We look forward to providing services to you. Should you have any questions regarding any items, please do not hesitate to contact.

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1 Organizer Employee benefit plan This organizer is designed to assist you in gathering the information necessary to prepare the current year s annual return/report. Please complete it in full and provide details and documentation as requested. For your convenience, there is an engagement letter enclosed which explains the services that will be provided to the plan sponsor. Please sign a copy of the engagement letter and return the signed copy in the enclosed envelope. Keep the other copy for your records. Your Form 5500 annual return/report is due on needs to be received no later than extension of time be filed for this return/report.. In order to meet this filing deadline, your completed organizer. Any information received after this date may require that an NOTE: The terms key employee, highly compensated employee, nonexempt transaction, and parties-in-interest are explained at the end of this organizer. We look forward to providing services to you. Should you have any questions regarding any items, please do not hesitate to contact. Phone In particular, if you are uncertain of the appropriate response for any of the requested items, please consult the contact above. Certification: The undersigned certifies, to the best of his or her knowledge, that the information documented in and provided with this organizer is complete and accurate. Certified by Title Reviewed Oct. 1, 2017 Qualified retirement plan tax return organizer (Form 5500 series) 1

2 Plan name Plan year Contact person Phone number Sponsor name Sponsor address Plan number Federal EIN Type of entity Plan administrator Administrator address Trustee Federal EIN Trust ID number Trustee address Record keeper Plan attorney Investment adviser Previously provided Attached Yes No N/A 101) If this is the first year in which we are to prepare your Form 5500, furnish the following items: 1) Plan document, trust agreement, adoption agreement, and amendments 2) Prior three years summary annual reports 3) Most current summary plan description and summary(ies) of material modifications 4) Copies of any tax elections or revocations in effect 5) Permission to contact predecessor preparer for this tax return 6) If permission is granted, please provide the predecessor s contact information. 7) Prior three years plan financial statements 8) Prior three years Forms 5500, 5500-SF, or 5500-EZ 9) Prior three years employee censuses, including balances and vesting information Qualified retirement plan tax return organizer (Form 5500 series) 2

3 Previously provided Attached Yes No N/A 10) Most recent IRS determination letter or opinion letter 11) If the plan allows participant loans, provide copies of loan documents and amortization schedules. 102) Provide the name of the individuals who will be signing the Form 5500 as the: 1. Plan Administrator: 2. Plan Sponsor: 103) Would you like our firm to transmit the Form 5500 to the Department of Labor (DOL) on behalf of the Plan Administrator and use the alternative method of manually signing? 1. If so, please sign and return the EFAST2 filing authorization to our office. 104) Furnish the following items for the current year: 1. Employee census (complete the sample attached or update the attached census from the prior year). Electronic format is preferred. 2. Plan financial statements 3. If there are no financial statements for the plan, provide the following: a. Recap of receipts and disbursements for all bank accounts b. Reconciled bank statements as of the plan s year end c. Recaps or copies of all monthly brokerage or investment accounts for the plan year d. Schedule of fair market values of all investments as of the close of the plan year 4. Detail of employer contributions for the plan year. Indicate dates accrued and paid or scheduled to be paid. 5. Form 5500, Schedule A(s), if a portion or the entire plan is invested in insurance contracts 6. Any Form 5500 Schedule C, Service Provider Information, compensation disclosures that you received a. Did any service provider receive direct or indirect compensation from the plan during the plan year that is not included in the Schedule C compensation disclosure that you received? If yes, provide additional information concerning this compensation. Qualified retirement plan tax return organizer (Form 5500 series) 3

