| Return Reference | Explanation |
|---|---|
| FORM 990, PART V | ADDITIONAL INFO |
| PAGE 4, PART V 1C | THIS DOES NOT APPLY |
| PAGE 5, PART V 3A | DID NOT HAVE ANY UNRELATED INCOME |
| FORM 990, PART VI | ADDITIONAL INFO |
| PAGE 6 PART VI 2 | THOMAS L SIECK, AGENT IS THE FATHER OF JEFFERY SIECK, VP |
| PAGE 6 PART VI 2 | JOANN SIECK, DIRECTOR IS THE MOTHER OF JEFFREY SIECK DIRECTOR |
| PAGE 6 PART VI 2 | THOMAS SIECK, AGENT IS SPOUSE OF JOANN SIECK, DIRECTOR |
| PAGE 6 PART VI 6 | EACH POLICY HOLDER IS A MEMBER |
| PAGE 6 PART VI 7A | EACH POLICYHOLDER HAS ONE VOTE. POLICY HOLDER CAN NOMINATE MEMBER TO BOARD OF DIRECTORS AT ANNUAL MEETING |
| PAGE 6 PART VI 7B | NO, BUT POLICYHOLDERS ARE ADVISED AT ANNUAL MEETING OF ALL DECISIONS |
| PAGE 6 PART VI 9 | NAMES AND ADDRESSES OF ALL INVOLVED ARE PROVIDED IN PART VII, SECTION A PAGE 7 |
| PAGE 6 PART VI 11B | NO SPECIFIC PROCESS EXCEPT THAT COPIES ARE PROVIDED TO ALL DIRECTORS |
| PAGE 6 PART VI 19 | EACH POLICYHOLDER RECEIVED A POLICY FORM WHICH INCLUDES THE BY-LAWS AND ARTICLES OF INCOPROATION. COPIES OF THE FINANCIAL STATEMETNS ARE DISTRIBUTED TO EACH PERSON WHO ATTENDS THE ANNUAL MEETING. ANNUAL STATEMENTS ARE FILED WITH TEH STATE OF NE DEPT OF INSURANCE AND ARE AVAILABLE TO THE PUBLIC |
| FORM 990 PART VI LINE 2 | RELATED PARTY INFORMATION AMONG OFFICERS THOMAS SIECK AGENT, JEFFEREY SIEKC VP FATHER/SON; JOANNE SIECK DIRECTOR AND JEFFREY SIECK VP MOTHER/SON; THOMAS L SIECK AGENT AND JOANN SIECK DIRECTOR, SPOUSE |
| FORM 990 PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS | EACH POLICY HOLDER IS A MEMBER |
| FORM 990 PART VI LINE 11B ORGANIZATIONS PROCESS TO REVIEW FORM 990 | COPIES ARE PROVIDED TO ALL DIRECTORS AND REVIEWED FOR APPROVAL PRIOR TO FILING |
| FORM 990 PART VI LINE 19 GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | EACH POLICYHOLDER RECEIVED A POLICY FROM WHICH INCLUDES THE BYLAWS AND ARTICLES OF INCORPORATION. COPIES OF THE FNANCIAL STATEMENT ARE DISTRIBUTED TO EACH PERSON WHO ATTENDS THE ANNUAL MEETING. ANNUAL STATEMENTS ARE FILED WITH THE STATE OF NEBRASKA OF INSURANCE AND ARE AVAIL TO THE PUBLIC |
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