401k Plan data: MITRA QSR 401(K) PLAN plan

MITRA QSR 401(K) PLAN 401k Plan overview

Plan Name	MITRA QSR 401(K) PLAN
Plan identification number	001

MITRA QSR 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

MITRA QSR KNE, LLC has sponsored the creation of one or more 401k plans.

Company Name: MITRA QSR KNE, LLC

Employer identification number (EIN): 454457421

NAIC Classification: 722513
NAIC Description: Limited-Service Restaurants

Additional information about MITRA QSR KNE, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 5186294

More information about MITRA QSR KNE, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MITRA QSR 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 SAMANTHA PELKOWSKI
001 2017-01-01
001 2016-01-01 JITEN PATEL
001 2015-01-01 PUSHPAK PATEL
001 2014-01-01 PUSHPAK PATEL 2015-10-15

Plan Statistics for MITRA QSR 401(K) PLAN

401k plan membership statisitcs for MITRA QSR 401(K) PLAN

Measure Date Value
2021: MITRA QSR 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 2,704
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 0
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 0
Number of participants with account balances 2021-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 43
2020: MITRA QSR 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 2,447
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 2,206
Number of other retired or separated participants entitled to future benefits 2020-01-01 372
Total of all active and inactive participants 2020-01-01 2,578
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 2,578
Number of participants with account balances 2020-01-01 601
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 15
2019: MITRA QSR 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 2,384
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 1,738
Number of retired or separated participants receiving benefits 2019-01-01 53
Number of other retired or separated participants entitled to future benefits 2019-01-01 329
Total of all active and inactive participants 2019-01-01 2,120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 2,120
Number of participants with account balances 2019-01-01 602
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 90
2018: MITRA QSR 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 3,123
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 2,917
Number of retired or separated participants receiving benefits 2018-01-01 21
Number of other retired or separated participants entitled to future benefits 2018-01-01 268
Total of all active and inactive participants 2018-01-01 3,206
Total participants 2018-01-01 3,206
Number of participants with account balances 2018-01-01 602
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 178
2017: MITRA QSR 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 2,693
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 2,388
Number of retired or separated participants receiving benefits 2017-01-01 5
Number of other retired or separated participants entitled to future benefits 2017-01-01 80
Total of all active and inactive participants 2017-01-01 2,473
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 2,473
Number of participants with account balances 2017-01-01 554
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 21
2016: MITRA QSR 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,902
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1,396
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 73
Total of all active and inactive participants 2016-01-01 1,475
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 1,475
Number of participants with account balances 2016-01-01 190
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 39
2015: MITRA QSR 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,598
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1,310
Number of other retired or separated participants entitled to future benefits 2015-01-01 57
Total of all active and inactive participants 2015-01-01 1,367
Total participants 2015-01-01 1,367
Number of participants with account balances 2015-01-01 186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 45

Measure	Date	Value
2021: MITRA QSR 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	2,704
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	0
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	0
Number of participants with account balances	2021-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	43
2020: MITRA QSR 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	2,447
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	2,206
Number of other retired or separated participants entitled to future benefits	2020-01-01	372
Total of all active and inactive participants	2020-01-01	2,578
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	2,578
Number of participants with account balances	2020-01-01	601
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	15
2019: MITRA QSR 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	2,384
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,738
Number of retired or separated participants receiving benefits	2019-01-01	53
Number of other retired or separated participants entitled to future benefits	2019-01-01	329
Total of all active and inactive participants	2019-01-01	2,120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	2,120
Number of participants with account balances	2019-01-01	602
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	90
2018: MITRA QSR 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	3,123
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	2,917
Number of retired or separated participants receiving benefits	2018-01-01	21
Number of other retired or separated participants entitled to future benefits	2018-01-01	268
Total of all active and inactive participants	2018-01-01	3,206
Total participants	2018-01-01	3,206
Number of participants with account balances	2018-01-01	602
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	178
2017: MITRA QSR 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	2,693
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	2,388
Number of retired or separated participants receiving benefits	2017-01-01	5
Number of other retired or separated participants entitled to future benefits	2017-01-01	80
Total of all active and inactive participants	2017-01-01	2,473
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	2,473
Number of participants with account balances	2017-01-01	554
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	21
2016: MITRA QSR 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,902
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,396
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	73
Total of all active and inactive participants	2016-01-01	1,475
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	1,475
Number of participants with account balances	2016-01-01	190
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	39
2015: MITRA QSR 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,598
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,310
Number of other retired or separated participants entitled to future benefits	2015-01-01	57
Total of all active and inactive participants	2015-01-01	1,367
Total participants	2015-01-01	1,367
Number of participants with account balances	2015-01-01	186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	45