4 Previously provided Attached Yes No N/A 7. Page one of the income tax return (Form 1040, Schedule C if sole proprietorship or LLC member) of the sponsor 8. Copies of new loan documents and amortization schedules 9. Copies of a new summary plan description or summary(ies) of material modifications 10. Any IRS determination letter or opinion letter received during the past year 11. Do you maintain any other qualified benefit plans? If yes, describe. 12. Have there been any changes in the tax year of the plan sponsor or the plan? If so, explain. 13. Has the plan sponsor extended the time to file its federal tax return? If so, provide a copy of the extension. 105) Are there any individuals in the company who have worked more than 1,000 hours who are not considered to be common law employees (e.g., independent contractors)? If yes, include these individuals on the employee census form and identify them as leased or not leased. 106) If the plan invests in any Master Trust Investment Arrangement (MTIA), Common Collective Trusts (CCT), Pooled Separate Accounts (PSA) or IE, provide a schedule with the following information: name of the MTIA, CCT, PSA, or IE; name of the sponsor of the fund; EIN and plan number of the fund; and dollar value invested in the fund as of the end of the plan year. 107) If the Form 5500 is being prepared for a Direct Filing Entity (DFE), provide a schedule listing the plan name, the name of the plan sponsor, and the EIN and plan number for each plan invested in the DFE. 108) Provide the EIN(s) of payor(s) who paid benefits on behalf of the plan to participants or beneficiaries during the plan year. EIN: EIN: 1. Provide a listing of terminated participants, date of termination, date paid, and the account balance distributed with detail of federal and states taxes withheld. Also, include the reason for the distribution (i.e., termination, in-service, hardship, etc.). 2. Did all participants who received distributions receive required Forms 1099-R, Distributions from Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.? Qualified retirement plan tax return organizer (Form 5500 series) 4

5 Previously provided Attached Yes No N/A 3. Attach copies of Forms 1099-R issued. 4. Has the plan failed to provide a benefit when due? 109) Was a resolution to terminate the plan adopted during the plan year? If yes, provide a copy of the executed resolution. 110) Were there any amendments during the plan year? If yes, provide copies of the amendment(s). 111) Has the plan been audited by the Internal Revenue Service, the Department of Labor, or the Pension Benefit Guaranty Corporation? If yes, attach copies of all correspondence. 1. Were any plan corrections needed as a result of the examination? If so, provide the detail of the correction(s). 112) Have there been any disputed claims or lawsuits filed or threatened with respect to the plan? If yes, attach copies of all correspondence. 113) Was the plan insured by a fidelity bond for loss through fraud or dishonesty? If yes, complete the following: Name of Surety Company: Amount of Bond: 114) If this is a single-employer or a multiemployer defined benefit plan and the total number of participants is 1,000 or more (Schedule R Retirement Plan Information Part VI): 1) Provide the percentage of plan assets held as: Stock: % Investment grade debt: % High-yield debt: % Real estate: % Other: % 2) Provide the average duration of the combined investment-grade and high-yield debt: 0 3 years 3 6 years 6 9 years 9 12 years years years years 21+ years 3) What duration measure was used to calculate the above? Effective duration Modified duration Macaulay duration Other (specify) 115) If this is a single-employer or a multiemployer defined benefit plan and if any liabilities to participants or their beneficiaries under the plan as of the end of the plan year consist (in whole or in part) of liabilities to such participants and beneficiaries under two or more pension plans as of immediately before such plan year, provide the requested additional plan information (see the instructions for Schedule R, Retirement Plan Information). Qualified retirement plan tax return organizer (Form 5500 series) 5

6 Previously provided Attached Yes No N/A 116) If this is a defined benefit plan, provide a copy of Schedule SB or MB, as applicable. 1. Provide the name and contact information of the plan s actuary preparing the Schedule SB or MB. a. Name of actuary: b. Firm name: c. Phone: d. Address: 2. Have you filed Form 1, with Schedule A, Form 1-EZ and Form 1-ES, as applicable, with the Pension Benefit Guaranty Corporation (PBGC)? 3. Is the plan covered by the PBGC insurance program? If yes, enter the confirmation number for the PBGC premium filing for the plan year. 117) Is the plan a Multiple Employer Welfare Arrangements (MEWAs) or Certain Entities Claiming Exception (ECEs)? If so, have you filed Form M-1? a. Provide the receipt confirmation code for the 2017 Form M-1 annual report. 118) List officers and owner(s) of sponsor company and percentage of ownership: Name Title Ownership percent Qualified retirement plan tax return organizer (Form 5500 series) 6

