401k Plan data: BLAZE PIZZA 401K PLAN plan

BLAZE PIZZA 401K PLAN 401k Plan overview

Plan Name	BLAZE PIZZA 401K PLAN
Plan identification number	001

BLAZE PIZZA 401K 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.
Plan covering Self-Employed individuals.
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

BLAZE PIZZA, LLC has sponsored the creation of one or more 401k plans.

Company Name: BLAZE PIZZA, LLC

Employer identification number (EIN): 453799574

NAIC Classification: 722513
NAIC Description: Limited-Service Restaurants

Additional information about BLAZE PIZZA, LLC

Jurisdiction of Incorporation: California Department of State

Incorporation Date:

Company Identification Number: 201130910077

More information about BLAZE PIZZA, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLAZE PIZZA 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-12-30
001 2021-12-30
001 2020-12-30
001 2020-12-30
001 2019-12-30
001 2019-12-30
001 2019-12-30
001 2019-12-30
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2017-01-01
001 2016-01-01

Plan Statistics for BLAZE PIZZA 401K PLAN

401k plan membership statisitcs for BLAZE PIZZA 401K PLAN

Measure Date Value
2022: BLAZE PIZZA 401K PLAN 2022 401k membership
Total participants, beginning-of-year 2022-12-30 149
Total number of active participants reported on line 7a of the Form 5500 2022-12-30 211
Number of retired or separated participants receiving benefits 2022-12-30 0
Number of other retired or separated participants entitled to future benefits 2022-12-30 33
Total of all active and inactive participants 2022-12-30 244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-12-30 0
Total participants 2022-12-30 244
Number of participants with account balances 2022-12-30 81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-12-30 0
2021: BLAZE PIZZA 401K PLAN 2021 401k membership
Total participants, beginning-of-year 2021-12-30 173
Total number of active participants reported on line 7a of the Form 5500 2021-12-30 113
Number of retired or separated participants receiving benefits 2021-12-30 0
Number of other retired or separated participants entitled to future benefits 2021-12-30 36
Total of all active and inactive participants 2021-12-30 149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-12-30 0
Total participants 2021-12-30 149
Number of participants with account balances 2021-12-30 78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-12-30 0
2020: BLAZE PIZZA 401K PLAN 2020 401k membership
Total participants, beginning-of-year 2020-12-30 187
Total number of active participants reported on line 7a of the Form 5500 2020-12-30 151
Number of retired or separated participants receiving benefits 2020-12-30 0
Number of other retired or separated participants entitled to future benefits 2020-12-30 22
Total of all active and inactive participants 2020-12-30 173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-12-30 0
Total participants 2020-12-30 173
Number of participants with account balances 2020-12-30 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-12-30 0
2019: BLAZE PIZZA 401K PLAN 2019 401k membership
Total participants, beginning-of-year 2019-12-30 270
Total number of active participants reported on line 7a of the Form 5500 2019-12-30 155
Number of retired or separated participants receiving benefits 2019-12-30 0
Number of other retired or separated participants entitled to future benefits 2019-12-30 32
Total of all active and inactive participants 2019-12-30 187
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-12-30 0
Total participants 2019-12-30 187
Number of participants with account balances 2019-12-30 75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-12-30 0
Total participants, beginning-of-year 2019-01-01 207
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 138
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 138
Number of participants with account balances 2019-01-01 89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: BLAZE PIZZA 401K PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 185
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 140
Number of retired or separated participants receiving benefits 2018-01-01 6
Number of other retired or separated participants entitled to future benefits 2018-01-01 61
Total of all active and inactive participants 2018-01-01 207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 207
Number of participants with account balances 2018-01-01 148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: BLAZE PIZZA 401K PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 93
Number of retired or separated participants receiving benefits 2017-01-01 1
Number of other retired or separated participants entitled to future benefits 2017-01-01 44
Total of all active and inactive participants 2017-01-01 138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 138
Number of participants with account balances 2017-01-01 136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 7
2016: BLAZE PIZZA 401K PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 104
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 29
Total of all active and inactive participants 2016-01-01 133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 133
Number of participants with account balances 2016-01-01 130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0