Financial Data on MITRA QSR 401(K) PLAN

Measure	Date	Value
2021 : MITRA QSR 401(K) PLAN 2021 401k financial data
Total transfer of assets from this plan	2021-12-01	$3,158,841
Total income from all sources (including contributions)	2021-12-01	$695,091
Total of all expenses incurred	2021-12-01	$295,696
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-01	$289,133
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-01	$424,373
Value of total assets at end of year	2021-12-01	$0
Value of total assets at beginning of year	2021-12-01	$2,759,446
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-01	$6,563
Total interest from all sources	2021-12-01	$3,105
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-01	No
Was this plan covered by a fidelity bond	2021-12-01	Yes
Value of fidelity bond cover	2021-12-01	$500,000
If this is an individual account plan, was there a blackout period	2021-12-01	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-01	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-01	No
Contributions received from participants	2021-12-01	$332,950
Participant contributions at end of year	2021-12-01	$0
Participant contributions at beginning of year	2021-12-01	$54,845
Participant contributions at end of year	2021-12-01	$0
Participant contributions at beginning of year	2021-12-01	$16
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-01	$51,845
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-01	No
Value of net income/loss	2021-12-01	$399,395
Value of net assets at end of year (total assets less liabilities)	2021-12-01	$0
Value of net assets at beginning of year (total assets less liabilities)	2021-12-01	$2,759,446
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-01	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-01	No
Were any leases to which the plan was party in default or uncollectible	2021-12-01	No
Value of interest in pooled separate accounts at end of year	2021-12-01	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-01	$2,689,252
Interest on participant loans	2021-12-01	$3,105
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-01	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-01	$15,330
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-01	$267,613
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-01	No
Was there a failure to transmit to the plan any participant contributions	2021-12-01	No
Has the plan failed to provide any benefit when due under the plan	2021-12-01	No
Contributions received in cash from employer	2021-12-01	$39,578
Employer contributions (assets) at end of year	2021-12-01	$0
Employer contributions (assets) at beginning of year	2021-12-01	$3
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-01	$289,133
Contract administrator fees	2021-12-01	$6,563
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	2021-12-01	Yes
Did the plan have assets held for investment	2021-12-01	No
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	2021-12-01	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-01	Yes
Opinion of an independent qualified public accountant for this plan	2021-12-01	Unqualified
Accountancy firm name	2021-12-01	PHILIP C. MAY PC
Accountancy firm EIN	2021-12-01	800794417
2020 : MITRA QSR 401(K) PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$790,513
Total of all expenses incurred	2020-12-31	$268,270
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$186,072
Expenses. Certain deemed distributions of participant loans	2020-12-31	$72,302
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$458,520
Value of total assets at end of year	2020-12-31	$2,759,446
Value of total assets at beginning of year	2020-12-31	$2,237,203
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$9,896
Total interest from all sources	2020-12-31	$3,926
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
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	$385,736
Participant contributions at end of year	2020-12-31	$54,845
Participant contributions at beginning of year	2020-12-31	$129,259
Participant contributions at end of year	2020-12-31	$16
Participant contributions at beginning of year	2020-12-31	$16
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$18,817
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$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	2020-12-31	No
Value of net income/loss	2020-12-31	$522,243
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,759,446
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,237,203
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
Value of interest in pooled separate accounts at end of year	2020-12-31	$2,689,252
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$2,094,924
Interest on participant loans	2020-12-31	$3,926
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	$15,330
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$13,001
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	$328,067
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	No
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	$53,967
Employer contributions (assets) at end of year	2020-12-31	$3
Employer contributions (assets) at beginning of year	2020-12-31	$3
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$186,072
Contract administrator fees	2020-12-31	$9,896
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
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	PHILIP C. MAY PC
Accountancy firm EIN	2020-12-31	800794417
2019 : MITRA QSR 401(K) PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$787,876
Total of all expenses incurred	2019-12-31	$133,615
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$129,555
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$468,826
Value of total assets at end of year	2019-12-31	$2,237,203
Value of total assets at beginning of year	2019-12-31	$1,582,942
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$4,060
Total interest from all sources	2019-12-31	$3,435
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	$359,947
Participant contributions at end of year	2019-12-31	$129,259
Participant contributions at beginning of year	2019-12-31	$108,796
Participant contributions at end of year	2019-12-31	$16
Participant contributions at beginning of year	2019-12-31	$10,641
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$55,244
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
Value of net income/loss	2019-12-31	$654,261
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,237,203
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,582,942
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	$2,094,924
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$1,443,990
Interest on participant loans	2019-12-31	$3,435
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$13,001
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$17,588
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$315,615
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	$53,635
Employer contributions (assets) at end of year	2019-12-31	$3
Employer contributions (assets) at beginning of year	2019-12-31	$1,927
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$129,555
Contract administrator fees	2019-12-31	$4,060
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	PHILLIP C. MAY PC
Accountancy firm EIN	2019-12-31	800794417
2018 : MITRA QSR 401(K) PLAN 2018 401k financial data
Total transfer of assets to this plan	2018-12-31	$207,144
Total income from all sources (including contributions)	2018-12-31	$444,451
Total of all expenses incurred	2018-12-31	$252,370
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$239,618
Expenses. Certain deemed distributions of participant loans	2018-12-31	$5,805
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$542,399
Value of total assets at end of year	2018-12-31	$1,582,942
Value of total assets at beginning of year	2018-12-31	$1,183,717
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$6,947
Total interest from all sources	2018-12-31	$1,499
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$900,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$420,872
Participant contributions at end of year	2018-12-31	$108,796
Participant contributions at beginning of year	2018-12-31	$23,499
Participant contributions at end of year	2018-12-31	$10,641
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$5,989
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$192,081
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,582,942
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,183,717
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$1,443,990
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$1,132,340
Interest on participant loans	2018-12-31	$1,499
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$17,588
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$27,878
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-99,447
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$115,538
Employer contributions (assets) at end of year	2018-12-31	$1,927
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$239,618
Contract administrator fees	2018-12-31	$6,947
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	PHILLIP C. MAY PC
Accountancy firm EIN	2018-12-31	800794417
2017 : MITRA QSR 401(K) PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$490,752
Total of all expenses incurred	2017-12-31	$144,423
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$141,480
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$345,725
Value of total assets at end of year	2017-12-31	$1,183,717
Value of total assets at beginning of year	2017-12-31	$837,388
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,943
Total interest from all sources	2017-12-31	$1,182
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$90,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$278,648
Participant contributions at end of year	2017-12-31	$23,499
Participant contributions at beginning of year	2017-12-31	$1,826
Participant contributions at beginning of year	2017-12-31	$77,705
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$17,382
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$346,329
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,183,717
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$837,388
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$1,160,218
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$744,653
Interest on participant loans	2017-12-31	$1,182
Interest earned on other investments	2017-12-31	$667
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$27,878
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$39,209
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$143,845
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	$49,695
Employer contributions (assets) at beginning of year	2017-12-31	$13,204
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$141,480
Contract administrator fees	2017-12-31	$2,943
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	2017-12-31	No
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	PHILLIP C. MAY PC
Accountancy firm EIN	2017-12-31	800794417
2016 : MITRA QSR 401(K) PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$329,632
Total of all expenses incurred	2016-12-31	$71,522
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$69,638
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$293,189
Value of total assets at end of year	2016-12-31	$837,388
Value of total assets at beginning of year	2016-12-31	$579,278
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,884
Total interest from all sources	2016-12-31	$257
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	No
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$247,414
Participant contributions at end of year	2016-12-31	$1,826
Participant contributions at beginning of year	2016-12-31	$2,415
Participant contributions at end of year	2016-12-31	$77,705
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$258,110
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$837,388
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$579,278
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$744,653
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$576,863
Interest on participant loans	2016-12-31	$257
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$36,186
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	Yes
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	$45,775
Employer contributions (assets) at end of year	2016-12-31	$13,204
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$69,638
Contract administrator fees	2016-12-31	$1,884
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	PHILLIP C. MAY PC
Accountancy firm EIN	2016-12-31	800794417
2015 : MITRA QSR 401(K) PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$448,317
Total of all expenses incurred	2015-12-31	$92,405
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$89,895
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$464,356
Value of total assets at end of year	2015-12-31	$579,278
Value of total assets at beginning of year	2015-12-31	$223,366
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$2,510
Total interest from all sources	2015-12-31	$1,031
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	No
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	$304,107
Participant contributions at end of year	2015-12-31	$2,415
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$100,000
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
Value of net income/loss	2015-12-31	$355,912
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$579,278
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$223,366
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$576,863
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$223,366
Interest on participant loans	2015-12-31	$1,031
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-17,070
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	$60,249
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$89,895
Contract administrator fees	2015-12-31	$2,510
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	PHILLIP C. MAY PC
Accountancy firm EIN	2015-12-31	800794417