7 119) Does any key employee, or any member of the key employee s family, own an interest in any other non-publicly traded business? If yes, complete the following. Employee name Relationship to owner Name and type of entity Ownership percent Yes No N/A 120) Do any relatives of any key employee or highly compensated employee work for the company? If yes, identify them on the employee census. 121) Did all new participants receive a summary plan description? 122) Have participants received required annual information about their account balance(s), vested percentage(s), and matching contributions? 123) Was the prior year Summary Annual Report (SAR) for the plan year distributed to participants? 124) Has there been any reversion of plan assets to the employer during the plan year? 125) Has there been a termination of the appointment of either of the following? Accountant Enrolled actuary If yes, attach explanation(s) regarding the change. 1. Provide the following information of the former accountant or enrolled actuary: Name Address Phone EIN 126) Did any of the following transactions occur between the plan and any parties-in-interest (e.g., employer or participant)? If yes, attach an explanation. 1. The sale, exchange, or leasing of any property 2. The lending of money or other extension or credit (with certain exemptions for plan loans to participants or beneficiaries) Qualified retirement plan tax return organizer (Form 5500 series) 7

8 Yes No N/A 3. The furnishing of goods, services, or facilities 4. The transfer to, or use by, or for the benefit of, a party-in- interest of any income or assets of the plan 5. The plan s acquisition or retention of any employer security or employer property 127) If the plan is funded, has it been audited by an independent qualified public accountant? If yes, provide the audited financial statements. If no, complete the following questions concerning transactions during the plan year. 1. Is an opinion of an independent qualified public accountant not necessary because the plan is a CCT, PSA, or MTIA? 2. Will an opinion be attached to the next Form 5500? 128) Were participant contributions transmitted to the plan on a timely basis? 1. If no, describe or attach a statement as to what steps have been taken to correct the late deposits. 129) If the plan is a 401(k) plan subject to Actual Deferral Percentage (ADP) and/or Actual Contribution Percentage (ACP) testing, provide a copy of the test. Were any loans, leases by the plan, or fixed obligations due to the plan in default as of the close of the plan year or classified during the year as uncollectible? 1. Provide an explanation of what steps have been taken or will be taken to collect overdue amounts for each loan or lease. 130) If the plan has 100 participants or more and contained assets that were not participant directed, were any plan transactions, or series of transactions in excess of 5% of the current value of the plan s assets? 131) Did the plan engage in any nonexempt transactions with parties-in-interest (see below for a list of nonexempt transactions)? 132) Did the plan receive or hold any nonpublicly traded securities or other assets that were not appraised in writing by an unrelated third-party appraiser during the plan year? 133) Did the plan have any non-cash contributions whose current value was neither readily determinable on an established market nor set by an independent third-party appraiser? 134) Was there a blackout period during the plan year? Provide a copy of the blackout notice. 135) Were all plan assets distributed to participants or beneficiaries, transferred to another plan, or brought under the control of the Pension Benefit Guaranty Corporation? 136) Provide a copy of the coverage testing under Sec. 410(b). 137) Is the plan maintained in a U.S. territory, i.e., Puerto Rico (if no election under ERISA section 1022(i)(2) has been made), American Samoa, Guam, the Commonwealth of the Northern Marina Islands, or the U.S. Virgin Islands? Qualified retirement plan tax return organizer (Form 5500 series) 8

9 Employee census Employee name (last, first, initial) Social Security number Type codes* Date of birth Date of hire Date of term Date of rehire Hours of service Compensation** Employee contributions Tax-deferred After tax Distribution in plan year *See type codes on the attached page. ** Compensation is defined by the plan. Qualified retirement plan tax return organizer (Form 5500 series) 9