Measure	Date	Value
2022: BLAZE PIZZA 401K PLAN 2022 401k membership
Total participants, beginning-of-year	2022-12-30	149
Total number of active participants reported on line 7a of the Form 5500	2022-12-30	211
Number of retired or separated participants receiving benefits	2022-12-30	0
Number of other retired or separated participants entitled to future benefits	2022-12-30	33
Total of all active and inactive participants	2022-12-30	244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-12-30	0
Total participants	2022-12-30	244
Number of participants with account balances	2022-12-30	81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-12-30	0
2021: BLAZE PIZZA 401K PLAN 2021 401k membership
Total participants, beginning-of-year	2021-12-30	173
Total number of active participants reported on line 7a of the Form 5500	2021-12-30	113
Number of retired or separated participants receiving benefits	2021-12-30	0
Number of other retired or separated participants entitled to future benefits	2021-12-30	36
Total of all active and inactive participants	2021-12-30	149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-12-30	0
Total participants	2021-12-30	149
Number of participants with account balances	2021-12-30	78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-12-30	0
2020: BLAZE PIZZA 401K PLAN 2020 401k membership
Total participants, beginning-of-year	2020-12-30	187
Total number of active participants reported on line 7a of the Form 5500	2020-12-30	151
Number of retired or separated participants receiving benefits	2020-12-30	0
Number of other retired or separated participants entitled to future benefits	2020-12-30	22
Total of all active and inactive participants	2020-12-30	173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-12-30	0
Total participants	2020-12-30	173
Number of participants with account balances	2020-12-30	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-12-30	0
2019: BLAZE PIZZA 401K PLAN 2019 401k membership
Total participants, beginning-of-year	2019-12-30	270
Total number of active participants reported on line 7a of the Form 5500	2019-12-30	155
Number of retired or separated participants receiving benefits	2019-12-30	0
Number of other retired or separated participants entitled to future benefits	2019-12-30	32
Total of all active and inactive participants	2019-12-30	187
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-12-30	0
Total participants	2019-12-30	187
Number of participants with account balances	2019-12-30	75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-12-30	0
Total participants, beginning-of-year	2019-01-01	207
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	138
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	138
Number of participants with account balances	2019-01-01	89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: BLAZE PIZZA 401K PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	185
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	140
Number of retired or separated participants receiving benefits	2018-01-01	6
Number of other retired or separated participants entitled to future benefits	2018-01-01	61
Total of all active and inactive participants	2018-01-01	207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	207
Number of participants with account balances	2018-01-01	148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: BLAZE PIZZA 401K PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	93
Number of retired or separated participants receiving benefits	2017-01-01	1
Number of other retired or separated participants entitled to future benefits	2017-01-01	44
Total of all active and inactive participants	2017-01-01	138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	138
Number of participants with account balances	2017-01-01	136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	7
2016: BLAZE PIZZA 401K PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	104
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	29
Total of all active and inactive participants	2016-01-01	133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	133
Number of participants with account balances	2016-01-01	130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0

