401k Plan data: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN plan

F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 401k Plan overview

Plan Name	F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN
Plan identification number	501

F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

F L MALIK, INC. has sponsored the creation of one or more 401k plans.

Company Name: F L MALIK, INC.

Employer identification number (EIN): 752263467

NAIC Classification: 424300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2016-12-01 FRANCES L MALIK
501 2015-12-01 FRANCES L MALIK
501 2014-12-01 FRANCES L MALIK
501 2013-12-01 FRANCES L MALIK
501 2012-12-01 FRANCES L MALIK

Plan id#	Filing Submission Date	Name of Administrator
501	2016-12-01	FRANCES L MALIK
501	2015-12-01	FRANCES L MALIK
501	2014-12-01	FRANCES L MALIK
501	2013-12-01	FRANCES L MALIK
501	2012-12-01	FRANCES L MALIK

Plan Statistics for F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN

401k plan membership statisitcs for F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2016: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-12-01 0
Total number of active participants reported on line 7a of the Form 5500 2016-12-01 0
Number of retired or separated participants receiving benefits 2016-12-01 0
Number of other retired or separated participants entitled to future benefits 2016-12-01 0
Total of all active and inactive participants 2016-12-01 0
2015: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-12-01 13
Total number of active participants reported on line 7a of the Form 5500 2015-12-01 11
Number of retired or separated participants receiving benefits 2015-12-01 0
Number of other retired or separated participants entitled to future benefits 2015-12-01 0
Total of all active and inactive participants 2015-12-01 11
2014: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-12-01 12
Total number of active participants reported on line 7a of the Form 5500 2014-12-01 13
Number of retired or separated participants receiving benefits 2014-12-01 0
Number of other retired or separated participants entitled to future benefits 2014-12-01 0
Total of all active and inactive participants 2014-12-01 13
2013: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-12-01 10
Total number of active participants reported on line 7a of the Form 5500 2013-12-01 12
Number of retired or separated participants receiving benefits 2013-12-01 0
Number of other retired or separated participants entitled to future benefits 2013-12-01 0
Total of all active and inactive participants 2013-12-01 12
2012: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-12-01 10
Total number of active participants reported on line 7a of the Form 5500 2012-12-01 9
Number of retired or separated participants receiving benefits 2012-12-01 0
Number of other retired or separated participants entitled to future benefits 2012-12-01 0
Total of all active and inactive participants 2012-12-01 9

Measure	Date	Value
2016: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-12-01	0
Total number of active participants reported on line 7a of the Form 5500	2016-12-01	0
Number of retired or separated participants receiving benefits	2016-12-01	0
Number of other retired or separated participants entitled to future benefits	2016-12-01	0
Total of all active and inactive participants	2016-12-01	0
2015: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-12-01	13
Total number of active participants reported on line 7a of the Form 5500	2015-12-01	11
Number of retired or separated participants receiving benefits	2015-12-01	0
Number of other retired or separated participants entitled to future benefits	2015-12-01	0
Total of all active and inactive participants	2015-12-01	11
2014: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-12-01	12
Total number of active participants reported on line 7a of the Form 5500	2014-12-01	13
Number of retired or separated participants receiving benefits	2014-12-01	0
Number of other retired or separated participants entitled to future benefits	2014-12-01	0
Total of all active and inactive participants	2014-12-01	13
2013: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-12-01	10
Total number of active participants reported on line 7a of the Form 5500	2013-12-01	12
Number of retired or separated participants receiving benefits	2013-12-01	0
Number of other retired or separated participants entitled to future benefits	2013-12-01	0
Total of all active and inactive participants	2013-12-01	12
2012: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-12-01	10
Total number of active participants reported on line 7a of the Form 5500	2012-12-01	9
Number of retired or separated participants receiving benefits	2012-12-01	0
Number of other retired or separated participants entitled to future benefits	2012-12-01	0
Total of all active and inactive participants	2012-12-01	9

