03-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-03-01	0
2008: JERRY & CAROLE FARMS, INC. 401K PLAN 2008 401k membership
Total participants, beginning-of-year	2008-03-01	6
Total number of active participants reported on line 7a of the Form 5500	2008-03-01	6
Number of retired or separated participants receiving benefits	2008-03-01	0
Number of other retired or separated participants entitled to future benefits	2008-03-01	0
Total of all active and inactive participants	2008-03-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-03-01	0
Total participants	2008-03-01	6
Number of participants with account balances	2008-03-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-03-01	0
2007: JERRY & CAROLE FARMS, INC. 401K PLAN 2007 401k membership
Total participants, beginning-of-year	2007-03-01	6
Total number of active participants reported on line 7a of the Form 5500	2007-03-01	6
Number of retired or separated participants receiving benefits	2007-03-01	0
Number of other retired or separated participants entitled to future benefits	2007-03-01	0
Total of all active and inactive participants	2007-03-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2007-03-01	0
Total participants	2007-03-01	6
Number of participants with account balances	2007-03-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2007-03-01	0

Financial Data on JERRY & CAROLE FARMS, INC. 401K PLAN

Measure	Date	Value
2014 : JERRY & CAROLE FARMS, INC. 401K PLAN 2014 401k financial data
Total plan liabilities at end of year	2014-02-28	$0
Total plan liabilities at beginning of year	2014-02-28	$0
Total income from all sources	2014-02-28	$29,065
Expenses. Total of all expenses incurred	2014-02-28	$13,099
Benefits paid (including direct rollovers)	2014-02-28	$6,472
Total plan assets at end of year	2014-02-28	$807,685
Total plan assets at beginning of year	2014-02-28	$791,719
Value of fidelity bond covering the plan	2014-02-28	$120,000
Total contributions received or receivable from participants	2014-02-28	$0
Expenses. Other expenses not covered elsewhere	2014-02-28	$151
Contributions received from other sources (not participants or employers)	2014-02-28	$0
Other income received	2014-02-28	$16,616
Noncash contributions received	2014-02-28	$0
Net income (gross income less expenses)	2014-02-28	$15,966
Net plan assets at end of year (total assets less liabilities)	2014-02-28	$807,685
Net plan assets at beginning of year (total assets less liabilities)	2014-02-28	$791,719
Assets. Value of assets in partnership/joint-venture interests	2014-02-28	$0
Total contributions received or receivable from employer(s)	2014-02-28	$12,449
Value of certain deemed distributions of participant loans	2014-02-28	$0
Value of corrective distributions	2014-02-28	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-02-28	$6,476
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-02-28	$0
2013 : JERRY & CAROLE FARMS, INC. 401K PLAN 2013 401k financial data
Transfers to/from the plan	2013-02-28	$0
Total plan liabilities at end of year	2013-02-28	$0
Total plan liabilities at beginning of year	2013-02-28	$0
Total income from all sources	2013-02-28	$65,855
Expenses. Total of all expenses incurred	2013-02-28	$116,463
Benefits paid (including direct rollovers)	2013-02-28	$110,201
Total plan assets at end of year	2013-02-28	$791,719
Total plan assets at beginning of year	2013-02-28	$842,327
Value of fidelity bond covering the plan	2013-02-28	$120,000
Total contributions received or receivable from participants	2013-02-28	$0
Expenses. Other expenses not covered elsewhere	2013-02-28	$0
Contributions received from other sources (not participants or employers)	2013-02-28	$0