Financial Data on BLAZE PIZZA 401K PLAN

Measure	Date	Value
2023 : BLAZE PIZZA 401K PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets	2023-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total income from all sources (including contributions)	2023-12-31	$1,427,397
Total loss/gain on sale of assets	2023-12-31	$0
Total of all expenses incurred	2023-12-31	$865,420
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-12-31	$864,310
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-12-31	$718,759
Value of total assets at end of year	2023-12-31	$4,367,499
Value of total assets at beginning of year	2023-12-31	$3,805,522
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-12-31	$1,110
Total interest from all sources	2023-12-31	$2,365
Total dividends received (eg from common stock, registered investment company shares)	2023-12-31	$205,603
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2023-12-31	$205,603
Was this plan covered by a fidelity bond	2023-12-31	Yes
Value of fidelity bond cover	2023-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2023-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2023-12-31	No
Contributions received from participants	2023-12-31	$389,504
Participant contributions at end of year	2023-12-31	$42,087
Participant contributions at beginning of year	2023-12-31	$27,904
Income. Received or receivable in cash from other sources (including rollovers)	2023-12-31	$161,043
Administrative expenses (other) incurred	2023-12-31	$1,110
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-12-31	No
Value of net income/loss	2023-12-31	$561,977
Value of net assets at end of year (total assets less liabilities)	2023-12-31	$4,367,499
Value of net assets at beginning of year (total assets less liabilities)	2023-12-31	$3,805,522
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-12-31	No
Were any leases to which the plan was party in default or uncollectible	2023-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-12-31	$4,325,335
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-12-31	$3,777,545
Interest on participant loans	2023-12-31	$2,361
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2023-12-31	$77
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2023-12-31	$73
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2023-12-31	$73
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2023-12-31	$4
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2023-12-31	$500,670
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-12-31	No
Was there a failure to transmit to the plan any participant contributions	2023-12-31	No
Has the plan failed to provide any benefit when due under the plan	2023-12-31	No
Contributions received in cash from employer	2023-12-31	$168,212
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-12-31	$864,310
Did the plan have assets held for investment	2023-12-31	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	2023-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-12-31	No
Opinion of an independent qualified public accountant for this plan	2023-12-31	Unqualified
Accountancy firm name	2023-12-31	BAKER TILLY US, LLP
Accountancy firm EIN	2023-12-31	301413443
2022 : BLAZE PIZZA 401K PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-29	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-29	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-29	$0
Total income from all sources (including contributions)	2022-12-29	$-213,992
Total loss/gain on sale of assets	2022-12-29	$0
Total of all expenses incurred	2022-12-29	$217,240
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-29	$216,330
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-29	$587,119
Value of total assets at end of year	2022-12-29	$3,805,522
Value of total assets at beginning of year	2022-12-29	$4,236,754
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-29	$910
Total interest from all sources	2022-12-29	$1,344
Total dividends received (eg from common stock, registered investment company shares)	2022-12-29	$303,098
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-29	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-29	$303,098
Was this plan covered by a fidelity bond	2022-12-29	Yes
Value of fidelity bond cover	2022-12-29	$2,000,000
If this is an individual account plan, was there a blackout period	2022-12-29	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-29	No
Contributions received from participants	2022-12-29	$407,261
Participant contributions at end of year	2022-12-29	$27,904
Participant contributions at beginning of year	2022-12-29	$38,504
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-29	$14,371
Administrative expenses (other) incurred	2022-12-29	$910
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-29	No
Value of net income/loss	2022-12-29	$-431,232
Value of net assets at end of year (total assets less liabilities)	2022-12-29	$3,805,522
Value of net assets at beginning of year (total assets less liabilities)	2022-12-29	$4,236,754
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-29	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-29	No
Were any leases to which the plan was party in default or uncollectible	2022-12-29	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-29	$3,777,545
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-29	$4,198,176
Interest on participant loans	2022-12-29	$1,344
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-29	$73
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-29	$74
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-29	$74
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-29	$-1,105,553
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-29	No
Was there a failure to transmit to the plan any participant contributions	2022-12-29	No
Has the plan failed to provide any benefit when due under the plan	2022-12-29	No
Contributions received in cash from employer	2022-12-29	$165,487
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-29	$216,330
Did the plan have assets held for investment	2022-12-29	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	2022-12-29	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-29	No
Opinion of an independent qualified public accountant for this plan	2022-12-29	Unqualified
Accountancy firm name	2022-12-29	BAKER TILLY US, LLP
Accountancy firm EIN	2022-12-29	390859910
2021 : BLAZE PIZZA 401K PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-27	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-27	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-27	$0
Total income from all sources (including contributions)	2021-12-27	$1,877,826
Total loss/gain on sale of assets	2021-12-27	$0
Total of all expenses incurred	2021-12-27	$629,777
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-27	$537,858
Value of total corrective distributions	2021-12-27	$90,639
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-27	$1,312,423
Value of total assets at end of year	2021-12-27	$4,236,754
