401k Plan data: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN plan

TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN
Plan identification number	001

TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) 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.
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.
Plan covering Self-Employed individuals.
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

TOM PETRUS & MILLER, AAL, LLLC has sponsored the creation of one or more 401k plans.

Company Name: TOM PETRUS & MILLER, AAL, LLLC

Employer identification number (EIN): 990315575

NAIC Classification: 541110
NAIC Description: Offices of Lawyers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01 MICHAEL TOM 2021-07-31
001 2019-01-01 MICHAEL TOM 2020-06-14
001 2018-01-01 MICHAEL TOM 2019-09-07
001 2017-01-01
001 2016-01-01 MICHAEL TOM MICHAEL TOM 2017-09-04
001 2015-01-01 MICHAEL TOM MICHAEL TOM 2016-10-05
001 2014-01-01 RICHARD MILLER
001 2013-01-01 MICHAEL D. TOM
001 2012-01-01 MICHAEL D. TOM MICHAEL D. TOM 2013-08-12
001 2011-01-01 MICHAEL D. TOM MICHAEL D. TOM 2012-10-01
001 2009-01-01 MICHAEL D. TOM MICHAEL D. TOM 2010-09-11

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01	MICHAEL TOM	2021-07-31
001	2019-01-01	MICHAEL TOM	2020-06-14
001	2018-01-01	MICHAEL TOM	2019-09-07
001	2017-01-01
001	2016-01-01	MICHAEL TOM		MICHAEL TOM	2017-09-04
001	2015-01-01	MICHAEL TOM		MICHAEL TOM	2016-10-05
001	2014-01-01	RICHARD MILLER
001	2013-01-01	MICHAEL D. TOM
001	2012-01-01	MICHAEL D. TOM		MICHAEL D. TOM	2013-08-12
001	2011-01-01	MICHAEL D. TOM		MICHAEL D. TOM	2012-10-01
001	2009-01-01	MICHAEL D. TOM		MICHAEL D. TOM	2010-09-11

