401k Plan data: EMPLOYEES ONLY 401(K) PLAN plan

EMPLOYEES ONLY 401(K) PLAN 401k Plan overview

Plan Name	EMPLOYEES ONLY 401(K) PLAN
Plan identification number	333

EMPLOYEES ONLY 401(K) 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.
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

EMPLOYEES ONLY, INC. has sponsored the creation of one or more 401k plans.

Company Name: EMPLOYEES ONLY, INC.

Employer identification number (EIN): 383280836

NAIC Classification: 561300

Additional information about EMPLOYEES ONLY, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 2009-06-10

Company Identification Number: P09000050889

Legal Registered Office Address: BAKKALAPULO & ASSOCIATES, PA

CLEARWATER

33765

More information about EMPLOYEES ONLY, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEES ONLY 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
333 2017-01-01 MARIO APRUZZESE MARIO APRUZZESE 2018-10-11
333 2016-01-01 MARIO APRUZZESE MARIO APRUZZESE 2017-10-16
333 2015-01-01 MARIO APRUZZESE
333 2014-01-01 JANINE GRADOWSKI
333 2013-08-01 MARIO APRUZZESE 2014-10-15 MARIO APRUZZESE 2014-10-15
333 2009-01-01 MARIO APRUZZESE MARIO APRUZZESE 2010-07-15
333 2009-01-01 MARIO APRUZZESE MARIO APRUZZESE 2010-07-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
333	2017-01-01	MARIO APRUZZESE		MARIO APRUZZESE	2018-10-11
333	2016-01-01	MARIO APRUZZESE		MARIO APRUZZESE	2017-10-16
333	2015-01-01	MARIO APRUZZESE
333	2014-01-01	JANINE GRADOWSKI
333	2013-08-01	MARIO APRUZZESE	2014-10-15	MARIO APRUZZESE	2014-10-15
333	2009-01-01	MARIO APRUZZESE		MARIO APRUZZESE	2010-07-15
333	2009-01-01	MARIO APRUZZESE		MARIO APRUZZESE	2010-07-15

Plan Statistics for EMPLOYEES ONLY 401(K) PLAN

401k plan membership statisitcs for EMPLOYEES ONLY 401(K) PLAN

Measure Date Value
2017: EMPLOYEES ONLY 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 489
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 400
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 67
Total of all active and inactive participants 2017-01-01 469
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 469
Number of participants with account balances 2017-01-01 187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 3
2016: EMPLOYEES ONLY 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 370
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 350
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 78
Total of all active and inactive participants 2016-01-01 428
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 428
Number of participants with account balances 2016-01-01 186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 1
2015: EMPLOYEES ONLY 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 467
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 369
Number of retired or separated participants receiving benefits 2015-01-01 1
Number of other retired or separated participants entitled to future benefits 2015-01-01 61
Total of all active and inactive participants 2015-01-01 431
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 431
Number of participants with account balances 2015-01-01 159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 59
2014: EMPLOYEES ONLY 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 308
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 349
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 74
Total of all active and inactive participants 2014-01-01 423
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 423
Number of participants with account balances 2014-01-01 251
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 70
2009: EMPLOYEES ONLY 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 588
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 0
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 0
Number of participants with account balances 2009-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2017: EMPLOYEES ONLY 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	489
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	400
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	67
Total of all active and inactive participants	2017-01-01	469
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	469
Number of participants with account balances	2017-01-01	187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	3
2016: EMPLOYEES ONLY 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	370
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	350
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	78
Total of all active and inactive participants	2016-01-01	428
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	428
Number of participants with account balances	2016-01-01	186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	1
2015: EMPLOYEES ONLY 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	467
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	369
Number of retired or separated participants receiving benefits	2015-01-01	1
Number of other retired or separated participants entitled to future benefits	2015-01-01	61
Total of all active and inactive participants	2015-01-01	431
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	431
Number of participants with account balances	2015-01-01	159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	59
2014: EMPLOYEES ONLY 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	308
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	349
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	74
Total of all active and inactive participants	2014-01-01	423
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	423
Number of participants with account balances	2014-01-01	251
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	70
2009: EMPLOYEES ONLY 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	588
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	0
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	0
Number of participants with account balances	2009-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on EMPLOYEES ONLY 401(K) PLAN