Value of total assets at beginning of year	2021-12-27	$2,988,705
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-27	$1,280
Total interest from all sources	2021-12-27	$1,620
Total dividends received (eg from common stock, registered investment company shares)	2021-12-27	$308,512
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-27	$308,512
Was this plan covered by a fidelity bond	2021-12-27	Yes
Value of fidelity bond cover	2021-12-27	$2,000,000
If this is an individual account plan, was there a blackout period	2021-12-27	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-27	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-27	No
Contributions received from participants	2021-12-27	$402,237
Participant contributions at end of year	2021-12-27	$38,504
Participant contributions at beginning of year	2021-12-27	$52,407
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-27	$755,635
Administrative expenses (other) incurred	2021-12-27	$1,280
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-27	No
Value of net income/loss	2021-12-27	$1,248,049
Value of net assets at end of year (total assets less liabilities)	2021-12-27	$4,236,754
Value of net assets at beginning of year (total assets less liabilities)	2021-12-27	$2,988,705
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-27	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-27	No
Were any leases to which the plan was party in default or uncollectible	2021-12-27	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-27	$4,198,176
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-27	$2,936,225
Interest on participant loans	2021-12-27	$1,620
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-27	$74
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-27	$73
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-27	$73
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-27	$255,271
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-27	No
Was there a failure to transmit to the plan any participant contributions	2021-12-27	No
Has the plan failed to provide any benefit when due under the plan	2021-12-27	No
Contributions received in cash from employer	2021-12-27	$154,551
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-27	$537,858
Did the plan have assets held for investment	2021-12-27	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	2021-12-27	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-27	No
Opinion of an independent qualified public accountant for this plan	2021-12-27	Disclaimer
Accountancy firm name	2021-12-27	SQUAR MILNER LLP
Accountancy firm EIN	2021-12-27	330835986
2020 : BLAZE PIZZA 401K PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-27	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-27	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-27	$0
Total income from all sources (including contributions)	2020-12-27	$963,747
Total loss/gain on sale of assets	2020-12-27	$0
Total of all expenses incurred	2020-12-27	$686,957
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-27	$685,577
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-27	$549,366
Value of total assets at end of year	2020-12-27	$2,988,705
Value of total assets at beginning of year	2020-12-27	$2,711,915
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-27	$1,380
Total interest from all sources	2020-12-27	$4,188
Total dividends received (eg from common stock, registered investment company shares)	2020-12-27	$129,561
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-27	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-27	$129,561
Was this plan covered by a fidelity bond	2020-12-27	Yes
Value of fidelity bond cover	2020-12-27	$2,000,000
If this is an individual account plan, was there a blackout period	2020-12-27	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-27	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-27	No
Contributions received from participants	2020-12-27	$405,546
Participant contributions at end of year	2020-12-27	$52,407
Participant contributions at beginning of year	2020-12-27	$67,409
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-27	$5,226
Administrative expenses (other) incurred	2020-12-27	$1,380
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-27	No
Value of net income/loss	2020-12-27	$276,790
Value of net assets at end of year (total assets less liabilities)	2020-12-27	$2,988,705
Value of net assets at beginning of year (total assets less liabilities)	2020-12-27	$2,711,915
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-27	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-27	No
Were any leases to which the plan was party in default or uncollectible	2020-12-27	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-27	$2,936,225
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-27	$2,644,434
Interest on participant loans	2020-12-27	$4,187
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-27	$73
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-27	$72
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-27	$72
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-27	$1
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-27	$280,594
Net investment gain or loss from common/collective trusts	2020-12-27	$38
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-27	No
Was there a failure to transmit to the plan any participant contributions	2020-12-27	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-27	No
Contributions received in cash from employer	2020-12-27	$138,594
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-27	$685,577
Did the plan have assets held for investment	2020-12-27	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	2020-12-27	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-27	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-12-27	Yes
Opinion of an independent qualified public accountant for this plan	2020-12-27	Disclaimer
Accountancy firm name	2020-12-27	SQUAR MILNER LLP
Accountancy firm EIN	2020-12-27	330835986
2019 : BLAZE PIZZA 401K PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-29	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-29	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-29	$0
Total income from all sources (including contributions)	2019-12-29	$1,066,378
Total loss/gain on sale of assets	2019-12-29	$0
Total of all expenses incurred	2019-12-29	$312,463
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-29	$308,556
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-29	$649,691
Value of total assets at end of year	2019-12-29	$2,711,915
Value of total assets at beginning of year	2019-12-29	$1,958,000
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-29	$3,907
Total interest from all sources	2019-12-29	$3,116
Total dividends received (eg from common stock, registered investment company shares)	2019-12-29	$131,415
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-29	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-29	$131,415