Other income received	2013-02-28	$53,603
Noncash contributions received	2013-02-28	$0
Net income (gross income less expenses)	2013-02-28	$-50,608
Net plan assets at end of year (total assets less liabilities)	2013-02-28	$791,719
Net plan assets at beginning of year (total assets less liabilities)	2013-02-28	$842,327
Assets. Value of assets in partnership/joint-venture interests	2013-02-28	$57,063
Total contributions received or receivable from employer(s)	2013-02-28	$12,252
Value of certain deemed distributions of participant loans	2013-02-28	$0
Value of corrective distributions	2013-02-28	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-02-28	$6,262
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-02-28	$0
2012 : JERRY & CAROLE FARMS, INC. 401K PLAN 2012 401k financial data
Transfers to/from the plan	2012-02-29	$0
Total plan liabilities at end of year	2012-02-29	$0
Total plan liabilities at beginning of year	2012-02-29	$0
Total income from all sources	2012-02-29	$17,793
Expenses. Total of all expenses incurred	2012-02-29	$0
Benefits paid (including direct rollovers)	2012-02-29	$0
Total plan assets at end of year	2012-02-29	$842,327
Total plan assets at beginning of year	2012-02-29	$824,534
Value of fidelity bond covering the plan	2012-02-29	$120,000
Total contributions received or receivable from participants	2012-02-29	$0
Expenses. Other expenses not covered elsewhere	2012-02-29	$0
Contributions received from other sources (not participants or employers)	2012-02-29	$0
Other income received	2012-02-29	$7,125
Noncash contributions received	2012-02-29	$0
Net income (gross income less expenses)	2012-02-29	$17,793
Net plan assets at end of year (total assets less liabilities)	2012-02-29	$842,327
Net plan assets at beginning of year (total assets less liabilities)	2012-02-29	$824,534
Assets. Value of assets in partnership/joint-venture interests	2012-02-29	$57,063
Total contributions received or receivable from employer(s)	2012-02-29	$10,668
Value of certain deemed distributions of participant loans	2012-02-29	$0
Value of corrective distributions	2012-02-29	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-02-29	$0
2011 : JERRY & CAROLE FARMS, INC. 401K PLAN 2011 401k financial data
Transfers to/from the plan	2011-02-28	$0
Total plan liabilities at end of year	2011-02-28	$0
Total plan liabilities at beginning of year	2011-02-28	$0
Total income from all sources	2011-02-28	$75,529
Expenses. Total of all expenses incurred	2011-02-28	$0
Benefits paid (including direct rollovers)	2011-02-28	$0
Total plan assets at end of year	2011-02-28	$824,534
Total plan assets at beginning of year	2011-02-28	$749,005
Value of fidelity bond covering the plan	2011-02-28	$120,000
Total contributions received or receivable from participants	2011-02-28	$0
Expenses. Other expenses not covered elsewhere	2011-02-28	$0
Contributions received from other sources (not participants or employers)	2011-02-28	$0
Other income received	2011-02-28	$0
Noncash contributions received	2011-02-28	$65,952
Net income (gross income less expenses)	2011-02-28	$75,529
Net plan assets at end of year (total assets less liabilities)	2011-02-28	$824,534
Net plan assets at beginning of year (total assets less liabilities)	2011-02-28	$749,005
Assets. Value of assets in partnership/joint-venture interests	2011-02-28	$57,152
Total contributions received or receivable from employer(s)	2011-02-28	$9,577
Value of certain deemed distributions of participant loans	2011-02-28	$0
Value of corrective distributions	2011-02-28	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-02-28	$0
2010 : JERRY & CAROLE FARMS, INC. 401K PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-02-28	$0

