401k Plan data: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN plan

THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 401k Plan overview

Plan Name	THE ROBERTS MOTOR COMPANY RETIREMENT PLAN
Plan identification number	001

THE ROBERTS MOTOR COMPANY RETIREMENT PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
Plan covered by PBGC that was terminated and closed out for PBGC purposes - Before the end of the plan year (or a prior plan year), (1) the plan terminated in a standard (or distress) termination and completed the distribution of plan assets in satisfaction of all benefit liabilities (or all ERISA Title IV benefits for distress termination); or (2) a trustee was appointed for a terminated plan pursuant to ERISA section 4042.
Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).
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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

ROBERTS MOTOR COMPANY has sponsored the creation of one or more 401k plans.

Company Name: ROBERTS MOTOR COMPANY

Employer identification number (EIN): 930266530

NAIC Classification: 541600

Additional information about ROBERTS MOTOR COMPANY

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division

Incorporation Date: 2017-06-08

Company Identification Number: 2100519

Legal Registered Office Address: 111 SW 5TH AVE

PORTLAND
United States of America (USA)
97204

More information about ROBERTS MOTOR COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE ROBERTS MOTOR COMPANY RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01 PAMELA BLACKWELL PAMELA BLACKWELL 2016-04-27
001 2014-01-01 PAMELA BLACKWELL PAMELA BLACKWELL 2015-10-14
001 2013-01-01 PAMELA BLACKWELL PAMELA BLACKWELL 2014-10-06
001 2012-01-01 PAMELA T. BLACKWELL
001 2011-01-01 PAMELA T. BLACKWELL
001 2010-06-01 PAMELA BLACKWELL 2011-07-22 PAMELA BLACKWELL 2011-07-22
001 2009-01-01 JOHN CLEMENTS

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2015-01-01	PAMELA BLACKWELL		PAMELA BLACKWELL	2016-04-27
001	2014-01-01	PAMELA BLACKWELL		PAMELA BLACKWELL	2015-10-14
001	2013-01-01	PAMELA BLACKWELL		PAMELA BLACKWELL	2014-10-06
001	2012-01-01	PAMELA T. BLACKWELL
001	2011-01-01	PAMELA T. BLACKWELL
001	2010-06-01	PAMELA BLACKWELL	2011-07-22	PAMELA BLACKWELL	2011-07-22
001	2009-01-01	JOHN CLEMENTS

Plan Statistics for THE ROBERTS MOTOR COMPANY RETIREMENT PLAN

401k plan membership statisitcs for THE ROBERTS MOTOR COMPANY RETIREMENT PLAN

Measure Date Value
2015: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
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 0
Total of all active and inactive participants 2015-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 0
Number of participants with account balances 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 19
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1
Number of retired or separated participants receiving benefits 2014-01-01 11
Number of other retired or separated participants entitled to future benefits 2014-01-01 4
Total of all active and inactive participants 2014-01-01 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 80
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1
Number of retired or separated participants receiving benefits 2013-01-01 11
Number of other retired or separated participants entitled to future benefits 2013-01-01 7
Total of all active and inactive participants 2013-01-01 19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 83
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 2
Number of retired or separated participants receiving benefits 2012-01-01 8
Number of other retired or separated participants entitled to future benefits 2012-01-01 70
Total of all active and inactive participants 2012-01-01 80
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 119
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 2
Number of retired or separated participants receiving benefits 2011-01-01 7
Number of other retired or separated participants entitled to future benefits 2011-01-01 74
Total of all active and inactive participants 2011-01-01 83
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 2
Number of retired or separated participants receiving benefits 2009-01-01 6
Number of other retired or separated participants entitled to future benefits 2009-01-01 114
Total of all active and inactive participants 2009-01-01 122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2015: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
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	0
Total of all active and inactive participants	2015-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	0
Number of participants with account balances	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	19
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1
Number of retired or separated participants receiving benefits	2014-01-01	11
Number of other retired or separated participants entitled to future benefits	2014-01-01	4
Total of all active and inactive participants	2014-01-01	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	80
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1
Number of retired or separated participants receiving benefits	2013-01-01	11
Number of other retired or separated participants entitled to future benefits	2013-01-01	7
Total of all active and inactive participants	2013-01-01	19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	83
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	2
Number of retired or separated participants receiving benefits	2012-01-01	8
Number of other retired or separated participants entitled to future benefits	2012-01-01	70
Total of all active and inactive participants	2012-01-01	80
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	119
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	2
Number of retired or separated participants receiving benefits	2011-01-01	7
Number of other retired or separated participants entitled to future benefits	2011-01-01	74
Total of all active and inactive participants	2011-01-01	83
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	2
Number of retired or separated participants receiving benefits	2009-01-01	6
Number of other retired or separated participants entitled to future benefits	2009-01-01	114
Total of all active and inactive participants	2009-01-01	122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on THE ROBERTS MOTOR COMPANY RETIREMENT PLAN