Was this plan covered by a fidelity bond	2019-12-29	Yes
Value of fidelity bond cover	2019-12-29	$2,000,000
If this is an individual account plan, was there a blackout period	2019-12-29	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-29	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-29	No
Contributions received from participants	2019-12-29	$431,312
Participant contributions at end of year	2019-12-29	$67,409
Participant contributions at beginning of year	2019-12-29	$19,437
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-29	$12,138
Administrative expenses (other) incurred	2019-12-29	$3,907
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-29	No
Value of net income/loss	2019-12-29	$753,915
Value of net assets at end of year (total assets less liabilities)	2019-12-29	$2,711,915
Value of net assets at beginning of year (total assets less liabilities)	2019-12-29	$1,958,000
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-29	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-29	No
Were any leases to which the plan was party in default or uncollectible	2019-12-29	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-29	$2,644,434
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-29	$1,938,563
Interest on participant loans	2019-12-29	$833
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-29	$72
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-29	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-29	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-29	$2,283
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-29	$282,156
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-29	No
Was there a failure to transmit to the plan any participant contributions	2019-12-29	No
Has the plan failed to provide any benefit when due under the plan	2019-12-29	No
Contributions received in cash from employer	2019-12-29	$206,241
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-29	$308,556
Did the plan have assets held for investment	2019-12-29	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	2019-12-29	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-29	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-29	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-29	Disclaimer
Accountancy firm name	2019-12-29	SQUAR MILNER LLP
Accountancy firm EIN	2019-12-29	330835986
2018 : BLAZE PIZZA 401K PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$878,387
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$120,229
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$119,502
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,013,357
Value of total assets at end of year	2018-12-31	$1,958,000
Value of total assets at beginning of year	2018-12-31	$1,199,842
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$727
Total interest from all sources	2018-12-31	$692
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	No
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$389,589
Participant contributions at end of year	2018-12-31	$19,437
Participant contributions at beginning of year	2018-12-31	$8,744
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$434,870
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$758,158
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,958,000
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,199,842
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$1,938,563
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$1,191,098
Interest on participant loans	2018-12-31	$692
Net investment gain/loss from pooled separate accounts	2018-12-31	$-135,662
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$188,898
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$119,502
Contract administrator fees	2018-12-31	$727
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	SQUAR MILNER LLP
Accountancy firm EIN	2018-12-31	330835986
2017 : BLAZE PIZZA 401K 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	$694,649
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$14,020
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$13,374
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$546,984
Value of total assets at end of year	2017-12-31	$1,199,842
Value of total assets at beginning of year	2017-12-31	$519,213
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$646
Total interest from all sources	2017-12-31	$517
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	No
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$359,525
Participant contributions at end of year	2017-12-31	$8,744
Participant contributions at beginning of year	2017-12-31	$1,643
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	$680,629
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,199,842
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$519,213
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 registered invesment companies (eg mutual funds) at end of year	2017-12-31	$1,191,098
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$517,570
Interest on participant loans	2017-12-31	$517
Net investment gain/loss from pooled separate accounts	2017-12-31	$147,148
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	$187,459
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$13,374
Contract administrator fees	2017-12-31	$646
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	SQUAR MILNER
Accountancy firm EIN	2017-12-31	421768324
2016 : BLAZE PIZZA 401K 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	$520,581
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$1,368
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$1,164
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$499,316
Value of total assets at end of year	2016-12-31	$519,213
Value of total assets at beginning of year	2016-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$204
Total interest from all sources	2016-12-31	$4
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	No
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$299,537
Participant contributions at end of year	2016-12-31	$1,643
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$17,977
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	$519,213
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$519,213
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$0
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 registered invesment companies (eg mutual funds) at end of year	2016-12-31	$517,570
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$0
Interest on participant loans	2016-12-31	$4
Net investment gain/loss from pooled separate accounts	2016-12-31	$21,261
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	No
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	$181,802
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$1,164
Contract administrator fees	2016-12-31	$204
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	SQUAR MILNER
Accountancy firm EIN	2016-12-31	421768324