Measure	Date	Value
2017 : EMPLOYEES ONLY 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets from this plan	2017-12-31	$312,340
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$10,438
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$4,888
Total income from all sources (including contributions)	2017-12-31	$947,991
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$363,008
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$296,946
Value of total corrective distributions	2017-12-31	$9,679
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$397,942
Value of total assets at end of year	2017-12-31	$3,797,011
Value of total assets at beginning of year	2017-12-31	$3,518,818
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$56,383
Total interest from all sources	2017-12-31	$3,528
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
Administrative expenses professional fees incurred	2017-12-31	$4,999
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
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	$310,314
Participant contributions at end of year	2017-12-31	$91,194
Participant contributions at beginning of year	2017-12-31	$87,124
Participant contributions at end of year	2017-12-31	$26,324
Participant contributions at beginning of year	2017-12-31	$10,470
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$4,163
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$4,619
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$2,221
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$10,438
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$4,888
Other income not declared elsewhere	2017-12-31	$4,704
Administrative expenses (other) incurred	2017-12-31	$12,759
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	$584,983
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$3,786,573
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,513,930
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	$3,250,771
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$2,969,820
Interest on participant loans	2017-12-31	$3,528
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$418,352
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$446,122
Net investment gain/loss from pooled separate accounts	2017-12-31	$541,817
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	$87,628
Employer contributions (assets) at end of year	2017-12-31	$5,751
Employer contributions (assets) at beginning of year	2017-12-31	$3,061
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$292,783
Contract administrator fees	2017-12-31	$38,625
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	JASON F. CLAUSEN, P.C.
Accountancy firm EIN	2017-12-31	274097479
2016 : EMPLOYEES ONLY 401(K) 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	$4,888
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$6,367
Total income from all sources (including contributions)	2016-12-31	$759,974
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$464,763
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$405,339
Expenses. Certain deemed distributions of participant loans	2016-12-31	$1,248
Value of total corrective distributions	2016-12-31	$4,677
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$329,387
Value of total assets at end of year	2016-12-31	$3,518,818
Value of total assets at beginning of year	2016-12-31	$3,225,086
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$53,499
Total interest from all sources	2016-12-31	$2,886
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
Administrative expenses professional fees incurred	2016-12-31	$48
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
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	$258,048
Participant contributions at end of year	2016-12-31	$87,124
Participant contributions at beginning of year	2016-12-31	$40,087
Participant contributions at end of year	2016-12-31	$10,470
Participant contributions at beginning of year	2016-12-31	$21,900
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$2,243
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-12-31	$111,236
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$2,221
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$2,476
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$4,888
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$6,367
Other income not declared elsewhere	2016-12-31	$161,496
Administrative expenses (other) incurred	2016-12-31	$12,947
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	$295,211
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,513,930
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$3,218,719
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	$2,969,820
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$2,699,224
Interest on participant loans	2016-12-31	$2,886
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$446,122
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$447,043
Net investment gain/loss from pooled separate accounts	2016-12-31	$266,205
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	$69,096
Employer contributions (assets) at end of year	2016-12-31	$3,061
Employer contributions (assets) at beginning of year	2016-12-31	$14,356
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$294,103
Contract administrator fees	2016-12-31	$40,504
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	JASON F. CLAUSEN, P.C.
Accountancy firm EIN	2016-12-31	274097479
2015 : EMPLOYEES ONLY 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets from this plan	2015-12-31	$4,691,867
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$6,367
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$2,280
Total income from all sources (including contributions)	2015-12-31	$330,489
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$990,983
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$839,013
Expenses. Certain deemed distributions of participant loans	2015-12-31	$67,789
Value of total corrective distributions	2015-12-31	$6,367
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$393,636
Value of total assets at end of year	2015-12-31	$3,225,086
Value of total assets at beginning of year	2015-12-31	$8,573,360
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$77,814
Total interest from all sources	2015-12-31	$4,353
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	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$289,812
Participant contributions at end of year	2015-12-31	$40,087
Participant contributions at beginning of year	2015-12-31	$233,446
Participant contributions at end of year	2015-12-31	$21,900
Participant contributions at beginning of year	2015-12-31	$36,576
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$8,172
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-12-31	$1
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$2,476
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$3,193
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$6,367
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$2,280
Other income not declared elsewhere	2015-12-31	$86
Administrative expenses (other) incurred	2015-12-31	$21,526
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	$-660,494
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$3,218,719
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$8,571,080
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
Value of interest in pooled separate accounts at end of year	2015-12-31	$2,699,224
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$7,194,496
Interest on participant loans	2015-12-31	$4,353
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$447,043
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$894,507
Net investment gain/loss from pooled separate accounts	2015-12-31	$-67,586
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	$95,652
Employer contributions (assets) at end of year	2015-12-31	$14,356
Employer contributions (assets) at beginning of year	2015-12-31	$211,142
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$839,012
Contract administrator fees	2015-12-31	$56,288
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	Yes
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	TEMPLETON & COMPANY
Accountancy firm EIN	2015-12-31	141918990
2014 : EMPLOYEES ONLY 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$599,319
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$2,280
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$13,422
Total income from all sources (including contributions)	2014-12-31	$1,175,750
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,428,168
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,279,839
Expenses. Certain deemed distributions of participant loans	2014-12-31	$43,254
Value of total corrective distributions	2014-12-31	$2,280
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$991,144
Value of total assets at end of year	2014-12-31	$8,573,360
Value of total assets at beginning of year	2014-12-31	$8,237,601
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$102,795
Total interest from all sources	2014-12-31	$14,488
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	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$523,038
Participant contributions at end of year	2014-12-31	$233,446
Participant contributions at beginning of year	2014-12-31	$161,531
Participant contributions at end of year	2014-12-31	$36,576
Participant contributions at beginning of year	2014-12-31	$14,763
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$68,906
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$2,797
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$3,193
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$238
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$2,280
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$13,422
Other income not declared elsewhere	2014-12-31	$115
Administrative expenses (other) incurred	2014-12-31	$29,077
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	$-252,418
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$8,571,080
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$8,224,179
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 pooled separate accounts at end of year	2014-12-31	$7,194,496
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$6,770,194
Interest on participant loans	2014-12-31	$14,488
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$894,507
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,106,201
Net investment gain/loss from pooled separate accounts	2014-12-31	$170,003
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	Yes
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	$399,200
Employer contributions (assets) at end of year	2014-12-31	$211,142
Employer contributions (assets) at beginning of year	2014-12-31	$184,674
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,277,042
Contract administrator fees	2014-12-31	$73,718
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-12-31	Yes
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	TEMPLETON & COMPANY
Accountancy firm EIN	2014-12-31	141918990

