401k Plan data: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN plan

GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 401k Plan overview

Plan Name	GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN
Plan identification number	002

GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING 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
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
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.
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

GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION

Employer identification number (EIN): 953447342

NAIC Classification: 621330
NAIC Description: Offices of Mental Health Practitioners (except Physicians)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 GEORGE PRATT 2023-10-16
002 2020-01-01 GEORGE PRATT 2021-10-14 GEORGE PRATT 2021-10-14
002 2018-01-01 GEORGE PRATT 2019-10-12 GEORGE PRATT 2019-10-12
002 2015-01-01 GEORGE PRATT
002 2014-01-01 GEORGE PRATT
002 2013-01-01 GEORGE PRATT
002 2012-01-01 GEORGE PRATT
002 2011-01-01 GEORGE PRATT
002 2009-01-01 GEORGE PRATT

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01	GEORGE PRATT	2023-10-16
002	2020-01-01	GEORGE PRATT	2021-10-14	GEORGE PRATT	2021-10-14
002	2018-01-01	GEORGE PRATT	2019-10-12	GEORGE PRATT	2019-10-12
002	2015-01-01	GEORGE PRATT
002	2014-01-01	GEORGE PRATT
002	2013-01-01	GEORGE PRATT
002	2012-01-01	GEORGE PRATT
002	2011-01-01	GEORGE PRATT
002	2009-01-01	GEORGE PRATT

Plan Statistics for GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN

401k plan membership statisitcs for GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN

Measure Date Value
2015: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 3
Number of retired or separated participants receiving benefits 2015-01-01 1
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 4
Number of participants with account balances 2015-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 3
Number of retired or separated participants receiving benefits 2014-01-01 1
Total of all active and inactive participants 2014-01-01 4
Total participants 2014-01-01 4
Number of participants with account balances 2014-01-01 4
2013: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 3
Total of all active and inactive participants 2013-01-01 3
Total participants 2013-01-01 3
Number of participants with account balances 2013-01-01 3
2012: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 3
Total of all active and inactive participants 2012-01-01 3
Total participants 2012-01-01 3
Number of participants with account balances 2012-01-01 3
2011: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 3
Total of all active and inactive participants 2011-01-01 3
Total participants 2011-01-01 3
Number of participants with account balances 2011-01-01 3
2009: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 4
Total of all active and inactive participants 2009-01-01 4
Total participants 2009-01-01 4
Number of participants with account balances 2009-01-01 4

Measure	Date	Value
2015: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	3
Number of retired or separated participants receiving benefits	2015-01-01	1
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	4
Number of participants with account balances	2015-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	3
Number of retired or separated participants receiving benefits	2014-01-01	1
Total of all active and inactive participants	2014-01-01	4
Total participants	2014-01-01	4
Number of participants with account balances	2014-01-01	4
2013: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	3
Total of all active and inactive participants	2013-01-01	3
Total participants	2013-01-01	3
Number of participants with account balances	2013-01-01	3
2012: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	3
Total of all active and inactive participants	2012-01-01	3
Total participants	2012-01-01	3
Number of participants with account balances	2012-01-01	3
2011: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	3
Total of all active and inactive participants	2011-01-01	3
Total participants	2011-01-01	3
Number of participants with account balances	2011-01-01	3
2009: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	4
Total of all active and inactive participants	2009-01-01	4
Total participants	2009-01-01	4
Number of participants with account balances	2009-01-01	4

