401k Plan data: THE EMPLOYEE 401(K) RETIREMENT PLAN plan

THE EMPLOYEE 401(K) RETIREMENT PLAN 401k Plan overview

Plan Name	THE EMPLOYEE 401(K) RETIREMENT PLAN
Plan identification number	002

THE EMPLOYEE 401(K) 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.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

LA LOMITA, INC. has sponsored the creation of one or more 401k plans.

Company Name: LA LOMITA, INC.

Employer identification number (EIN): 742435469

NAIC Classification: 722511
NAIC Description: Full-Service Restaurants

Additional information about LA LOMITA, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1986-08-05

Company Identification Number: 0100631700

Legal Registered Office Address: 2105 REMINGTON AVE

EDINBURG
United States of America (USA)
78539

More information about LA LOMITA, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE EMPLOYEE 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2018-01-01 PATRICIA NIELSEN 2019-03-07
002 2017-01-01 PATRICIA NIELSEN
002 2017-01-01 PATRICIA NIELSEN
002 2016-01-01
002 2011-01-01 PATRICIA NIELSEN 2012-07-26

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2018-01-01	PATRICIA NIELSEN	2019-03-07
002	2017-01-01	PATRICIA NIELSEN
002	2017-01-01	PATRICIA NIELSEN
002	2016-01-01
002	2011-01-01	PATRICIA NIELSEN	2012-07-26

Plan Statistics for THE EMPLOYEE 401(K) RETIREMENT PLAN

401k plan membership statisitcs for THE EMPLOYEE 401(K) RETIREMENT PLAN

Measure Date Value
2017: THE EMPLOYEE 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 168
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 20
Number of retired or separated participants receiving benefits 2017-01-01 2
Number of other retired or separated participants entitled to future benefits 2017-01-01 31
Total of all active and inactive participants 2017-01-01 53
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 53
Number of participants with account balances 2017-01-01 38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 12
2016: THE EMPLOYEE 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 201
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 158
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 8
Total of all active and inactive participants 2016-01-01 166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 166
Number of participants with account balances 2016-01-01 41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0

Measure	Date	Value
2017: THE EMPLOYEE 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	168
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	20
Number of retired or separated participants receiving benefits	2017-01-01	2
Number of other retired or separated participants entitled to future benefits	2017-01-01	31
Total of all active and inactive participants	2017-01-01	53
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	53
Number of participants with account balances	2017-01-01	38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	12
2016: THE EMPLOYEE 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	201
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	158
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	8
Total of all active and inactive participants	2016-01-01	166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	166
Number of participants with account balances	2016-01-01	41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0

Financial Data on THE EMPLOYEE 401(K) RETIREMENT PLAN

Measure	Date	Value
2017 : THE EMPLOYEE 401(K) RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$514,489
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$92,994
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$58,327
Expenses. Certain deemed distributions of participant loans	2017-12-31	$16,335
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$275,716
Value of total assets at end of year	2017-12-31	$2,410,296
Value of total assets at beginning of year	2017-12-31	$1,988,801
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$18,332
Total interest from all sources	2017-12-31	$4,312
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$241,030
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$202,798
Participant contributions at end of year	2017-12-31	$57,542
Participant contributions at beginning of year	2017-12-31	$64,009
Participant contributions at end of year	2017-12-31	$3,751
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$1,897
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$421,495
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,410,296
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,988,801
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in pooled separate accounts at end of year	2017-12-31	$2,330,700
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$1,922,895
Interest on participant loans	2017-12-31	$4,312
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$6,535
Net investment gain/loss from pooled separate accounts	2017-12-31	$234,461
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$72,918
Employer contributions (assets) at end of year	2017-12-31	$9,871
Employer contributions (assets) at beginning of year	2017-12-31	$1,897
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$58,327
Contract administrator fees	2017-12-31	$18,332
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	TEMPLETON & COMPANY
Accountancy firm EIN	2017-12-31	141918990
2016 : THE EMPLOYEE 401(K) RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$383,034
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$151,364
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$151,364
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$276,037
Value of total assets at end of year	2016-12-31	$1,988,801
Value of total assets at beginning of year	2016-12-31	$1,757,131
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$0
Total interest from all sources	2016-12-31	$2,957
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$198,880
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$200,080
Participant contributions at end of year	2016-12-31	$64,009
Participant contributions at beginning of year	2016-12-31	$82,615
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$231,670
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,988,801
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,757,131
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$1,922,895
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$1,674,516
Interest on participant loans	2016-12-31	$2,957
Net investment gain/loss from pooled separate accounts	2016-12-31	$104,040
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$75,957
Employer contributions (assets) at end of year	2016-12-31	$1,897
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$151,364
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	TEMPLETON & COMPANY
Accountancy firm EIN	2016-12-31	141918990

Form 5500 Responses for THE EMPLOYEE 401(K) RETIREMENT PLAN

2017: THE EMPLOYEE 401(K) RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: THE EMPLOYEE 401(K) RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

932448-003

Policy instance

Insurance contract or identification number	932448-003
Number of Individuals Covered	53
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $10,063
Total amount of fees paid to insurance company	USD $2,905
Are there contracts with allocated funds for individual policies?	0
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?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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
Commission paid to Insurance Broker	USD $10,063
Insurance broker organization code?	3
Amount paid for insurance broker fees	2905
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	PINNACLE FINANCIAL SERVICES

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Company Name:	LA LOMITA, INC.
Employer identification number (EIN):	742435469
NAIC Classification:	722511
NAIC Description:	Full-Service Restaurants

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1986-08-05
Company Identification Number:	0100631700
Legal Registered Office Address:	2105 REMINGTON AVE EDINBURG United States of America (USA) 78539