Form 5500 Responses for BLAZE PIZZA 401K PLAN

2022: BLAZE PIZZA 401K PLAN 2022 form 5500 responses
2022-12-30	Type of plan entity	Single employer plan
2022-12-30	Submission has been amended	No
2022-12-30	This submission is the final filing	No
2022-12-30	This return/report is a short plan year return/report (less than 12 months)	No
2022-12-30	Plan is a collectively bargained plan	No
2022-12-30	Plan funding arrangement – Trust	Yes
2022-12-30	Plan benefit arrangement - Trust	Yes
2021: BLAZE PIZZA 401K PLAN 2021 form 5500 responses
2021-12-30	Type of plan entity	Single employer plan
2021-12-30	Submission has been amended	No
2021-12-30	This submission is the final filing	No
2021-12-30	This return/report is a short plan year return/report (less than 12 months)	No
2021-12-30	Plan is a collectively bargained plan	No
2021-12-30	Plan funding arrangement – Trust	Yes
2021-12-30	Plan benefit arrangement - Trust	Yes
2020: BLAZE PIZZA 401K PLAN 2020 form 5500 responses
2020-12-30	Type of plan entity	Single employer plan
2020-12-30	Submission has been amended	No
2020-12-30	This submission is the final filing	No
2020-12-30	This return/report is a short plan year return/report (less than 12 months)	Yes
2020-12-30	Plan is a collectively bargained plan	No
2020-12-30	Plan funding arrangement – Trust	Yes
2020-12-30	Plan benefit arrangement - Trust	Yes
2019: BLAZE PIZZA 401K PLAN 2019 form 5500 responses
2019-12-30	Type of plan entity	Single employer plan
2019-12-30	Submission has been amended	Yes
2019-12-30	This submission is the final filing	No
2019-12-30	This return/report is a short plan year return/report (less than 12 months)	Yes
2019-12-30	Plan is a collectively bargained plan	No
2019-12-30	Plan funding arrangement – Trust	Yes
2019-12-30	Plan benefit arrangement - Trust	Yes
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: BLAZE PIZZA 401K PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: BLAZE PIZZA 401K 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 benefit arrangement – Insurance	Yes
2016: BLAZE PIZZA 401K PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	First time form 5500 has been submitted	Yes
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 benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

632895

Policy instance

Insurance contract or identification number	632895
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-29
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

632895

Policy instance

Insurance contract or identification number	632895
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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?	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?	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

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

632895

Policy instance

Insurance contract or identification number	632895
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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?	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?	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

Potentially related plans

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Company Name:	BLAZE PIZZA, LLC
Employer identification number (EIN):	453799574
NAIC Classification:	722513
NAIC Description:	Limited-Service Restaurants

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:
Company Identification Number:	201130910077