401k Plan data: THE DIAMOND CENTER SAFE HARBOR 401(K) PLAN plan

THE DIAMOND CENTER SAFE HARBOR 401(K) PLAN 401k Plan overview

Plan Name	THE DIAMOND CENTER SAFE HARBOR 401(K) PLAN
Plan identification number	001

THE DIAMOND CENTER SAFE HARBOR 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.
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

LAVERNE JEWELERS, INC. has sponsored the creation of one or more 401k plans.

Company Name: LAVERNE JEWELERS, INC.

Employer identification number (EIN): 954522614

NAIC Classification: 448310
NAIC Description: Jewelry Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE DIAMOND CENTER SAFE HARBOR 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 RAY LANTZ 2018-10-01 RAY LANTZ 2018-10-01
001 2016-01-01 RAY LANTZ 2017-09-29 RAY LANTZ 2017-09-29
001 2015-01-01 RAY LANTZ 2016-10-05 RAY LANTZ 2016-10-05
001 2014-01-01 ROBBIN LANTZ 2015-05-04
001 2013-01-01 ROBBIN LANTZ 2014-05-19
001 2012-01-01 ROBBIN LANTZ 2013-08-12
001 2011-01-01 ROBBIN LANTZ 2012-05-14
001 2010-01-01 ROBBIN LANTZ 2011-10-31

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01	RAY LANTZ	2018-10-01	RAY LANTZ	2018-10-01
001	2016-01-01	RAY LANTZ	2017-09-29	RAY LANTZ	2017-09-29
001	2015-01-01	RAY LANTZ	2016-10-05	RAY LANTZ	2016-10-05
001	2014-01-01	ROBBIN LANTZ	2015-05-04
001	2013-01-01	ROBBIN LANTZ	2014-05-19
001	2012-01-01	ROBBIN LANTZ	2013-08-12
001	2011-01-01	ROBBIN LANTZ	2012-05-14
001	2010-01-01	ROBBIN LANTZ	2011-10-31

Financial Data on THE DIAMOND CENTER SAFE HARBOR 401(K) PLAN

Measure	Date	Value
2008 : THE DIAMOND CENTER SAFE HARBOR 401(K) PLAN 2008 401k financial data
Total plan liabilities at beginning of year	2008-12-31	$0
Total income from all sources	2008-12-31	$-23,289
Expenses. Total of all expenses incurred	2008-12-31	$1,230
Benefits paid (including direct rollovers)	2008-12-31	$1,230
Total plan assets at end of year	2008-12-31	$142,935
Total plan assets at beginning of year	2008-12-31	$167,454
Value of fidelity bond covering the plan	2008-12-31	$25,000
Total contributions received or receivable from participants	2008-12-31	$7,459
Other income received	2008-12-31	$-49,363
Net income (gross income less expenses)	2008-12-31	$-24,519
Net plan assets at end of year (total assets less liabilities)	2008-12-31	$142,935
Net plan assets at beginning of year (total assets less liabilities)	2008-12-31	$167,454
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2008-12-31	$4,215
Total contributions received or receivable from employer(s)	2008-12-31	$18,615

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

6-15158

Policy instance

Insurance contract or identification number	6-15158
Number of Individuals Covered	3
Insurance policy start date	2008-02-01
Insurance policy end date	2008-12-31
Total amount of commissions paid to insurance broker	USD $3,695
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:	LAVERNE JEWELERS, INC.
Employer identification number (EIN):	954522614
NAIC Classification:	448310
NAIC Description:	Jewelry Stores