401k Plan data: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN plan

STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 401k Plan overview

Plan Name	STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN
Plan identification number	001

STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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

STEVEN ROBERT ORIGINALS, LLC has sponsored the creation of one or more 401k plans.

Company Name: STEVEN ROBERT ORIGINALS, LLC

Employer identification number (EIN): 841318535

NAIC Classification: 311800
NAIC Description: Bakeries and Tortilla Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01 RAVINDER BHALWAL 2021-10-05
001 2019-01-01 RAVINDER BHALWAL 2020-10-12
001 2018-01-01 STEVEN FABOS 2019-10-09
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-08-01 CHARLES KOSMONT

Plan Statistics for STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN

401k plan membership statisitcs for STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN

Measure Date Value
2022: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 2,009
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 1,746
Number of retired or separated participants receiving benefits 2022-01-01 3
Number of other retired or separated participants entitled to future benefits 2022-01-01 265
Total of all active and inactive participants 2022-01-01 2,014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 2,014
Number of participants with account balances 2022-01-01 1,239
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 1,565
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 1,496
Number of retired or separated participants receiving benefits 2021-01-01 5
Number of other retired or separated participants entitled to future benefits 2021-01-01 508
Total of all active and inactive participants 2021-01-01 2,009
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 2,009
Number of participants with account balances 2021-01-01 1,343
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 1,852
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 1,289
Number of retired or separated participants receiving benefits 2020-01-01 3
Number of other retired or separated participants entitled to future benefits 2020-01-01 273
Total of all active and inactive participants 2020-01-01 1,565
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 1,565
Number of participants with account balances 2020-01-01 1,025
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,364
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 1,058
Number of retired or separated participants receiving benefits 2019-01-01 4
Number of other retired or separated participants entitled to future benefits 2019-01-01 344
Total of all active and inactive participants 2019-01-01 1,406
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 1,406
Number of participants with account balances 2019-01-01 918
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 461
2018: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 1,491
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 993
Number of retired or separated participants receiving benefits 2018-01-01 17
Number of other retired or separated participants entitled to future benefits 2018-01-01 354
Total of all active and inactive participants 2018-01-01 1,364
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 1,364
Number of participants with account balances 2018-01-01 919
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 294
2017: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1,431
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 975
Number of retired or separated participants receiving benefits 2017-01-01 2
Number of other retired or separated participants entitled to future benefits 2017-01-01 458
Total of all active and inactive participants 2017-01-01 1,435
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 1,435
Number of participants with account balances 2017-01-01 1,291
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 73
2016: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,114
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 932
Number of retired or separated participants receiving benefits 2016-01-01 6
Number of other retired or separated participants entitled to future benefits 2016-01-01 443
Total of all active and inactive participants 2016-01-01 1,381
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 1,381
Number of participants with account balances 2016-01-01 1,003
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 349
2015: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 848
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 893
Number of retired or separated participants receiving benefits 2015-01-01 6
Number of other retired or separated participants entitled to future benefits 2015-01-01 208
Total of all active and inactive participants 2015-01-01 1,107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 1,107
Number of participants with account balances 2015-01-01 754
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 219
2014: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-08-01 742
Total number of active participants reported on line 7a of the Form 5500 2014-08-01 816
Number of retired or separated participants receiving benefits 2014-08-01 0
Number of other retired or separated participants entitled to future benefits 2014-08-01 31
Total of all active and inactive participants 2014-08-01 847
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-08-01 0
Total participants 2014-08-01 847
Number of participants with account balances 2014-08-01 359
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-08-01 29