Plan Statistics for TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN

Measure Date Value
2020: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 21
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 4
Total of all active and inactive participants 2020-01-01 25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 25
Number of participants with account balances 2020-01-01 25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 18
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 4
Total of all active and inactive participants 2019-01-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 22
Number of participants with account balances 2019-01-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 26
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 20
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 3
Total of all active and inactive participants 2018-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 23
Number of participants with account balances 2018-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 26
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 23
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 3
Total of all active and inactive participants 2017-01-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 26
Number of participants with account balances 2017-01-01 26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 23
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 2
Total of all active and inactive participants 2016-01-01 25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 25
Number of participants with account balances 2016-01-01 25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 22
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 2
Total of all active and inactive participants 2015-01-01 24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 24
Number of participants with account balances 2015-01-01 24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 20
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 3
Total of all active and inactive participants 2014-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 23
Number of participants with account balances 2014-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 21
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 3
Total of all active and inactive participants 2013-01-01 25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 25
Number of participants with account balances 2013-01-01 25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 22
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 3
Total of all active and inactive participants 2012-01-01 25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 25
Number of participants with account balances 2012-01-01 25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 22
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 3
Total of all active and inactive participants 2011-01-01 25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 25
Number of participants with account balances 2011-01-01 25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 22
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 1
Total of all active and inactive participants 2009-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 23
Number of participants with account balances 2009-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2020: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	21
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	4
Total of all active and inactive participants	2020-01-01	25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	25
Number of participants with account balances	2020-01-01	25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	18
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	4
Total of all active and inactive participants	2019-01-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	22
Number of participants with account balances	2019-01-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	26
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	20
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	3
Total of all active and inactive participants	2018-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	23
Number of participants with account balances	2018-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	26
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	23
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	3
Total of all active and inactive participants	2017-01-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	26
Number of participants with account balances	2017-01-01	26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	23
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	2
Total of all active and inactive participants	2016-01-01	25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	25
Number of participants with account balances	2016-01-01	25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	22
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	2
Total of all active and inactive participants	2015-01-01	24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	24
Number of participants with account balances	2015-01-01	24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	20
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	3
Total of all active and inactive participants	2014-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	23
Number of participants with account balances	2014-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	21
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	3
Total of all active and inactive participants	2013-01-01	25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	25
Number of participants with account balances	2013-01-01	25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	22
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	3
Total of all active and inactive participants	2012-01-01	25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	25
Number of participants with account balances	2012-01-01	25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	22
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	3
Total of all active and inactive participants	2011-01-01	25
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	25
Number of participants with account balances	2011-01-01	25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	22
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	1
Total of all active and inactive participants	2009-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	23
Number of participants with account balances	2009-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2020 : TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2020 401k financial data
Transfers to/from the plan	2020-12-31	$0
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$1,440,386
Expenses. Total of all expenses incurred	2020-12-31	$266,731
Benefits paid (including direct rollovers)	2020-12-31	$265,365
Total plan assets at end of year	2020-12-31	$8,382,402
Total plan assets at beginning of year	2020-12-31	$7,208,747
Value of fidelity bond covering the plan	2020-12-31	$1,000,000
Total contributions received or receivable from participants	2020-12-31	$215,820
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$115,384
Other income received	2020-12-31	$976,079
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$1,173,655
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$8,382,402
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$7,208,747
Assets. Value of participant loans	2020-12-31	$49,956
Assets. Value of real-estate (other than employer real property)	2020-12-31	$0
Total contributions received or receivable from employer(s)	2020-12-31	$133,103
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$1,366
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2019 401k financial data
Transfers to/from the plan	2019-12-31	$0
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$1,606,830
Expenses. Total of all expenses incurred	2019-12-31	$141,844
Benefits paid (including direct rollovers)	2019-12-31	$141,511
Total plan assets at end of year	2019-12-31	$7,208,747
Total plan assets at beginning of year	2019-12-31	$5,743,761
Value of fidelity bond covering the plan	2019-12-31	$1,000,000
Total contributions received or receivable from participants	2019-12-31	$201,550
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$0
Other income received	2019-12-31	$1,280,949
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$1,464,986
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$7,208,747
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$5,743,761
Assets. Value of participant loans	2019-12-31	$52,738
Assets. Value of real-estate (other than employer real property)	2019-12-31	$211,500
Total contributions received or receivable from employer(s)	2019-12-31	$124,331
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$333
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2018 401k financial data
Transfers to/from the plan	2018-12-31	$0
Total plan liabilities at end of year	2018-12-31	$0