Financial Data on F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN

Measure	Date	Value
2017 : F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2017 401k financial data
Transfers to/from the plan	2017-11-30	$-66,146
Total plan liabilities at beginning of year	2017-11-30	$89
Total income from all sources	2017-11-30	$75
Expenses. Total of all expenses incurred	2017-11-30	$705
Benefits paid (including direct rollovers)	2017-11-30	$671
Total plan assets at end of year	2017-11-30	$0
Total plan assets at beginning of year	2017-11-30	$66,865
Other income received	2017-11-30	$75
Net income (gross income less expenses)	2017-11-30	$-630
Net plan assets at end of year (total assets less liabilities)	2017-11-30	$0
Net plan assets at beginning of year (total assets less liabilities)	2017-11-30	$66,776
Expenses. Administrative service providers (salaries,fees and commissions)	2017-11-30	$34
2016 : F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2016 401k financial data
Total plan liabilities at end of year	2016-11-30	$89
Total income from all sources	2016-11-30	$51,795
Expenses. Total of all expenses incurred	2016-11-30	$28,524
Benefits paid (including direct rollovers)	2016-11-30	$21,928
Total plan assets at end of year	2016-11-30	$66,865
Total plan assets at beginning of year	2016-11-30	$43,505
Total contributions received or receivable from participants	2016-11-30	$51,697
Other income received	2016-11-30	$98
Net income (gross income less expenses)	2016-11-30	$23,271
Net plan assets at end of year (total assets less liabilities)	2016-11-30	$66,776
Net plan assets at beginning of year (total assets less liabilities)	2016-11-30	$43,505
Expenses. Administrative service providers (salaries,fees and commissions)	2016-11-30	$6,596
2015 : F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2015 401k financial data
Total income from all sources	2015-11-30	$52,225
Expenses. Total of all expenses incurred	2015-11-30	$31,946
Benefits paid (including direct rollovers)	2015-11-30	$25,198
Total plan assets at end of year	2015-11-30	$43,505
Total plan assets at beginning of year	2015-11-30	$23,226
Total contributions received or receivable from participants	2015-11-30	$52,207
Other income received	2015-11-30	$18
Net income (gross income less expenses)	2015-11-30	$20,279
Net plan assets at end of year (total assets less liabilities)	2015-11-30	$43,505
Net plan assets at beginning of year (total assets less liabilities)	2015-11-30	$23,226
Expenses. Administrative service providers (salaries,fees and commissions)	2015-11-30	$6,748
2014 : F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2014 401k financial data
Total plan liabilities at beginning of year	2014-11-30	$48
Total income from all sources	2014-11-30	$41,430
Expenses. Total of all expenses incurred	2014-11-30	$30,541
Benefits paid (including direct rollovers)	2014-11-30	$24,754
Total plan assets at end of year	2014-11-30	$23,226
Total plan assets at beginning of year	2014-11-30	$12,385
Total contributions received or receivable from participants	2014-11-30	$41,424
Other income received	2014-11-30	$6
Net income (gross income less expenses)	2014-11-30	$10,889
Net plan assets at end of year (total assets less liabilities)	2014-11-30	$23,226
Net plan assets at beginning of year (total assets less liabilities)	2014-11-30	$12,337
Expenses. Administrative service providers (salaries,fees and commissions)	2014-11-30	$5,787
2013 : F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2013 401k financial data
Total plan liabilities at end of year	2013-11-30	$48
Total income from all sources	2013-11-30	$29,031
Expenses. Total of all expenses incurred	2013-11-30	$16,694
Benefits paid (including direct rollovers)	2013-11-30	$11,773
Total plan assets at end of year	2013-11-30	$12,385
Total plan assets at beginning of year	2013-11-30	$0
Total contributions received or receivable from participants	2013-11-30	$29,028
Other income received	2013-11-30	$3
Net income (gross income less expenses)	2013-11-30	$12,337
Net plan assets at end of year (total assets less liabilities)	2013-11-30	$12,337
Net plan assets at beginning of year (total assets less liabilities)	2013-11-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-11-30	$4,921

Form 5500 Responses for F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN

2016: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2016 form 5500 responses
2016-12-01	Type of plan entity	Single employer plan
2016-12-01	This submission is the final filing	Yes
2016-12-01	Plan funding arrangement – Trust	Yes
2016-12-01	Plan benefit arrangement - Trust	Yes
2015: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2015 form 5500 responses
2015-12-01	Type of plan entity	Single employer plan
2015-12-01	Plan funding arrangement – Trust	Yes
2015-12-01	Plan benefit arrangement - Trust	Yes
2014: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2014 form 5500 responses
2014-12-01	Type of plan entity	Single employer plan
2014-12-01	Plan funding arrangement – Trust	Yes
2014-12-01	Plan benefit arrangement - Trust	Yes
2013: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2013 form 5500 responses
2013-12-01	Type of plan entity	Single employer plan
2013-12-01	Plan funding arrangement – Trust	Yes
2013-12-01	Plan benefit arrangement - Trust	Yes
2012: F L MALIK, INC. SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2012 form 5500 responses
2012-12-01	Type of plan entity	Single employer plan
2012-12-01	First time form 5500 has been submitted	Yes
2012-12-01	Plan funding arrangement – Trust	Yes
2012-12-01	Plan benefit arrangement - Trust	Yes

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Company Name:	F L MALIK, INC.
Employer identification number (EIN):	752263467
NAIC Classification:	424300