Measure	Date	Value
2022: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	2,009
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,746
Number of retired or separated participants receiving benefits	2022-01-01	3
Number of other retired or separated participants entitled to future benefits	2022-01-01	265
Total of all active and inactive participants	2022-01-01	2,014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	2,014
Number of participants with account balances	2022-01-01	1,239
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,565
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	1,496
Number of retired or separated participants receiving benefits	2021-01-01	5
Number of other retired or separated participants entitled to future benefits	2021-01-01	508
Total of all active and inactive participants	2021-01-01	2,009
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	2,009
Number of participants with account balances	2021-01-01	1,343
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,852
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,289
Number of retired or separated participants receiving benefits	2020-01-01	3
Number of other retired or separated participants entitled to future benefits	2020-01-01	273
Total of all active and inactive participants	2020-01-01	1,565
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	1,565
Number of participants with account balances	2020-01-01	1,025
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,364
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,058
Number of retired or separated participants receiving benefits	2019-01-01	4
Number of other retired or separated participants entitled to future benefits	2019-01-01	344
Total of all active and inactive participants	2019-01-01	1,406
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	1,406
Number of participants with account balances	2019-01-01	918
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	461
2018: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1,491
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	993
Number of retired or separated participants receiving benefits	2018-01-01	17
Number of other retired or separated participants entitled to future benefits	2018-01-01	354
Total of all active and inactive participants	2018-01-01	1,364
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	1,364
Number of participants with account balances	2018-01-01	919
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	294
2017: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,431
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	975
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	458
Total of all active and inactive participants	2017-01-01	1,435
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	1,435
Number of participants with account balances	2017-01-01	1,291
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	73
2016: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,114
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	932
Number of retired or separated participants receiving benefits	2016-01-01	6
Number of other retired or separated participants entitled to future benefits	2016-01-01	443
Total of all active and inactive participants	2016-01-01	1,381
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	1,381
Number of participants with account balances	2016-01-01	1,003
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	349
2015: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	848
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	893
Number of retired or separated participants receiving benefits	2015-01-01	6
Number of other retired or separated participants entitled to future benefits	2015-01-01	208
Total of all active and inactive participants	2015-01-01	1,107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	1,107
Number of participants with account balances	2015-01-01	754
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	219
2014: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-08-01	742
Total number of active participants reported on line 7a of the Form 5500	2014-08-01	816
Number of retired or separated participants receiving benefits	2014-08-01	0
Number of other retired or separated participants entitled to future benefits	2014-08-01	31
Total of all active and inactive participants	2014-08-01	847
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-08-01	0
Total participants	2014-08-01	847
Number of participants with account balances	2014-08-01	359
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-08-01	29