Total plan liabilities at beginning of year	2018-12-31	$0
Total income from all sources	2018-12-31	$-90,434
Expenses. Total of all expenses incurred	2018-12-31	$446,343
Benefits paid (including direct rollovers)	2018-12-31	$445,627
Total plan assets at end of year	2018-12-31	$5,743,761
Total plan assets at beginning of year	2018-12-31	$6,280,538
Value of fidelity bond covering the plan	2018-12-31	$1,000,000
Total contributions received or receivable from participants	2018-12-31	$124,912
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$0
Other income received	2018-12-31	$-351,887
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$-536,777
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$5,743,761
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$6,280,538
Assets. Value of participant loans	2018-12-31	$31,519
Assets. Value of real-estate (other than employer real property)	2018-12-31	$225,000
Total contributions received or receivable from employer(s)	2018-12-31	$136,541
Value of certain deemed distributions of participant loans	2018-12-31	$0
Value of corrective distributions	2018-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$716
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$1,100,330
Expenses. Total of all expenses incurred	2017-12-31	$195,479
Benefits paid (including direct rollovers)	2017-12-31	$194,954
Total plan assets at end of year	2017-12-31	$6,280,538
Total plan assets at beginning of year	2017-12-31	$5,375,687
Value of fidelity bond covering the plan	2017-12-31	$500,000
Total contributions received or receivable from participants	2017-12-31	$113,853
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$852,231
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$904,851
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$6,280,538
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$5,375,687
Assets. Value of participant loans	2017-12-31	$32,624
Assets. Value of real-estate (other than employer real property)	2017-12-31	$225,000
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	2017-12-31	$1,479
Total contributions received or receivable from employer(s)	2017-12-31	$134,246
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$525
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$714,306
Expenses. Total of all expenses incurred	2016-12-31	$78,154
Benefits paid (including direct rollovers)	2016-12-31	$77,788
Total plan assets at end of year	2016-12-31	$5,375,687
Total plan assets at beginning of year	2016-12-31	$4,739,535
Value of fidelity bond covering the plan	2016-12-31	$1,000,000
Total contributions received or receivable from participants	2016-12-31	$119,900
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$458,586
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$636,152
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$5,375,687
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$4,739,535
Assets. Value of participant loans	2016-12-31	$35,005
Assets. Value of real-estate (other than employer real property)	2016-12-31	$235,000
Total contributions received or receivable from employer(s)	2016-12-31	$135,820
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$366
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$1,093
Total income from all sources	2015-12-31	$297,096
Expenses. Total of all expenses incurred	2015-12-31	$97,684
Benefits paid (including direct rollovers)	2015-12-31	$97,359
Total plan assets at end of year	2015-12-31	$4,739,535
Total plan assets at beginning of year	2015-12-31	$4,541,216
Value of fidelity bond covering the plan	2015-12-31	$1,000,000
Total contributions received or receivable from participants	2015-12-31	$152,450
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$14,024
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$199,412
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$4,739,535
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$4,540,123
Assets. Value of participant loans	2015-12-31	$61,763
Assets. Value of real-estate (other than employer real property)	2015-12-31	$171,600
Total contributions received or receivable from employer(s)	2015-12-31	$130,622
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$325
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$1,093
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$479,796
Expenses. Total of all expenses incurred	2014-12-31	$4,334
Benefits paid (including direct rollovers)	2014-12-31	$3,029
Total plan assets at end of year	2014-12-31	$4,541,216
Total plan assets at beginning of year	2014-12-31	$4,064,661
Value of fidelity bond covering the plan	2014-12-31	$1,000,000
Total contributions received or receivable from participants	2014-12-31	$88,334
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$4,291
Other income received	2014-12-31	$309,918
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$475,462
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$4,540,123
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$4,064,661
Assets. Value of participant loans	2014-12-31	$46,257
Assets. Value of real-estate (other than employer real property)	2014-12-31	$156,000
Total contributions received or receivable from employer(s)	2014-12-31	$77,253
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$1,305
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$871,383
Expenses. Total of all expenses incurred	2013-12-31	$43,906
Benefits paid (including direct rollovers)	2013-12-31	$43,830
Total plan assets at end of year	2013-12-31	$4,064,661
Total plan assets at beginning of year	2013-12-31	$3,237,184
Value of fidelity bond covering the plan	2013-12-31	$1,000,000
Total contributions received or receivable from participants	2013-12-31	$82,785
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$728,740
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$827,477
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$4,064,661
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$3,237,184
Assets. Value of participant loans	2013-12-31	$61,929
Assets. Value of real-estate (other than employer real property)	2013-12-31	$156,000
Total contributions received or receivable from employer(s)	2013-12-31	$59,858
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$76
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$450,798
Expenses. Total of all expenses incurred	2012-12-31	$70,956
Benefits paid (including direct rollovers)	2012-12-31	$70,666
Total plan assets at end of year	2012-12-31	$3,237,184
Total plan assets at beginning of year	2012-12-31	$2,857,342
Value of fidelity bond covering the plan	2012-12-31	$500,000
Total contributions received or receivable from participants	2012-12-31	$0
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$396,150
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$379,842
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$3,237,184
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$2,857,342
Assets. Value of participant loans	2012-12-31	$68,282
Assets. Value of real-estate (other than employer real property)	2012-12-31	$156,000
Total contributions received or receivable from employer(s)	2012-12-31	$54,648
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$290
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$-24,345
Expenses. Total of all expenses incurred	2011-12-31	$374
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$2,857,342
Total plan assets at beginning of year	2011-12-31	$2,882,061
Value of fidelity bond covering the plan	2011-12-31	$500,000
Total contributions received or receivable from participants	2011-12-31	$0
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-72,547
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$-24,719
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$2,857,342
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$2,882,061
Assets. Value of participant loans	2011-12-31	$85,759
Assets. Value of real-estate (other than employer real property)	2011-12-31	$156,000
Total contributions received or receivable from employer(s)	2011-12-31	$48,202
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	$374
2010 : TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$428,600
Expenses. Total of all expenses incurred	2010-12-31	$25,069
Benefits paid (including direct rollovers)	2010-12-31	$25,045
Total plan assets at end of year	2010-12-31	$2,882,061
Total plan assets at beginning of year	2010-12-31	$2,478,530
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$0
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$245,731
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$403,531
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$2,882,061
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,478,530
Assets. Value of participant loans	2010-12-31	$18,601
Assets. Value of real-estate (other than employer real property)	2010-12-31	$156,000
Total contributions received or receivable from employer(s)	2010-12-31	$182,869
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	$24
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN

