401k Plan data: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN plan

THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 401k Plan overview

Plan Name	THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN
Plan identification number	501

THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Temporary disability (accident and sickness) Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

THE FORT WORTH CLUB has sponsored the creation of one or more 401k plans.

Company Name: THE FORT WORTH CLUB

Employer identification number (EIN): 750275110

NAIC Classification: 721110
NAIC Description: Hotels (except Casino Hotels) and Motels

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01
501 2021-01-01
501 2020-01-01
501 2019-01-01
501 2018-01-01 GARY SARLES
501 2017-01-01 GARY SARLES
501 2016-01-01 GARY SARLES
501 2015-01-01 GARY SARLES
501 2014-01-01 GARY SARLES
501 2013-01-01 GARY SARLES
501 2012-01-01 GARY SARLES
501 2011-01-01 GARY SARLES
501 2009-01-01 GINGER SHEPPARD
501 2009-01-01 GARY SARLES

Plan Statistics for THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN

401k plan membership statisitcs for THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN

Measure Date Value
2022: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 150
Total of all active and inactive participants 2022-01-01 150
Total participants 2022-01-01 150
2021: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 118
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 120
Total of all active and inactive participants 2021-01-01 120
Total participants 2021-01-01 120
2020: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 168
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 118
Total of all active and inactive participants 2020-01-01 118
Total participants 2020-01-01 118
2019: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 168
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 169
Total of all active and inactive participants 2019-01-01 169
Total participants 2019-01-01 169
2018: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 160
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 168
Total of all active and inactive participants 2018-01-01 168
Total participants 2018-01-01 168
2017: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 153
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 160
Total of all active and inactive participants 2017-01-01 160
Total participants 2017-01-01 160
2016: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 153
Total of all active and inactive participants 2016-01-01 153
Total participants 2016-01-01 153
2015: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 152
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 171
Total of all active and inactive participants 2015-01-01 171
Total participants 2015-01-01 171
2014: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 152
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 152
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 2014-01-01 152
Total participants 2014-01-01 152
2013: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 143
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 152
Total of all active and inactive participants 2013-01-01 152
Total participants 2013-01-01 152
2012: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 137
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 143
Total of all active and inactive participants 2012-01-01 143
Total participants 2012-01-01 143
2011: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 183
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 137
Total of all active and inactive participants 2011-01-01 137
Total participants 2011-01-01 137
2009: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 104
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 103
Total of all active and inactive participants 2009-01-01 103
Total participants 2009-01-01 103

Measure	Date	Value
2022: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	150
Total of all active and inactive participants	2022-01-01	150
Total participants	2022-01-01	150
2021: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	120
Total of all active and inactive participants	2021-01-01	120
Total participants	2021-01-01	120
2020: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	168
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	118
Total of all active and inactive participants	2020-01-01	118
Total participants	2020-01-01	118
2019: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	168
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	169
Total of all active and inactive participants	2019-01-01	169
Total participants	2019-01-01	169
2018: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	160
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	168
Total of all active and inactive participants	2018-01-01	168
Total participants	2018-01-01	168
2017: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	153
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	160
Total of all active and inactive participants	2017-01-01	160
Total participants	2017-01-01	160
2016: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	153
Total of all active and inactive participants	2016-01-01	153
Total participants	2016-01-01	153
2015: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	152
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	171
Total of all active and inactive participants	2015-01-01	171
Total participants	2015-01-01	171
2014: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	152
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	152
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	152
Total participants	2014-01-01	152
2013: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	143
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	152
Total of all active and inactive participants	2013-01-01	152
Total participants	2013-01-01	152
2012: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	137
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	143
Total of all active and inactive participants	2012-01-01	143
Total participants	2012-01-01	143
2011: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	183
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	137
Total of all active and inactive participants	2011-01-01	137
Total participants	2011-01-01	137
2009: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	104
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	103
Total of all active and inactive participants	2009-01-01	103
Total participants	2009-01-01	103

Form 5500 Responses for THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN

2022: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT 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 – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT 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 – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT 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 – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT 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 – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT 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 – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT 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 – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT 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 – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT 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 – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT 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 – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: THE FORT WORTH CLUB OF FORT WORTH TEXAS EMPLOYEE INJURY BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010088139

Policy instance

Insurance contract or identification number	000010088139
Number of Individuals Covered	100
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $953
Total amount of fees paid to insurance company	USD $379
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $7,660
Commission paid to Insurance Broker	USD $953
Amount paid for insurance broker fees	379
Insurance broker organization code?	3
Insurance broker name	HIGGINBOTHAM INSURANCE AGENCY INC.

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Company Name:	THE FORT WORTH CLUB
Employer identification number (EIN):	750275110
NAIC Classification:	721110
NAIC Description:	Hotels (except Casino Hotels) and Motels