Form 5500 Responses for MITRA QSR 401(K) PLAN

2021: MITRA QSR 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	Yes
2021-01-01	This submission is the final filing	Yes
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: MITRA QSR 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: MITRA QSR 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: MITRA QSR 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: MITRA QSR 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	Yes
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: MITRA QSR 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: MITRA QSR 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

834145

Policy instance

Insurance contract or identification number	834145
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-01
Total amount of commissions paid to insurance broker	USD $14,458
Total amount of fees paid to insurance company	USD $1,026
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,458
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	6

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

834145

Policy instance

Insurance contract or identification number	834145
Number of Individuals Covered	574
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $10,527
Total amount of fees paid to insurance company	USD $1,050
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,527
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	6

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

834145

Policy instance

Insurance contract or identification number	834145
Number of Individuals Covered	575
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of fees paid to insurance company	USD $7,312
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	6479
Insurance broker organization code?	6

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

834145

Policy instance

Insurance contract or identification number	834145
Number of Individuals Covered	590
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of fees paid to insurance company	USD $7,703
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	531
Insurance broker organization code?	5

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

834145

Policy instance

Insurance contract or identification number	834145
Number of Individuals Covered	559
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of fees paid to insurance company	USD $6,444
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

MITRA QSR KNE, LLC EMPLOYEE BENEFIT PLAN [EIN = 475602899]

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Company Name:	MITRA QSR KNE, LLC
Employer identification number (EIN):	454457421
NAIC Classification:	722513
NAIC Description:	Limited-Service Restaurants

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	5186294