2020: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
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: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) PROFIT SHARING PLAN 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
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) 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: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) 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
2013: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) 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
2012: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) 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
2011: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) 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
2009: TOM PETRUS & MILLER, ATTORNEYS AT LAW, A LIMITED LIABILITY LAW COMPANY 401(K) 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

Insurance Providers Used on plan

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

Policy contract number

335613-01

Policy instance

Insurance contract or identification number	335613-01
Number of Individuals Covered	25
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

335613-01

Policy instance

Insurance contract or identification number	335613-01
Number of Individuals Covered	22
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

335613-01

Policy instance

Insurance contract or identification number	335613-01
Number of Individuals Covered	23
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

335613-01

Policy instance

Insurance contract or identification number	335613-01
Number of Individuals Covered	26
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

335613-01

Policy instance

Insurance contract or identification number	335613-01
Number of Individuals Covered	4
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 $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?	Yes
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

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

Policy contract number

335613-01

Policy instance

Insurance contract or identification number	335613-01
Number of Individuals Covered	3
Insurance policy start date	2014-01-01
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 $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?	Yes
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

68023

Policy instance

Insurance contract or identification number	68023
Number of Individuals Covered	0
Insurance policy start date	2013-01-01
Insurance policy end date	2013-04-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $390
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
Amount paid for insurance broker fees	390
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker organization code?	5
Insurance broker name	SI GROUP CPCS

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

Policy contract number

335613-01

Policy instance

Insurance contract or identification number	335613-01
Number of Individuals Covered	3
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
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?	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?	Yes
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

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

Policy contract number

68023

Policy instance

Insurance contract or identification number	68023
Number of Individuals Covered	25
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,442
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
Amount paid for insurance broker fees	1442
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker organization code?	5
Insurance broker name	SI GROUP CPCS

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

Policy contract number

68023

Policy instance

Insurance contract or identification number	68023
Number of Individuals Covered	25
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,294
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

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

Policy contract number

68023

Policy instance

Insurance contract or identification number	68023
Number of Individuals Covered	25
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,052
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
Amount paid for insurance broker fees	1052
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker organization code?	5
Insurance broker name	SUEMORI & INOUYE, INC.

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Company Name:	TOM PETRUS & MILLER, AAL, LLLC
Employer identification number (EIN):	990315575
NAIC Classification:	541110
NAIC Description:	Offices of Lawyers