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| Plan Name | TRAVEL ACCIDENT |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | FBI WIND DOWN, INC. (FKA FURNITURE BRANDS INTERNATIONAL, INC.) |
| Employer identification number (EIN): | 430337683 |
| NAIC Classification: | 551112 |
| NAIC Description: | Offices of Other Holding Companies |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2011-05-24 | CATHRYN BEISEL | |||
| 504 | 2009-05-24 | CATHRYN BEISEL |
| 2011: TRAVEL ACCIDENT 2011 form 5500 responses | ||
|---|---|---|
| 2011-05-24 | Type of plan entity | Single employer plan |
| 2011-05-24 | Submission has been amended | No |
| 2011-05-24 | This submission is the final filing | No |
| 2011-05-24 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-05-24 | Plan is a collectively bargained plan | No |
| 2011-05-24 | Plan funding arrangement – Insurance | Yes |
| 2011-05-24 | Plan benefit arrangement – Insurance | Yes |
| 2009: TRAVEL ACCIDENT 2009 form 5500 responses | ||
| 2009-05-24 | Type of plan entity | Single employer plan |
| 2009-05-24 | Submission has been amended | No |
| 2009-05-24 | This submission is the final filing | No |
| 2009-05-24 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-05-24 | Plan is a collectively bargained plan | No |
| 2009-05-24 | Plan funding arrangement – Insurance | Yes |
| 2009-05-24 | Plan benefit arrangement – Insurance | Yes |
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