MEMBER INSURANCE AGENCY RETIREMENT SAVINGS PLAN
|
2012
|
362964176
|
2013-05-31
|
MEMBER INSURANCE AGENCY, INC.
|
50
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1996-07-01
|
Business code |
524210
|
Sponsor’s telephone number |
8003230131
|
Plan sponsor’s mailing address |
760 W. MAIN STREET, SUITE 100, BARRINGTON, IL, 60010
|
Plan sponsor’s
address |
760 W. MAIN STREET, SUITE 100, BARRINGTON, IL, 60010
|
Plan administrator’s name and address
Administrator’s EIN |
362964176 |
Plan administrator’s name |
MEMBER INSURANCE AGENCY, INC. |
Plan administrator’s
address |
760 W. MAIN STREET, SUITE 100, BARRINGTON, IL, 60010 |
Administrator’s telephone number |
8003230131 |
Number of participants as of the end of the plan year
Active participants |
32 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
14 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
46 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
5 |
Signature of
Role |
Plan administrator |
Date |
2013-05-31 |
Name of individual signing |
DOUGLAS JENSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-05-31 |
Name of individual signing |
DOUGLAS JENSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MEMBER INSURANCE AGENCY RETIREMENT SAVINGS PLAN
|
2011
|
362964176
|
2012-06-29
|
MEMBER INSURANCE AGENCY, INC.
|
57
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1996-07-01
|
Business code |
524210
|
Sponsor’s telephone number |
8472772628
|
Plan sponsor’s mailing address |
760 W. MAIN STREET, SUITE 100, BARRINGTON, IL, 60010
|
Plan sponsor’s
address |
760 W. MAIN STREET, SUITE 100, BARRINGTON, IL, 60010
|
Plan administrator’s name and address
Administrator’s EIN |
362964176 |
Plan administrator’s name |
MEMBER INSURANCE AGENCY, INC. |
Plan administrator’s
address |
760 W. MAIN STREET, SUITE 100, BARRINGTON, IL, 60010 |
Administrator’s telephone number |
8472772628 |
Number of participants as of the end of the plan year
Active participants |
31 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
19 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
46 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
7 |
Signature of
Role |
Plan administrator |
Date |
2012-06-29 |
Name of individual signing |
DOUGLAS JENSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MEMBER INSURANCE AGENCY RETIREMENT SAVINGS PLAN
|
2010
|
362964176
|
2011-04-26
|
MEMBER INSURANCE AGENCY, INC.
|
64
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1996-07-01
|
Business code |
524210
|
Sponsor’s telephone number |
8472772628
|
Plan sponsor’s mailing address |
760 W. MAIN STREET, SUITE 100, BARRINGTON, IL, 60010
|
Plan sponsor’s
address |
760 W. MAIN STREET, SUITE 100, BARRINGTON, IL, 60010
|
Plan administrator’s name and address
Administrator’s EIN |
362964176 |
Plan administrator’s name |
MEMBER INSURANCE AGENCY, INC. |
Plan administrator’s
address |
760 W. MAIN STREET, SUITE 100, BARRINGTON, IL, 60010 |
Administrator’s telephone number |
8472772628 |
Number of participants as of the end of the plan year
Active participants |
26 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
31 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
56 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
23 |
Signature of
Role |
Plan administrator |
Date |
2011-04-26 |
Name of individual signing |
DOUGLAS JENSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MEMBER INSURANCE AGENCY RETIREMENT SAVINGS PLAN
|
2009
|
362964176
|
2010-05-05
|
MEMBER INSURANCE AGENCY, INC.
|
65
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1996-07-01
|
Business code |
524210
|
Sponsor’s telephone number |
8472771800
|
Plan sponsor’s mailing address |
760 WEST MAIN STREET, SUITE 100, BARRINGTON, IL, 60010
|
Plan sponsor’s
address |
760 WEST MAIN STREET, SUITE 100, BARRINGTON, IL, 60010
|
Plan administrator’s name and address
Administrator’s EIN |
362964176 |
Plan administrator’s name |
MEMBER INSURANCE AGENCY, INC. |
Plan administrator’s
address |
760 WEST MAIN STREET, SUITE 100, BARRINGTON, IL, 60010 |
Administrator’s telephone number |
8472771800 |
Number of participants as of the end of the plan year
Active participants |
45 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
19 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
62 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
12 |
Signature of
Role |
Plan administrator |
Date |
2010-05-05 |
Name of individual signing |
DOUGLAS JENSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|