Financial Data on STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN

Measure	Date	Value
2022 : STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$194,260
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,380,731
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,307,805
Expenses. Certain deemed distributions of participant loans	2022-12-31	$6,001
Value of total corrective distributions	2022-12-31	$26,791
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,254,789
Value of total assets at end of year	2022-12-31	$4,670,717
Value of total assets at beginning of year	2022-12-31	$5,857,188
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$40,134
Total interest from all sources	2022-12-31	$7,942
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,085,752
Participant contributions at end of year	2022-12-31	$128,523
Participant contributions at beginning of year	2022-12-31	$136,709
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$1,414
Other income not declared elsewhere	2022-12-31	$2,528
Administrative expenses (other) incurred	2022-12-31	$40,134
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-1,186,471
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$4,670,717
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$5,857,188
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$4,420,130
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$5,485,815
Interest on participant loans	2022-12-31	$6,496
Interest earned on other investments	2022-12-31	$1,446
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$122,064
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$234,664
Net investment gain/loss from pooled separate accounts	2022-12-31	$-1,070,999
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$167,623
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,307,805
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	CAMPBELL TAYLOR WASHBURN
Accountancy firm EIN	2022-12-31	680251243
2021 : STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$11,627
Total income from all sources (including contributions)	2021-12-31	$2,058,131
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,073,974
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,019,588
Expenses. Certain deemed distributions of participant loans	2021-12-31	$5,422
Value of total corrective distributions	2021-12-31	$9,137
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,424,433
Value of total assets at end of year	2021-12-31	$5,857,188
Value of total assets at beginning of year	2021-12-31	$4,884,658
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$39,827
Total interest from all sources	2021-12-31	$9,786
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$1,182,576
Participant contributions at end of year	2021-12-31	$136,709
Participant contributions at beginning of year	2021-12-31	$172,329
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$148
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$117,549
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$11,627
Other income not declared elsewhere	2021-12-31	$4,273
Administrative expenses (other) incurred	2021-12-31	$39,827
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$984,157
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$5,857,188
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,873,031
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$5,485,815
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$0
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$4,481,314
Interest on participant loans	2021-12-31	$7,547
Interest earned on other investments	2021-12-31	$2,239
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$234,664
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$211,915
Net investment gain/loss from pooled separate accounts	2021-12-31	$619,639
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$124,308
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$18,952
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,019,588
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	2021-12-31	Yes
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	CAMPBELL TAYLOR WASHBURN
Accountancy firm EIN	2021-12-31	680251243
2020 : STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets	2020-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2020-12-31	$0
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$11,627
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$21,306
Expenses. Interest paid	2020-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,685,583
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,581,958
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,520,557
Expenses. Certain deemed distributions of participant loans	2020-12-31	$0
Value of total corrective distributions	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,121,700
Value of total assets at end of year	2020-12-31	$4,884,658
Value of total assets at beginning of year	2020-12-31	$4,790,712
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$61,401
Total income from rents	2020-12-31	$0
Total interest from all sources	2020-12-31	$9,606
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$0
Administrative expenses professional fees incurred	2020-12-31	$0
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$924,257
Participant contributions at end of year	2020-12-31	$172,329
Participant contributions at beginning of year	2020-12-31	$150,651
Participant contributions at end of year	2020-12-31	$148
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$36,733
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$11,627
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$21,306
Other income not declared elsewhere	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$4,356
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Income. Non cash contributions	2020-12-31	$0
Value of net income/loss	2020-12-31	$103,625
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$4,873,031
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$4,769,406
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$0
Value of interest in pooled separate accounts at end of year	2020-12-31	$4,481,314
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$4,494,799
Interest on participant loans	2020-12-31	$9,606
Income. Interest from loans (other than to participants)	2020-12-31	$0
Interest earned on other investments	2020-12-31	$0
Income. Interest from US Government securities	2020-12-31	$0
Income. Interest from corporate debt instruments	2020-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$211,915
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$145,262
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$0
Net investment gain/loss from pooled separate accounts	2020-12-31	$554,277
Net investment gain or loss from common/collective trusts	2020-12-31	$0
Net gain/loss from 103.12 investment entities	2020-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$160,710
Employer contributions (assets) at end of year	2020-12-31	$18,952
Employer contributions (assets) at beginning of year	2020-12-31	$0
Income. Dividends from preferred stock	2020-12-31	$0
Income. Dividends from common stock	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,520,557
Contract administrator fees	2020-12-31	$57,045
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Aggregate proceeds on sale of assets	2020-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2020-12-31	$0
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	CAMPBELL TAYLOR WASHBURN
Accountancy firm EIN	2020-12-31	680251243
2019 : STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$21,306
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$49,017
Total income from all sources (including contributions)	2019-12-31	$1,987,756
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$763,598
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$702,003
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,227,514
Value of total assets at end of year	2019-12-31	$4,790,712
Value of total assets at beginning of year	2019-12-31	$3,594,265
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$61,595
Total interest from all sources	2019-12-31	$7,523
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$1,028,943
Participant contributions at end of year	2019-12-31	$150,651
Participant contributions at beginning of year	2019-12-31	$105,853
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$34
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$21,306
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$49,017
Other income not declared elsewhere	2019-12-31	$7,466
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Income. Non cash contributions	2019-12-31	$0
Value of net income/loss	2019-12-31	$1,224,158
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$4,769,406
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,545,248
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$4,494,799
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$3,387,652
Interest on participant loans	2019-12-31	$7,523
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$145,262
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$100,760
Net investment gain/loss from pooled separate accounts	2019-12-31	$745,253
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$198,537
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$702,003
Contract administrator fees	2019-12-31	$61,595
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	CAMPBELL TAYLOR WASHBURN
Accountancy firm EIN	2019-12-31	680251243
2018 : STEVEN ROBERTS ORIGINALS, LLC 401(K) 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	$49,017
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$16,122
Expenses. Interest paid	2018-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$940,296
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$632,087
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$522,158
Expenses. Certain deemed distributions of participant loans	2018-12-31	$44,058
Value of total corrective distributions	2018-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,202,259
Value of total assets at end of year	2018-12-31	$3,594,265
Value of total assets at beginning of year	2018-12-31	$3,253,161
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$65,871
Total interest from all sources	2018-12-31	$6,050
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
Administrative expenses professional fees incurred	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
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	$994,144
Participant contributions at end of year	2018-12-31	$105,853
Participant contributions at beginning of year	2018-12-31	$115,464
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$20,120
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$49,017
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$16,122
Administrative expenses (other) incurred	2018-12-31	$0
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
Income. Non cash contributions	2018-12-31	$0
Value of net income/loss	2018-12-31	$308,209
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$3,545,248