10 Employee census instructions Type codes Type codes are used in calculating distributions and in preparing various government reports, and may also affect eligibility for certain benefits. Type 1: Employee status 1 = Active 6 = Leave of absence 2 = Terminated 7 = Deceased 3 = Retired 8 = Independent contractor/leased 4 = Disabled 9 = Independent contractor/not leased 5 = Excludable Hours of service Type 2: Key or highly compensated employee a = Key employee only b = Highly compensated only c = Key and highly compensated d = Family member of key employee Type 3: Marital status Y = Married N = Unmarried Hours of service may be the basis for determining eligibility to participate in the plan, eligibility to receive an employer contribution, and eligibility for vesting. Compensation For defined contribution plans, contributions and allocations are based upon a definition of compensation which generally will be contained in the plan document. Complete the employee census after indicating below how compensation is defined in the plan. Compensation reported as taxable income for W-2 purposes Wages paid during the plan year Compensation before 401(k) deferrals and after Sec. 125 deferrals Wages accrued during the plan year Includes bonus Includes tips Includes commissions Excludes bonus Excludes tips Excludes commissions Other Qualified retirement plan tax return organizer (Form 5500 series) 10

11 Schedule of investments in direct filing entities (a) (b) (c) (d) Name of MTIA, CCT, PSA, or IE Name of sponsor of entity listed in (a) EIN and plan # Dollar value invested Schedule of plans invested in direct filing entity (electronic schedule in this format is preferred) Plan name Name of plan sponsor EIN and plan number Qualified retirement plan tax return organizer (Form 5500 series) 11

12 Form 5500 Schedule R additional information schedule If this is a single-employer or a multiemployer defined benefit plan and if any liabilities to participants or their beneficiaries under the plan as of the end of the plan year consist (in whole or in part) of liabilities to such participants and beneficiaries under two or more pension plans as of immediately before such plan year, provide the following information. Name of plan EIN Plan number Funding percentage 1 of plan as of 1 The funding percentage should be provided for the last day of the previous plan year. For single-employer plans, the funding percentage is the funding target attainment percentage, where the numerator is the value of plan assets reduced by the sum of the amount of the prefunding balance and the funding standard carryover balance, and the denominator is the funding target for the plan (without regard to the at-risk status of the plan). For multi- employer plans, the funding percentage is the ratio where the numerator is the actuarial value of the plan s assets and the denominator is the accrued liability of the plan. If a plan whose funding percentage is required to be reported has terminated, write terminated in the space where the plan s funding percentage would otherwise have been reported. Definitions Key employee A key employee means any employee who at any time during the plan year containing the determination date meets any one of the tests described below: (A) Officer test. An officer of the employer whose annual compensation is greater than $175, The number of officers to be taken into account is limited to 50. If there are fewer than 50 officers for purposes of this test, the greater of 10% of total employees or three officers is used for the test. If there are more officers than the limited number, the officers with the highest one-year compensation during the five-year period are used. (B) 5% owner test. An employee who owns more than 5% of the employer. An individual is considered as owning stock owned directly or indirectly by a spouse, children, grandchildren, and parents. (C) 1% owner test. An employee who owns more than 1% of the employer and whose annual compensation exceeds $150,000. Highly compensated employee A highly compensated employee is an employee who (even if now terminated): (A) Was a more than 5% owner of the employer during the current or preceding year, or (B) Received compensation in excess of $120,000 3 in the preceding year. This amount will be adjusted periodically by the Secretary of the Treasury. The employer may elect under Sec. 414(q)(1)(B)(ii) to limit the class of employees receiving compensation in excess of $120,000 2 who are considered highly compensated employees to those who were in the top-paid group of employees for such preceding year. Under Sec. 414(q)(3), top-paid group means generally the top 20% of employees when ranked on the basis of compensation. 2 For plan years beginning in 2015 and 2016, the indexed limit is $170,000. For plan years beginning in 2017, the indexed limit is $175, For plan years beginning in , the indexed amount is $120,000. Qualified retirement plan tax return organizer (Form 5500 series) 12