Financial Data on GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN

Measure	Date	Value
2015 : GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$74,542
Expenses. Total of all expenses incurred	2015-12-31	$103,386
Benefits paid (including direct rollovers)	2015-12-31	$30,000
Total plan assets at end of year	2015-12-31	$1,248,135
Total plan assets at beginning of year	2015-12-31	$1,276,979
Value of fidelity bond covering the plan	2015-12-31	$125,000
Expenses. Other expenses not covered elsewhere	2015-12-31	$73,386
Other income received	2015-12-31	$56,546
Net income (gross income less expenses)	2015-12-31	$-28,844
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$1,248,135
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$1,276,979
Assets. Value of participant loans	2015-12-31	$21,626
Total contributions received or receivable from employer(s)	2015-12-31	$17,996
2014 : GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$129,808
Expenses. Total of all expenses incurred	2014-12-31	$22,153
Total plan assets at end of year	2014-12-31	$1,276,979
Total plan assets at beginning of year	2014-12-31	$1,169,324
Value of fidelity bond covering the plan	2014-12-31	$128,000
Expenses. Other expenses not covered elsewhere	2014-12-31	$22,153
Other income received	2014-12-31	$111,812
Net income (gross income less expenses)	2014-12-31	$107,655
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,276,979
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,169,324
Assets. Value of participant loans	2014-12-31	$26,595
Total contributions received or receivable from employer(s)	2014-12-31	$17,996
2013 : GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$171,449
Expenses. Total of all expenses incurred	2013-12-31	$9,145
Total plan assets at end of year	2013-12-31	$1,169,324
Total plan assets at beginning of year	2013-12-31	$1,007,020
Value of fidelity bond covering the plan	2013-12-31	$117,000
Expenses. Other expenses not covered elsewhere	2013-12-31	$9,145
Other income received	2013-12-31	$158,567
Net income (gross income less expenses)	2013-12-31	$162,304
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,169,324
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,007,020
Assets. Value of participant loans	2013-12-31	$3,673
Total contributions received or receivable from employer(s)	2013-12-31	$12,882
2012 : GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$97,544
Expenses. Total of all expenses incurred	2012-12-31	$9,145
Total plan assets at end of year	2012-12-31	$1,007,020
Total plan assets at beginning of year	2012-12-31	$919,444
Value of fidelity bond covering the plan	2012-12-31	$101,000
Expenses. Other expenses not covered elsewhere	2012-12-31	$9,145
Other income received	2012-12-31	$84,662
Net income (gross income less expenses)	2012-12-31	$88,399
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,007,020
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$919,444
Assets. Value of participant loans	2012-12-31	$14,387
Total contributions received or receivable from employer(s)	2012-12-31	$12,882
2011 : GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$50,330
Expenses. Total of all expenses incurred	2011-12-31	$31,769
Total plan assets at end of year	2011-12-31	$919,444
Total plan assets at beginning of year	2011-12-31	$900,883
Value of fidelity bond covering the plan	2011-12-31	$92,000
Expenses. Other expenses not covered elsewhere	2011-12-31	$31,769
Other income received	2011-12-31	$37,448
Net income (gross income less expenses)	2011-12-31	$18,561
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$919,444
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$900,883
Assets. Value of participant loans	2011-12-31	$24,655
Total contributions received or receivable from employer(s)	2011-12-31	$12,882
2010 : GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$143,736
Expenses. Total of all expenses incurred	2010-12-31	$9,145
Total plan assets at end of year	2010-12-31	$900,883
Total plan assets at beginning of year	2010-12-31	$766,292
Value of fidelity bond covering the plan	2010-12-31	$55,000
Total contributions received or receivable from participants	2010-12-31	$12,882
Expenses. Other expenses not covered elsewhere	2010-12-31	$9,145
Other income received	2010-12-31	$130,854
Net income (gross income less expenses)	2010-12-31	$134,591
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$900,883
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$766,292
Assets. Value of participant loans	2010-12-31	$34,497

Form 5500 Responses for GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN

2015: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING 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 funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT WEST LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

4896766

Policy instance

Insurance contract or identification number	4896766
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker name	DAVID A. PRATT

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

4888351

Policy instance

Insurance contract or identification number	4888351
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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
Insurance broker name	DAVID A. PRATT

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

P52040

Policy instance

Insurance contract or identification number	P52040
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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
Insurance broker name	DAVID A. PRATT

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

Policy contract number

51892651

Policy instance

Insurance contract or identification number	51892651
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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
Insurance broker name	DAVID A. PRATT

GREAT WEST LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

4896766

Policy instance

Insurance contract or identification number	4896766
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	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
Insurance broker name	DAVID A. PRATT

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

P52040

Policy instance

Insurance contract or identification number	P52040
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	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
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
Insurance broker name	DAVID A. PRATT

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

Policy contract number

51892651

Policy instance

Insurance contract or identification number	51892651
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	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

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

P52040

Policy instance

Insurance contract or identification number	P52040
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	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
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
Insurance broker name	DAVID A. PRATT

GREAT WEST LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

4896766

Policy instance

Insurance contract or identification number	4896766
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Insurance broker name	DAVID A. PRATT

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

Policy contract number

51892651

Policy instance

Insurance contract or identification number	51892651
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	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?	Yes
Insurance broker name	DAVID A. PRATT

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

46545476

Policy instance

Insurance contract or identification number	46545476
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
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
Insurance broker name	DAVID A. PRATT

GREAT WEST LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

4896766

Policy instance

Insurance contract or identification number	4896766
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

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

Policy contract number

51892651

Policy instance

Insurance contract or identification number	51892651
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

46545476

Policy instance

Insurance contract or identification number	46545476
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT WEST LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

4896766

Policy instance

Insurance contract or identification number	4896766
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

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

Policy contract number

51892651

Policy instance

Insurance contract or identification number	51892651
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

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

Policy contract number

51892651

Policy instance

Insurance contract or identification number	51892651
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

46545476

Policy instance

Insurance contract or identification number	46545476
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT WEST LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

4896766

Policy instance

Insurance contract or identification number	4896766
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

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Company Name:	GEORGE J. PRATT, PHD., A PSYCHOLOGICAL CORPORATION
Employer identification number (EIN):	953447342
NAIC Classification:	621330
NAIC Description:	Offices of Mental Health Practitioners (except Physicians)