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$3,237,039
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
Investment advisory and management fees	2018-12-31	$0
Value of interest in pooled separate accounts at end of year	2018-12-31	$3,387,652
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$3,075,461
Interest on participant loans	2018-12-31	$6,050
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$100,760
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$62,236
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from pooled separate accounts	2018-12-31	$-268,013
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	No
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	$187,995
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$522,158
Contract administrator fees	2018-12-31	$65,871
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	CAMPBELL TAYLOR & COMPANY
Accountancy firm EIN	2018-12-31	680251243
2017 : STEVEN ROBERTS ORIGINALS, LLC 401(K) 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	$16,122
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$8,829
Expenses. Interest paid	2017-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$1,466,345
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$301,788
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$254,613
Expenses. Certain deemed distributions of participant loans	2017-12-31	$6,196
Value of total corrective distributions	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,064,897
Value of total assets at end of year	2017-12-31	$3,253,161
Value of total assets at beginning of year	2017-12-31	$2,081,311
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$40,979
Total interest from all sources	2017-12-31	$1,772
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	$0
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
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	$862,827
Participant contributions at end of year	2017-12-31	$115,464
Participant contributions at beginning of year	2017-12-31	$11,258
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$28,684
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$16,122
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$8,829
Administrative expenses (other) incurred	2017-12-31	$0
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
Income. Non cash contributions	2017-12-31	$0
Value of net income/loss	2017-12-31	$1,164,557
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$3,237,039
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,072,482
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
Investment advisory and management fees	2017-12-31	$0
Value of interest in pooled separate accounts at end of year	2017-12-31	$3,075,461
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$1,997,459
Interest on participant loans	2017-12-31	$1,772
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$62,236
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$72,594
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from pooled separate accounts	2017-12-31	$399,676
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	No
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	$173,386
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$254,613
Contract administrator fees	2017-12-31	$40,979
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	CAMPBELL TAYLOR & COMPANY
Accountancy firm EIN	2017-12-31	680251243
2016 : STEVEN ROBERTS ORIGINALS, LLC 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	$8,829
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$1,994
Expenses. Interest paid	2016-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,396,012
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$211,946
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$182,142
Expenses. Certain deemed distributions of participant loans	2016-12-31	$1,876
Value of total corrective distributions	2016-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,300,683
Value of total assets at end of year	2016-12-31	$2,081,311
Value of total assets at beginning of year	2016-12-31	$890,410
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$27,928
Total interest from all sources	2016-12-31	$204
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	$0
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
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	$762,831
Participant contributions at end of year	2016-12-31	$11,258
Participant contributions at beginning of year	2016-12-31	$1,711
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$374,180
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$8,829
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$1,994
Other income not declared elsewhere	2016-12-31	$0
Administrative expenses (other) incurred	2016-12-31	$360
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
Income. Non cash contributions	2016-12-31	$0
Value of net income/loss	2016-12-31	$1,184,066
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,072,482
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$888,416
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
Investment advisory and management fees	2016-12-31	$0
Value of interest in pooled separate accounts at end of year	2016-12-31	$1,997,459
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$846,585
Interest on participant loans	2016-12-31	$204
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$72,594
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$42,114
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Net investment gain/loss from pooled separate accounts	2016-12-31	$95,125
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	$163,672
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$182,142
Contract administrator fees	2016-12-31	$27,568
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	CAMPBELL TAYLOR & COMPANY
Accountancy firm EIN	2016-12-31	680251243
2015 : STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$1,994
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$4,065
Expenses. Interest paid	2015-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$699,311
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$24,013
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$18,781
Expenses. Certain deemed distributions of participant loans	2015-12-31	$0
Value of total corrective distributions	2015-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$725,244
Value of total assets at end of year	2015-12-31	$890,410
Value of total assets at beginning of year	2015-12-31	$217,183
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$5,232
Total interest from all sources	2015-12-31	$20
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
Administrative expenses professional fees incurred	2015-12-31	$0
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	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$602,668
Participant contributions at end of year	2015-12-31	$1,711
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$1,994
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$4,065
Administrative expenses (other) incurred	2015-12-31	$0
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
Income. Non cash contributions	2015-12-31	$0
Value of net income/loss	2015-12-31	$675,298
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$888,416
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$213,118
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
Investment advisory and management fees	2015-12-31	$0
Value of interest in pooled separate accounts at end of year	2015-12-31	$846,585
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$209,468
Interest on participant loans	2015-12-31	$20
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$42,114
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$7,715
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$0
Net investment gain/loss from pooled separate accounts	2015-12-31	$-25,953
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	$122,576
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$18,781
Contract administrator fees	2015-12-31	$5,232
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	CAMPBELL TAYLOR & COMPANY
Accountancy firm EIN	2015-12-31	680251243
2014 : STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets	2014-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$0
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$4,065
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Expenses. Interest paid	2014-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$213,120
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$2
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$0
Expenses. Certain deemed distributions of participant loans	2014-12-31	$0
Value of total corrective distributions	2014-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$211,156
Value of total assets at end of year	2014-12-31	$217,183
Value of total assets at beginning of year	2014-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$2
Total income from rents	2014-12-31	$0
Total interest from all sources	2014-12-31	$0
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
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$0
Administrative expenses professional fees incurred	2014-12-31	$0
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	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$180,330
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$4,065
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$0
Other income not declared elsewhere	2014-12-31	$0
Administrative expenses (other) incurred	2014-12-31	$0
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
Income. Non cash contributions	2014-12-31	$0
Value of net income/loss	2014-12-31	$213,118
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$213,118
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$0
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
Investment advisory and management fees	2014-12-31	$0
Value of interest in pooled separate accounts at end of year	2014-12-31	$209,468
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$0
Interest on participant loans	2014-12-31	$0
Income. Interest from loans (other than to participants)	2014-12-31	$0
Interest earned on other investments	2014-12-31	$0
Income. Interest from US Government securities	2014-12-31	$0
Income. Interest from corporate debt instruments	2014-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$7,715
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$0
Net investment gain/loss from pooled separate accounts	2014-12-31	$1,964
Net investment gain or loss from common/collective trusts	2014-12-31	$0
Net gain/loss from 103.12 investment entities	2014-12-31	$0
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	No
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	$30,826
Income. Dividends from preferred stock	2014-12-31	$0
Income. Dividends from common stock	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$0
Contract administrator fees	2014-12-31	$2
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
Aggregate proceeds on sale of assets	2014-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2014-12-31	$0

