401k Plan data: THE CARPET HOUSE RETIREMENT PLAN plan

THE CARPET HOUSE RETIREMENT PLAN 401k Plan overview

Plan Name	THE CARPET HOUSE RETIREMENT PLAN
Plan identification number	002

THE CARPET HOUSE RETIREMENT PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Money purchase (other than target benefit) Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.

401k Sponsoring company profile

THE CARPET HOUSE has sponsored the creation of one or more 401k plans.

Company Name: THE CARPET HOUSE

Employer identification number (EIN): 370954061

NAIC Classification: 442210
NAIC Description: Floor Covering Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE CARPET HOUSE RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2018-01-01 JOHN RENFRO
002 2017-01-01 JOHN RENFRO
002 2016-01-01 JOHN RENFRO
002 2015-01-01 JOHN RENFRO
002 2014-01-01 JOHN RENFRO
002 2013-01-01 JOHN R. RENFRO JOHN R. RENFRO 2014-05-15
002 2012-01-01 JOHN R. RENFRO JOHN R. RENFRO 2013-07-25
002 2011-01-01 JOHN R. RENFRO JOHN R. RENFRO 2012-05-15
002 2010-01-01 JOHN R. RENFRO JOHN R. RENFRO 2011-07-28
002 2009-01-01 JOHN R. RENFRO JOHN R. RENFRO 2010-09-22

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2018-01-01	JOHN RENFRO
002	2017-01-01	JOHN RENFRO
002	2016-01-01	JOHN RENFRO
002	2015-01-01	JOHN RENFRO
002	2014-01-01	JOHN RENFRO
002	2013-01-01	JOHN R. RENFRO	JOHN R. RENFRO	2014-05-15
002	2012-01-01	JOHN R. RENFRO	JOHN R. RENFRO	2013-07-25
002	2011-01-01	JOHN R. RENFRO	JOHN R. RENFRO	2012-05-15
002	2010-01-01	JOHN R. RENFRO	JOHN R. RENFRO	2011-07-28
002	2009-01-01	JOHN R. RENFRO	JOHN R. RENFRO	2010-09-22

Plan Statistics for THE CARPET HOUSE RETIREMENT PLAN

401k plan membership statisitcs for THE CARPET HOUSE RETIREMENT PLAN

Measure Date Value
2018: THE CARPET HOUSE RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 0
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 0
Number of participants with account balances 2018-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: THE CARPET HOUSE RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 2
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 2
Number of participants with account balances 2017-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: THE CARPET HOUSE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 2
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 2
Number of participants with account balances 2016-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: THE CARPET HOUSE RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 2
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 2
Number of participants with account balances 2015-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: THE CARPET HOUSE RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 2
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 2
Number of participants with account balances 2014-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: THE CARPET HOUSE RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 3
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 2
Total of all active and inactive participants 2013-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 5
Number of participants with account balances 2013-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: THE CARPET HOUSE RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 4
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 1
Total of all active and inactive participants 2012-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 5
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: THE CARPET HOUSE RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 4
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 1
Total of all active and inactive participants 2011-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 5
Number of participants with account balances 2011-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: THE CARPET HOUSE RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 4
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 1
Total of all active and inactive participants 2010-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 5
2009: THE CARPET HOUSE RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 4
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 1
Total of all active and inactive participants 2009-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 5

Measure	Date	Value
2018: THE CARPET HOUSE RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	0
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	0
Number of participants with account balances	2018-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: THE CARPET HOUSE RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	2
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	2
Number of participants with account balances	2017-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: THE CARPET HOUSE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	2
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	2
Number of participants with account balances	2016-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: THE CARPET HOUSE RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	2
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	2
Number of participants with account balances	2015-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: THE CARPET HOUSE RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	2
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	2
Number of participants with account balances	2014-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: THE CARPET HOUSE RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	3
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	2
Total of all active and inactive participants	2013-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	5
Number of participants with account balances	2013-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: THE CARPET HOUSE RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	4
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	1
Total of all active and inactive participants	2012-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	5
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: THE CARPET HOUSE RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	4
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	1
Total of all active and inactive participants	2011-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	5
Number of participants with account balances	2011-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: THE CARPET HOUSE RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	4
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	1
Total of all active and inactive participants	2010-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	5
2009: THE CARPET HOUSE RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	4
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	1
Total of all active and inactive participants	2009-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	5

