Schedule A
- Row 1
- Filing Id
- 91037071026083
- Form Id
- 27938807
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 1030373031449040002
- Ins Broker 01 Name
- MICHAEL Y TAKAYAMA
- Ins Broker Comm Pd 01 Amount
- $222
- Ins Broker Fees Pd 01 Amount
- $0
- Ins Broker 01 Code
- 3
- Row 2
- Filing Id
- 91037071026083
- Form Id
- 27938807
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 2
- Row Num
- 1
- Image Form Id
- 1030373031449040002
- Ins Broker 01 Name
- LINSCO PRIVATE LEDGER
- Ins Broker Comm Pd 01 Amount
- $222
- Ins Broker Fees Pd 01 Amount
- $0
- Ins Broker 01 Code
- 3
- Row 3
- Filing Id
- 91037071026083
- Form Id
- 27938807
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 3
- Row Num
- 2
- Image Form Id
- 1030373031449040002
- Ins Broker 01 Name
- ASSOCIATED PENSION CONSULTANTS
- Ins Broker Comm Pd 01 Amount
- $0
- Ins Broker Fees Pd 01 Amount
- $17
- Ins Broker Fees Pd 01 Text
- TPA FORUM COMPENSATION
- Ins Broker 01 Code
- 5
- Row 4
- Ins Carrier Name: MANULIFE FINANCIAL
- Filing Id
- 91037071026083
- Form Id
- 27938807
- Schedule A EIN
- 68-0280605
- Schedule A Plan Num
- 001
- Schedule A Plan Year Begin Date
- 2001-07-01
- Schedule A Tax Period
- 20011001
- Ins Carrier Name
- MANULIFE FINANCIAL
- Ins Carrier EIN
- 01-0233346
- Ins Carrier Naic Code
- 9040
- Ins Contract Num
- 52546
- Ins Prsn Covered End of year Count
- 0
- Ins Policy From Date
- 2001-07-01
- Ins Policy To Date
- 2001-10-01
- Ins Broker Comm Total Amount
- $0
- Ins Broker Fees Total Amount
- $0
- Pension End of year Gen Account Amount
- $0
- Pension End of year Sep Account Amount
- $0
- Pension Prem Paid Total Amount
- $0
- Pension Unpaid Premium Amount
- $0
- Pension Contract Cost Amount
- $0
- Pension End Prev Bal Amount
- $0
- Pension Contribution Dep Amount
- $0
- Pension Divnd Cr Dep Amount
- $0
- Pension Interest Cr Dur Yr Amount
- $0
- Pension Transfer From Amount
- $0
- Pension Other Amount
- $0
- Pension Total Additions Amount
- $0
- Pension Total Bal Addn Amount
- $0
- Pension Bnfts Dsbrsd Amount
- $0
- Pension Admin Chrg Amount
- $0
- Pension Transfer To Amount
- $0
- Pension Oth Ded Amount
- $0
- Pension Total Ded Amount
- $0
- Pension End of year Bal Amount
- $0
- Wlfr Premium Rcvd Amount
- $0
- Wlfr Unpaid Due Amount
- $0
- Wlfr Reserve Amount
- $0
- Wlfr Total Earned Prem Amount
- $0
- Wlfr Claims Paid Amount
- $0
- Wlfr Incr Reserve Amount
- $0
- Wlfr Incurred Claim Amount
- $0
- Wlfr Claims Chrgd Amount
- $0
- Wlfr Ret Commissions Amount
- $0
- Wlfr Ret Admin Amount
- $0
- Wlfr Ret Oth Cost Amount
- $0
- Wlfr Ret Oth Expense Amount
- $0
- Wlfr Ret Taxes Amount
- $0
- Wlfr Ret Charges Amount
- $0
- Wlfr Ret Oth Chrgs Amount
- $0
- Wlfr Ret Total Amount
- $0
- Wlfr Refund Amount
- $0
- Wlfr Held Bnfts Amount
- $0
- Wlfr Claims Reserve Amount
- $0
- Wlfr Oth Reserve Amount
- $0
- Wlfr Divnds Due Amount
- $0
- Wlfr Total Charges Paid Amount
- $0
- Wlfr Acquis Cost Amount
- $0
Schedule D
- Row 1
- Filing Id
- 91037071026083
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 1030373031449040003
- Row 2
- Filing Id
- 91037071026083
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- LIFESTYLE-GROWTH
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 3
- Filing Id
- 91037071026083
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 2
- Row Num
- 1
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- LIFESTYLE-AGGRESSIVE
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 4
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 1
- Page Row Num
- 1
- Row Num
- 10
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- FOREIGN FUND
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 5
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 1
- Page Row Num
- 2
- Row Num
- 11
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- INTERNATIONAL STOCK FUND
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 6
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 1
- Page Row Num
- 3
- Row Num
- 12
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- ADV DIV GROWTH FUND
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 7
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 1
- Page Row Num
- 4
- Row Num
- 13
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- DISCOVERY
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 8
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 1
- Page Row Num
- 5
- Row Num
- 14
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- AGRESSIVE GROWTH FUND
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 9
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 1
- Page Row Num
- 6
- Row Num
- 15
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- SCIENCE & TECHNOLOGY FUND
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 10
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 2
- Page Row Num
- 1
- Row Num
- 16
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- BLUE CHIP
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 11
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 2
- Page Row Num
- 2
- Row Num
- 17
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- CONTRA FUND
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 12
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 2
- Page Row Num
- 3
- Row Num
- 18
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- SM-MD GROWTH
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 13
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 2
- Page Row Num
- 4
- Row Num
- 19
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- CONSTELLN FUND
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 14
- Filing Id
- 91037071026083
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 3
- Row Num
- 2
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- MONEY MARKET FUND
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 15
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 2
- Page Row Num
- 5
- Row Num
- 20
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- ENTERPRISE FUND
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 16
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 2
- Page Row Num
- 6
- Row Num
- 21
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- INDEX 500
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 17
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 3
- Page Row Num
- 1
- Row Num
- 22
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- SELECT TWENTY
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 18
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 3
- Page Row Num
- 2
- Row Num
- 23
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- VAL & REST
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 19
- Filing Id
- 91037071026083
- Page Id
- 1
- Page Seq
- 0
- Page Row Num
- 4
- Row Num
- 3
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- CORE BOND
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 20
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 4
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- SPECTRUM I
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 21
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 2
- Row Num
- 5
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- INCOME & GROWTH FUND
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 22
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 3
- Row Num
- 6
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- HIGH YIELD FUND
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 23
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 4
- Row Num
- 7
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- EQUITY INCOME FUND
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 24
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 5
- Row Num
- 8
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- BEACON
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0
- Row 25
- Filing Id
- 91037071026083
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 6
- Row Num
- 9
- Image Form Id
- 1030373031449040003
- DFE P1 Entity 01 Name
- WEITZ PTNS
- DFE P1 Spons 01 Name
- MANULIFE FINANCIAL
- DFE P1 Plan 01 EIN Plan number
- 010233346000
- DFE P1 Entity 01 Code
- P
- DFE P1 Plan Interest End of year 01 Amount
- $0