13 Nonexempt transactions Nonexempt transactions with a party-in-interest include any direct or indirect: (A) Sale, exchange, or lease of any property between the plan and a party-in-interest (B) Lending of money or other extension of credit between the plan and a party-in-interest (C) Furnishing of goods, services, or facilities between the plan and a party-in-interest (D) Transfer to, or use by for the benefit of, a party-in-interest of any income or assets of the plan (E) Acquisition on behalf of the plan of any employer security or employer real property in violation of ERISA Sec. 407(a) (F) Dealing with the assets of the plan for a fiduciary s own interest or own account (G) Acting in a fiduciary s individual or any other capacity in any transaction involving the plan on behalf of a party (or represent a party) whose interests are adverse to the interests of the plan or the interests of its participants or beneficiaries (H) A receipt of any consideration for his or her own personal account by a party-in-interest who is a fiduciary from any party dealing with the plan in connection with a transaction involving the income or assets of the plan. If you are unsure whether a transaction is exempt or not, you should consult with the plan s independent qualified public accountant, legal counsel, or both. Definitions Parties-in-interest Party-in-interest is deemed to include a disqualified person. See Sec. 4975(e)(2). The term party-in-interest means as to an employee benefit plan: (A) Any fiduciary (including, but not limited to, any administrator, officer, trustee, or custodian), counsel, or employee of the plan (B) A person providing services to the plan (C) An employer, any of whose employees are covered by the plan (D) An employee organization, any of whose members are covered by the plan (E) An owner, direct or indirect, of 50% or more of: (1) the combined voting power of all classes of stock entitled to vote or the total value of shares of all classes of stock of a corporation, (2) the capital interest or the profits interest of a partnership, or (3) the beneficial interest of a trust or unincorporated enterprise that is an employer or an employee organization described in C or D (F) A relative of any individual described in A, B, C, or E (G) A corporation, partnership, or trust or estate of which (or in which) 50% or more of: (1) the combined voting power of all classes of stock entitled to vote or the total value of shares of all classes of stock of such corporation, (2) the capital interest or profits interest of such partnership, or (3) the beneficial interest of such trust or estate is owned directly or indirectly, or held by, persons described in A, B, C, D, or E (H) An employee, officer, director (or individual having powers or responsibilities similar to those of officers or directors), or a 10% or more shareholder, directly or indirectly, of a person described in B, C, D, E, or G, or of the employee benefit plan (I) A 10% or more (directly or indirectly in capital or profits) partner or joint venture of a person described in B, C, D, E, or G Qualified retirement plan tax return organizer (Form 5500 series) 13

14 EFAST2 filing authorization for the Form 5500 Name of plan EIN/PN Plan year ending Authorization of practitioner to electronically sign and file I hereby authorize (Name of practitioner) return/ report through EFAST2. to electronically sign and file the above-named I understand in granting this authority that: I must manually sign and date the Form 5500 and provide a scanned copy of that signature page to (Name of practitioner) before the electronic filing can be initiated; (Name of practitioner) will retain a copy of this written authorization in his or her records; (Name of practitioner) will notify the individual signing below as plan administrator/ employer about any inquiries and information he or she receives from EFAST2, DOL, IRS, or PBGC regarding this annual return/report; and A copy of my signature, as it appears on the Form 5500, will be included with the return/report posted by the Department of Labor on the Internet for public disclosure. (Name of practitioner) shall not be deemed an administrator or other fiduciary with respect to any plan solely on account of the services performed under this authorization. This authorization is applicable only to the filing for the above-named plan and applies only for the plan year end stated above. Qualified retirement plan tax return organizer (Form 5500 series) Association of International Certified Professional Accountants. All rights reserved. AICPA and American Institute of CPAs are trademarks of the American Institute of Certified Public Accountants and are registered in the United States, European Union and other countries. The design mark is a trademark of the Association of International Certified Professional Accountants