401k Plan data: THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN plan

THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN
Plan identification number	001

THE CAPRICE RESTAURANT 401(K) PROFIT SHARING 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

THE CAPRICE RESTAURANT has sponsored the creation of one or more 401k plans.

Company Name: THE CAPRICE RESTAURANT

Employer identification number (EIN): 680311689

NAIC Classification: 722511
NAIC Description: Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01 CYNTHIA SITTMANN 2022-02-17 CINDY SITTMANN 2022-02-17
001 2018-01-01 CINDY SITTMANN 2019-10-09
001 2017-01-01 CINDY SITTMANN 2018-05-23
001 2016-01-01 CINDY SITTMANN 2017-07-12
001 2015-01-01 CINDY SITTMANN 2016-08-04
001 2014-01-01 CINDY SITTMANN 2015-09-09
001 2013-01-01 CHONG COOK 2014-07-24
001 2012-01-01 CHONG COOK
001 2011-01-01 CHONG COOK
001 2009-01-01 CHONG COOK

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2021-01-01	CYNTHIA SITTMANN	2022-02-17	CINDY SITTMANN	2022-02-17
001	2018-01-01	CINDY SITTMANN	2019-10-09
001	2017-01-01	CINDY SITTMANN	2018-05-23
001	2016-01-01	CINDY SITTMANN	2017-07-12
001	2015-01-01	CINDY SITTMANN	2016-08-04
001	2014-01-01	CINDY SITTMANN	2015-09-09
001	2013-01-01	CHONG COOK	2014-07-24
001	2012-01-01	CHONG COOK
001	2011-01-01	CHONG COOK
001	2009-01-01	CHONG COOK

Plan Statistics for THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN

Measure Date Value
2012: THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 12
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 5
Total of all active and inactive participants 2012-01-01 17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 17
Number of participants with account balances 2012-01-01 6
2011: THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 11
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 5
Total of all active and inactive participants 2011-01-01 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 16
Number of participants with account balances 2011-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 9
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 6
Total of all active and inactive participants 2009-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 15
Number of participants with account balances 2009-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2012: THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	12
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	5
Total of all active and inactive participants	2012-01-01	17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	17
Number of participants with account balances	2012-01-01	6
2011: THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	11
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	5
Total of all active and inactive participants	2011-01-01	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	16
Number of participants with account balances	2011-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	9
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	6
Total of all active and inactive participants	2009-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	15
Number of participants with account balances	2009-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2012 : THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$2,299
Expenses. Total of all expenses incurred	2012-12-31	$90
Total plan assets at end of year	2012-12-31	$20,241
Total plan assets at beginning of year	2012-12-31	$18,032
Other income received	2012-12-31	$2,299
Net income (gross income less expenses)	2012-12-31	$2,209
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$20,241
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$18,032
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$90
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$-1,515
Total plan assets at end of year	2011-12-31	$18,032
Total plan assets at beginning of year	2011-12-31	$19,547
Other income received	2011-12-31	$-1,515
Net income (gross income less expenses)	2011-12-31	$-1,515
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$18,032
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$19,547
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$4,544
Expenses. Total of all expenses incurred	2010-12-31	$5,960
Benefits paid (including direct rollovers)	2010-12-31	$5,960
Total plan assets at end of year	2010-12-31	$19,547
Total plan assets at beginning of year	2010-12-31	$20,963
Total contributions received or receivable from participants	2010-12-31	$621
Other income received	2010-12-31	$3,768
Net income (gross income less expenses)	2010-12-31	$-1,416
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$19,547
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$20,963
Total contributions received or receivable from employer(s)	2010-12-31	$155

Form 5500 Responses for THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN

2012: THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: THE CAPRICE RESTAURANT 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan 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

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

91663987

Policy instance

Insurance contract or identification number	91663987
Number of Individuals Covered	6
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $70
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $70
Insurance broker organization code?	3
Insurance broker name	SALL, CLU SIDNEY ROBERT

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

91663987

Policy instance

Insurance contract or identification number	91663987
Number of Individuals Covered	6
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $69
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

91663987

Policy instance

Insurance contract or identification number	91663987
Number of Individuals Covered	7
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $62
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $36
Insurance broker organization code?	3
Insurance broker name	SALL, CLU SIDNEY ROBERT

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Company Name:	THE CAPRICE RESTAURANT
Employer identification number (EIN):	680311689
NAIC Classification:	722511
NAIC Description:	Full-Service Restaurants