Form 5500 Responses for EMPLOYEES ONLY 401(K) PLAN

2017: EMPLOYEES ONLY 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Mulitple 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: EMPLOYEES ONLY 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Mulitple employer plan
2016-01-01	Submission has been amended	No
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
2015: EMPLOYEES ONLY 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Mulitple 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: EMPLOYEES ONLY 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Mulitple 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
2009: EMPLOYEES ONLY 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Mulitple employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	Yes
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

VARIOUS

Policy instance

Insurance contract or identification number	VARIOUS
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $7,365
Total amount of fees paid to insurance company	USD $9,601
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,365
Insurance broker organization code?	4
Amount paid for insurance broker fees	4508
Additional information about fees paid to insurance broker	TPA SUBSIDY
Insurance broker name	PINNACLE FINANCIAL SERVICES, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

VARIOUS

Policy instance

Insurance contract or identification number	VARIOUS
Number of Individuals Covered	209
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $10,986
Total amount of fees paid to insurance company	USD $26,728
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?	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,986
Insurance broker organization code?	4
Amount paid for insurance broker fees	11745
Additional information about fees paid to insurance broker	TPA SUBSIDY
Insurance broker name	LINCOLN FINANCIAL ADVISORS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

VARIOUS

Policy instance

Insurance contract or identification number	VARIOUS
Number of Individuals Covered	309
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $11,864
Total amount of fees paid to insurance company	USD $27,717
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?	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	13
Additional information about fees paid to insurance broker	MARKETING ALLOWANCE
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $11,864
Insurance broker name	PINNACLE FINANCIAL SERVICES, INC.

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Company Name:	EMPLOYEES ONLY, INC.
Employer identification number (EIN):	383280836
NAIC Classification:	561300

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	2009-06-10
Company Identification Number:	P09000050889
Legal Registered Office Address:	BAKKALAPULO & ASSOCIATES, PA CLEARWATER 33765