Form 5500 Responses for JERRY & CAROLE FARMS, INC. 401K PLAN

2013: JERRY & CAROLE FARMS, INC. 401K PLAN 2013 form 5500 responses
2013-03-01	Type of plan entity	Single employer plan
2013-03-01	Submission has been amended	No
2013-03-01	This submission is the final filing	No
2013-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-03-01	Plan is a collectively bargained plan	No
2013-03-01	Plan funding arrangement – Insurance	Yes
2013-03-01	Plan funding arrangement – Trust	Yes
2013-03-01	Plan benefit arrangement – Insurance	Yes
2013-03-01	Plan benefit arrangement - Trust	Yes
2012: JERRY & CAROLE FARMS, INC. 401K PLAN 2012 form 5500 responses
2012-03-01	Type of plan entity	Single employer plan
2012-03-01	Submission has been amended	No
2012-03-01	This submission is the final filing	No
2012-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-03-01	Plan is a collectively bargained plan	No
2012-03-01	Plan funding arrangement – Insurance	Yes
2012-03-01	Plan funding arrangement – Trust	Yes
2012-03-01	Plan benefit arrangement – Insurance	Yes
2012-03-01	Plan benefit arrangement - Trust	Yes
2011: JERRY & CAROLE FARMS, INC. 401K PLAN 2011 form 5500 responses
2011-03-01	Type of plan entity	Single employer plan
2011-03-01	Submission has been amended	No
2011-03-01	This submission is the final filing	No
2011-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-03-01	Plan is a collectively bargained plan	No
2011-03-01	Plan funding arrangement – Insurance	Yes
2011-03-01	Plan funding arrangement – Trust	Yes
2011-03-01	Plan benefit arrangement – Insurance	Yes
2011-03-01	Plan benefit arrangement - Trust	Yes
2010: JERRY & CAROLE FARMS, INC. 401K PLAN 2010 form 5500 responses
2010-03-01	Type of plan entity	Single employer plan
2010-03-01	Submission has been amended	No
2010-03-01	This submission is the final filing	No
2010-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-03-01	Plan is a collectively bargained plan	No
2010-03-01	Plan funding arrangement – Insurance	Yes
2010-03-01	Plan funding arrangement – Trust	Yes
2010-03-01	Plan benefit arrangement – Insurance	Yes
2010-03-01	Plan benefit arrangement - Trust	Yes
2009: JERRY & CAROLE FARMS, INC. 401K PLAN 2009 form 5500 responses
2009-03-01	Type of plan entity	Single employer plan
2009-03-01	Submission has been amended	Yes
2009-03-01	This submission is the final filing	No
2009-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-03-01	Plan is a collectively bargained plan	No
2009-03-01	Plan funding arrangement – Insurance	Yes
2009-03-01	Plan funding arrangement – Trust	Yes
2009-03-01	Plan benefit arrangement – Insurance	Yes
2009-03-01	Plan benefit arrangement - Trust	Yes
2008: JERRY & CAROLE FARMS, INC. 401K PLAN 2008 form 5500 responses
2008-03-01	Type of plan entity	Single employer plan
2008-03-01	Submission has been amended	Yes
2008-03-01	This submission is the final filing	No
2008-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-03-01	Plan is a collectively bargained plan	No
2008-03-01	Plan funding arrangement – Insurance	Yes
2008-03-01	Plan funding arrangement – Trust	Yes
2008-03-01	Plan benefit arrangement – Insurance	Yes
2008-03-01	Plan benefit arrangement - Trust	Yes
2007: JERRY & CAROLE FARMS, INC. 401K PLAN 2007 form 5500 responses
2007-03-01	Type of plan entity	Single employer plan
2007-03-01	Submission has been amended	Yes
2007-03-01	This submission is the final filing	No
2007-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-03-01	Plan is a collectively bargained plan	No
2007-03-01	Plan funding arrangement – Insurance	Yes
2007-03-01	Plan funding arrangement – Trust	Yes
2007-03-01	Plan benefit arrangement – Insurance	Yes
2007-03-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

96784

Policy instance

Insurance contract or identification number	96784
Number of Individuals Covered	3
Insurance policy start date	2013-03-01
Insurance policy end date	2014-02-28
Are there contracts with allocated funds for individual policies?	Yes
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

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

Policy contract number

96784

Policy instance

Insurance contract or identification number	96784
Number of Individuals Covered	3
Insurance policy start date	2011-03-01
Insurance policy end date	2012-02-29
Are there contracts with allocated funds for individual policies?	Yes
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

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

Policy contract number

96784

Policy instance

Insurance contract or identification number	96784
Number of Individuals Covered	3
Insurance policy start date	2010-03-01
Insurance policy end date	2011-02-28
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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

Potentially related plans

JERRY & JOHN GRIFFITH DBA GRIFFITH - GRAIN FARMS PROFIT-SHARING RETIREMENT PLAN & TRUST FOR SELF-EMPLOYED INDIVIDUALS [EIN = 610583243]

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Company Name:	JERRY & CAROLE FARMS, INC.
Employer identification number (EIN):	942312600
NAIC Classification:	111900
NAIC Description:	Other Crop Farming