Financial Data on THE CARPET HOUSE RETIREMENT PLAN

Measure	Date	Value
2018 : THE CARPET HOUSE RETIREMENT PLAN 2018 401k financial data
Total income from all sources	2018-01-31	$6,476
Expenses. Total of all expenses incurred	2018-01-31	$253,170
Benefits paid (including direct rollovers)	2018-01-31	$253,170
Total plan assets at end of year	2018-01-31	$0
Total plan assets at beginning of year	2018-01-31	$246,694
Other income received	2018-01-31	$6,476
Net income (gross income less expenses)	2018-01-31	$-246,694
Net plan assets at end of year (total assets less liabilities)	2018-01-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2018-01-31	$246,694
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-01-31	$0
Funding deficiency by the employer to the plan for this plan year	2018-01-31	$0
Minimum employer required contribution for this plan year	2018-01-31	$0
Amount contributed by the employer to the plan for this plan year	2018-01-31	$0
2017 : THE CARPET HOUSE RETIREMENT PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$29,906
Expenses. Total of all expenses incurred	2017-12-31	$0
Total plan assets at end of year	2017-12-31	$246,694
Total plan assets at beginning of year	2017-12-31	$216,788
Other income received	2017-12-31	$29,906
Net income (gross income less expenses)	2017-12-31	$29,906
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$246,694
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$216,788
2016 : THE CARPET HOUSE RETIREMENT PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$18,765
Expenses. Total of all expenses incurred	2016-12-31	$0
Total plan assets at end of year	2016-12-31	$216,788
Total plan assets at beginning of year	2016-12-31	$198,023
Other income received	2016-12-31	$18,765
Net income (gross income less expenses)	2016-12-31	$18,765
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$216,788
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$198,023
2015 : THE CARPET HOUSE RETIREMENT PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$1,253
Expenses. Total of all expenses incurred	2015-12-31	$0
Total plan assets at end of year	2015-12-31	$198,023
Total plan assets at beginning of year	2015-12-31	$196,770
Other income received	2015-12-31	$1,253
Net income (gross income less expenses)	2015-12-31	$1,253
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$198,023
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$196,770
2014 : THE CARPET HOUSE RETIREMENT PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$14,985
Expenses. Total of all expenses incurred	2014-12-31	$56,571
Benefits paid (including direct rollovers)	2014-12-31	$56,571
Total plan assets at end of year	2014-12-31	$196,770
Total plan assets at beginning of year	2014-12-31	$238,356
Other income received	2014-12-31	$14,985
Net income (gross income less expenses)	2014-12-31	$-41,586
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$196,770
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$238,356
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2014-12-31	$0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	2014-12-31	$0
2013 : THE CARPET HOUSE RETIREMENT PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$30,842
Expenses. Total of all expenses incurred	2013-12-31	$30,130
Benefits paid (including direct rollovers)	2013-12-31	$29,980
Total plan assets at end of year	2013-12-31	$238,356
Total plan assets at beginning of year	2013-12-31	$237,644
Value of fidelity bond covering the plan	2013-12-31	$10,000
Expenses. Other expenses not covered elsewhere	2013-12-31	$150
Net income (gross income less expenses)	2013-12-31	$712
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$238,356
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$237,644
Total contributions received or receivable from employer(s)	2013-12-31	$30,842
2012 : THE CARPET HOUSE RETIREMENT PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$0
Expenses. Total of all expenses incurred	2012-12-31	$30,150
Benefits paid (including direct rollovers)	2012-12-31	$30,000
Total plan assets at end of year	2012-12-31	$237,644
Total plan assets at beginning of year	2012-12-31	$267,794
Value of fidelity bond covering the plan	2012-12-31	$10,000
Expenses. Other expenses not covered elsewhere	2012-12-31	$150
Net income (gross income less expenses)	2012-12-31	$-30,150
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$237,644
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$267,794
2011 : THE CARPET HOUSE RETIREMENT PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$26,151
Expenses. Total of all expenses incurred	2011-12-31	$150
Total plan assets at end of year	2011-12-31	$267,794
Total plan assets at beginning of year	2011-12-31	$241,793
Value of fidelity bond covering the plan	2011-12-31	$10,000
Expenses. Other expenses not covered elsewhere	2011-12-31	$150
Other income received	2011-12-31	$26,151
Net income (gross income less expenses)	2011-12-31	$26,001
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$267,794
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$241,793
2010 : THE CARPET HOUSE RETIREMENT PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$42,405
Expenses. Total of all expenses incurred	2010-12-31	$55,150
Benefits paid (including direct rollovers)	2010-12-31	$55,000
Total plan assets at end of year	2010-12-31	$241,793
Total plan assets at beginning of year	2010-12-31	$254,538
Value of fidelity bond covering the plan	2010-12-31	$10,000
Expenses. Other expenses not covered elsewhere	2010-12-31	$150
Other income received	2010-12-31	$42,405
Net income (gross income less expenses)	2010-12-31	$-12,745
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$241,793
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$254,538

Form 5500 Responses for THE CARPET HOUSE RETIREMENT PLAN

2018: THE CARPET HOUSE RETIREMENT 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	Yes
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: THE CARPET HOUSE RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: THE CARPET HOUSE RETIREMENT 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 benefit arrangement – Insurance	Yes
2015: THE CARPET HOUSE RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	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 benefit arrangement – Insurance	Yes
2014: THE CARPET HOUSE RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: THE CARPET HOUSE RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: THE CARPET HOUSE RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: THE CARPET HOUSE RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: THE CARPET HOUSE RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: THE CARPET HOUSE RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METLIFE INVESTORS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93513 )

Policy contract number

3201318050

Policy instance

Insurance contract or identification number	3201318050
Number of Individuals Covered	2
Insurance policy start date	2018-01-01
Insurance policy end date	2018-01-31
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

METLIFE INVESTORS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93513 )

Policy contract number

3201318050

Policy instance

Insurance contract or identification number	3201318050
Number of Individuals Covered	2
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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

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Company Name:	THE CARPET HOUSE
Employer identification number (EIN):	370954061
NAIC Classification:	442210
NAIC Description:	Floor Covering Stores