Form 5500 Responses for STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN

2022: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2019 form 5500 responses
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)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: STEVEN ROBERTS ORIGINALS, LLC 401(K) 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 funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single 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: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	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: STEVEN ROBERTS ORIGINALS, LLC 401(K) PLAN 2014 form 5500 responses
2014-08-01	Type of plan entity	Single employer plan
2014-08-01	First time form 5500 has been submitted	Yes
2014-08-01	Submission has been amended	No
2014-08-01	This submission is the final filing	No
2014-08-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2014-08-01	Plan is a collectively bargained plan	No
2014-08-01	Plan funding arrangement – Insurance	Yes
2014-08-01	Plan funding arrangement – Trust	Yes
2014-08-01	Plan benefit arrangement – Insurance	Yes
2014-08-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

YH4656

Policy instance

Insurance contract or identification number	YH4656
Number of Individuals Covered	2014
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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?	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

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

YH4656

Policy instance

Insurance contract or identification number	YH4656
Number of Individuals Covered	2009
Insurance policy start date	2021-09-01
Insurance policy end date	2021-12-31
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?	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

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

811932

Policy instance

Insurance contract or identification number	811932
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-08-31
Total amount of commissions paid to insurance broker	USD $10,251
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,251
Insurance broker organization code?	3

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

811932

Policy instance

Insurance contract or identification number	811932
Number of Individuals Covered	1025
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $22,025
Total amount of fees paid to insurance company	USD $2,209
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
Commission paid to Insurance Broker	USD $22,025
Insurance broker organization code?	3
Amount paid for insurance broker fees	2209
Additional information about fees paid to insurance broker	TPA COMPENSATION

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

811932

Policy instance

Insurance contract or identification number	811932
Number of Individuals Covered	918
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $20,820
Total amount of fees paid to insurance company	USD $2,009
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
Commission paid to Insurance Broker	USD $20,820
Insurance broker organization code?	3
Amount paid for insurance broker fees	2009
Additional information about fees paid to insurance broker	TPA COMPENSATION

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

811932

Policy instance

Insurance contract or identification number	811932
Number of Individuals Covered	919
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $16,653
Total amount of fees paid to insurance company	USD $1,620
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
Commission paid to Insurance Broker	USD $16,653
Insurance broker organization code?	3
Amount paid for insurance broker fees	1620
Additional information about fees paid to insurance broker	TPA COMPENSATION

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

811932

Policy instance

Insurance contract or identification number	811932
Number of Individuals Covered	1291
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $13,094
Total amount of fees paid to insurance company	USD $1,682
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
Commission paid to Insurance Broker	USD $13,094
Insurance broker organization code?	3
Amount paid for insurance broker fees	1682
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker name	FLYNN, SHOJINAGA & ASSOCIATES, INC.

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

811932

Policy instance

Insurance contract or identification number	811932
Number of Individuals Covered	754
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,842
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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
Commission paid to Insurance Broker	USD $5,842
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY SMITH BARNEY LLC

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

811932

Policy instance

Insurance contract or identification number	811932
Number of Individuals Covered	359
Insurance policy start date	2014-08-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,152
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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
Commission paid to Insurance Broker	USD $2,152
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY SMITH BARNEY LLC

Potentially related plans

STEVEN ROBERTS LANDSCAPING [EIN = 141758678]

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Company Name:	STEVEN ROBERT ORIGINALS, LLC
Employer identification number (EIN):	841318535
NAIC Classification:	311800
NAIC Description:	Bakeries and Tortilla Manufacturing