401k Plan data: G & S STAFFING SERVICES, INC. RETIREMENT PLAN plan

G & S STAFFING SERVICES, INC. RETIREMENT PLAN 401k Plan overview

Plan Name	G & S STAFFING SERVICES, INC. RETIREMENT PLAN
Plan identification number	001

G & S STAFFING SERVICES, INC. RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
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

G & S STAFFING SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: G & S STAFFING SERVICES, INC.

Employer identification number (EIN): 411965500

NAIC Classification: 561300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan G & S STAFFING SERVICES, INC. RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01 SANDRA K NIELSEN 2022-02-09 SANDRA NIELSEN 2022-02-09
001 2020-01-01 SANDRA NIELSEN 2021-02-23 SANDRA NIELSEN 2021-02-23
001 2019-01-01 SANDRA NIELSEN 2020-07-30 SANDRA NIELSEN 2020-07-30
001 2018-01-01 SANDRA NIELSEN 2019-07-30 SANDRA NIELSEN 2019-07-30
001 2017-01-01 SANDY NIELSEN 2018-05-14 SANDY NIELSEN 2018-05-14
001 2016-01-01 SANDY NIELSEN 2017-03-15 SANDY NIELSEN 2017-03-15
001 2016-01-01 SANDY NIELSEN 2018-05-14 SANDY NIELSEN 2018-05-14
001 2015-01-01 SANDY NIELSEN
001 2014-01-01 SANDY NIELSEN
001 2013-01-01 SANDY NIELSEN 2014-04-25 SANDY NIELSEN 2014-04-25
001 2012-01-01 SANDY NIELSEN 2013-10-14 SANDY NIELSEN 2013-10-14
001 2011-07-01 SANDY NIELSEN 2012-07-25

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2021-01-01	SANDRA K NIELSEN	2022-02-09	SANDRA NIELSEN	2022-02-09
001	2020-01-01	SANDRA NIELSEN	2021-02-23	SANDRA NIELSEN	2021-02-23
001	2019-01-01	SANDRA NIELSEN	2020-07-30	SANDRA NIELSEN	2020-07-30
001	2018-01-01	SANDRA NIELSEN	2019-07-30	SANDRA NIELSEN	2019-07-30
001	2017-01-01	SANDY NIELSEN	2018-05-14	SANDY NIELSEN	2018-05-14
001	2016-01-01	SANDY NIELSEN	2017-03-15	SANDY NIELSEN	2017-03-15
001	2016-01-01	SANDY NIELSEN	2018-05-14	SANDY NIELSEN	2018-05-14
001	2015-01-01	SANDY NIELSEN
001	2014-01-01	SANDY NIELSEN
001	2013-01-01	SANDY NIELSEN	2014-04-25	SANDY NIELSEN	2014-04-25
001	2012-01-01	SANDY NIELSEN	2013-10-14	SANDY NIELSEN	2013-10-14
001	2011-07-01	SANDY NIELSEN	2012-07-25

Plan Statistics for G & S STAFFING SERVICES, INC. RETIREMENT PLAN

401k plan membership statisitcs for G & S STAFFING SERVICES, INC. RETIREMENT PLAN

Measure Date Value
2015: G & S STAFFING SERVICES, INC. RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 47
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 37
Total of all active and inactive participants 2015-01-01 84
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 84
Number of participants with account balances 2015-01-01 75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: G & S STAFFING SERVICES, INC. RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 47
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 77
Total of all active and inactive participants 2014-01-01 124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 124
Number of participants with account balances 2014-01-01 124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0

Measure	Date	Value
2015: G & S STAFFING SERVICES, INC. RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	47
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	37
Total of all active and inactive participants	2015-01-01	84
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	84
Number of participants with account balances	2015-01-01	75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: G & S STAFFING SERVICES, INC. RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	47
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	77
Total of all active and inactive participants	2014-01-01	124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	124
Number of participants with account balances	2014-01-01	124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0

Financial Data on G & S STAFFING SERVICES, INC. RETIREMENT PLAN

Measure	Date	Value
2015 : G & S STAFFING SERVICES, INC. RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$123,938
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$147,673
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$140,931
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$133,030
Value of total assets at end of year	2015-12-31	$406,941
Value of total assets at beginning of year	2015-12-31	$430,676
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$6,742
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$40,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-23,735
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$406,941
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$430,676
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$6,742
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$396,186
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$420,374
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$10,755
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$10,302
Net investment gain/loss from pooled separate accounts	2015-12-31	$-9,092
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$133,030
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$140,931
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	WESTBERG EISCHENS, PLLP
Accountancy firm EIN	2015-12-31	411792388
2014 : G & S STAFFING SERVICES, INC. RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$193,039
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$130,455
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$130,455
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$174,377
Value of total assets at end of year	2014-12-31	$430,676
Value of total assets at beginning of year	2014-12-31	$368,092
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$0
Total interest from all sources	2014-12-31	$213
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$40,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$62,584
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$430,676
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$368,092
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$420,374
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$363,048
Interest earned on other investments	2014-12-31	$213
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$10,302
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$5,044
Net investment gain/loss from pooled separate accounts	2014-12-31	$18,449
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$174,377
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$130,455
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	WESTBERG EISCHENS, PLLP
Accountancy firm EIN	2014-12-31	411792388

Form 5500 Responses for G & S STAFFING SERVICES, INC. RETIREMENT PLAN

2015: G & S STAFFING SERVICES, INC. RETIREMENT 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: G & S STAFFING SERVICES, INC. RETIREMENT 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
2014-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-827221

Policy instance

Insurance contract or identification number	GA-827221
Number of Individuals Covered	75
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,797
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?	Yes
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
Commission paid to Insurance Broker	USD $1,797
Insurance broker organization code?	4
Insurance broker name	EDWARD D JONES & CO L P.

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-827221

Policy instance

Insurance contract or identification number	GA-827221
Number of Individuals Covered	124
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,032
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?	Yes
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
Commission paid to Insurance Broker	USD $2,032
Insurance broker organization code?	4
Insurance broker name	EDWARD D JONES & CO L P.

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Company Name:	G & S STAFFING SERVICES, INC.
Employer identification number (EIN):	411965500
NAIC Classification:	561300