Measure	Date	Value
2015 : THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2015 401k financial data
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$26,867
Expenses. Total of all expenses incurred	2015-12-31	$1,262,808
Benefits paid (including direct rollovers)	2015-12-31	$1,257,647
Total plan assets at end of year	2015-12-31	$0
Total plan assets at beginning of year	2015-12-31	$1,235,941
Value of fidelity bond covering the plan	2015-12-31	$350,000
Other income received	2015-12-31	$26,867
Net income (gross income less expenses)	2015-12-31	$-1,235,941
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$1,235,941
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$5,161
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2014 401k financial data
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$20,521
Total income from all sources	2014-12-31	$24,867
Expenses. Total of all expenses incurred	2014-12-31	$202,661
Benefits paid (including direct rollovers)	2014-12-31	$197,976
Total plan assets at end of year	2014-12-31	$1,235,941
Total plan assets at beginning of year	2014-12-31	$1,434,256
Value of fidelity bond covering the plan	2014-12-31	$350,000
Other income received	2014-12-31	$24,867
Net income (gross income less expenses)	2014-12-31	$-177,794
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,235,941
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,413,735
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$4,685
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$20,521
Total plan liabilities at beginning of year	2013-12-31	$1,675
Total income from all sources	2013-12-31	$884,085
Expenses. Total of all expenses incurred	2013-12-31	$1,782,111
Benefits paid (including direct rollovers)	2013-12-31	$1,776,823
Total plan assets at end of year	2013-12-31	$1,434,256
Total plan assets at beginning of year	2013-12-31	$2,313,436
Value of fidelity bond covering the plan	2013-12-31	$350,000
Other income received	2013-12-31	$69,085
Net income (gross income less expenses)	2013-12-31	$-898,026
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,413,735
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$2,311,761
Total contributions received or receivable from employer(s)	2013-12-31	$815,000
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$5,288
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$1,675
Total plan liabilities at beginning of year	2012-12-31	$1,621
Total income from all sources	2012-12-31	$326,819
Expenses. Total of all expenses incurred	2012-12-31	$174,438
Benefits paid (including direct rollovers)	2012-12-31	$167,927
Total plan assets at end of year	2012-12-31	$2,313,436
Total plan assets at beginning of year	2012-12-31	$2,161,001
Value of fidelity bond covering the plan	2012-12-31	$350,000
Other income received	2012-12-31	$76,819
Net income (gross income less expenses)	2012-12-31	$152,381
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$2,311,761
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$2,159,380
Total contributions received or receivable from employer(s)	2012-12-31	$250,000
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$6,511
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$-54,199
Total unrealized appreciation/depreciation of assets	2011-12-31	$-54,199
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$1,621
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$3,222
Total income from all sources (including contributions)	2011-12-31	$30,016
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$376,748
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$369,186
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$0
Value of total assets at end of year	2011-12-31	$2,161,001
Value of total assets at beginning of year	2011-12-31	$2,509,334
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$7,562
Total interest from all sources	2011-12-31	$78,558
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$5,657
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$350,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$5,657
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$1,621
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$3,222
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-346,732
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$2,159,380
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$2,506,112
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Interest earned on other investments	2011-12-31	$78,558
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,917,939
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$2,217,730
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Income. Dividends from common stock	2011-12-31	$5,657
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$369,186
Contract administrator fees	2011-12-31	$7,562
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-31	$237,405
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$291,604
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	MOSS ADAMS LLP
Accountancy firm EIN	2011-12-31	910189318
2010 : THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$33,075
Total unrealized appreciation/depreciation of assets	2010-12-31	$33,075
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$3,222
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$3,351
Total income from all sources (including contributions)	2010-12-31	$132,677
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$79,928
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$66,946
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$0
Value of total assets at end of year	2010-12-31	$2,509,334
Value of total assets at beginning of year	2010-12-31	$2,456,714
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$12,982
Total interest from all sources	2010-12-31	$99,602
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$350,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$3,222
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$3,351
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$52,749
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$2,506,112
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$2,453,363
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Interest earned on other investments	2010-12-31	$99,602
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$2,217,730
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$2,198,185
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$66,946
Contract administrator fees	2010-12-31	$12,982
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$291,604
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$258,529
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	MOSS ADAMS LLP
Accountancy firm EIN	2010-12-31	910189318
2009 : THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for THE ROBERTS MOTOR COMPANY RETIREMENT PLAN

2015: THE ROBERTS MOTOR COMPANY 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	Yes
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 benefit arrangement – Insurance	Yes
2014: THE ROBERTS MOTOR COMPANY 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 benefit arrangement – Insurance	Yes
2013: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: THE ROBERTS MOTOR COMPANY RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

341121

Policy instance

Insurance contract or identification number	341121
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
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	1
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?	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

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

341121

Policy instance

Insurance contract or identification number	341121
Number of Individuals Covered	11
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
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	1
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?	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

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

341121

Policy instance

Insurance contract or identification number	341121
Number of Individuals Covered	19
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
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	1
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?	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

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

341121

Policy instance

Insurance contract or identification number	341121
Number of Individuals Covered	80
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
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	1
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?	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

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

341121

Policy instance

Insurance contract or identification number	341121
Number of Individuals Covered	83
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
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	1
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?	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

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

341121

Policy instance

Insurance contract or identification number	341121
Number of Individuals Covered	119
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
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	1
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?	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

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Company Name:	ROBERTS MOTOR COMPANY
Employer identification number (EIN):	930266530
NAIC Classification:	541600

Jurisdiction of Incorporation:	Oregon Secretary of State Corporations Division
Incorporation Date:	2017-06-08
Company Identification Number:	2100519
Legal Registered Office Address:	111 SW 5TH AVE PORTLAND United States of America (USA) 97204