401k Plan data: EMPLOYEE INJURY BENEFIT PLAN plan

EMPLOYEE INJURY BENEFIT PLAN 401k Plan overview

Plan Name	EMPLOYEE INJURY BENEFIT PLAN
Plan identification number	501

EMPLOYEE INJURY BENEFIT PLAN Benefits

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

401k Sponsoring company profile

POLYTEX FIBERS, CORP. has sponsored the creation of one or more 401k plans.

Company Name: POLYTEX FIBERS, CORP.

Employer identification number (EIN): 760033677

NAIC Classification: 326100

Additional information about POLYTEX FIBERS, CORP.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1982-09-24

Company Identification Number: 0062356600

Legal Registered Office Address: 9341 BAYTHORNE DR

HOUSTON
United States of America (USA)
77041

More information about POLYTEX FIBERS, CORP.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE INJURY BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-01-01 MARITZA RUBIO MARITZA RUBIO 2016-01-14
501 2014-01-01 MARITZA RUBIO MARITZA RUBIO 2015-01-15
501 2013-01-01 MARITZA RUBIO MARITZA RUBIO 2014-01-10
501 2012-01-01 MARITZA RUBIO MARITZA RUBIO 2013-01-30
501 2011-09-01 MARITZA RUBIO MARITZA RUBIO 2012-04-12
501 2010-09-01 MARITZA RUBIO MARITZA RUBIO 2012-01-05
501 2009-09-01 MARITZA RUBIO MARITZA RUBIO 2010-09-21

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2015-01-01	MARITZA RUBIO	MARITZA RUBIO	2016-01-14
501	2014-01-01	MARITZA RUBIO	MARITZA RUBIO	2015-01-15
501	2013-01-01	MARITZA RUBIO	MARITZA RUBIO	2014-01-10
501	2012-01-01	MARITZA RUBIO	MARITZA RUBIO	2013-01-30
501	2011-09-01	MARITZA RUBIO	MARITZA RUBIO	2012-04-12
501	2010-09-01	MARITZA RUBIO	MARITZA RUBIO	2012-01-05
501	2009-09-01	MARITZA RUBIO	MARITZA RUBIO	2010-09-21

Plan Statistics for EMPLOYEE INJURY BENEFIT PLAN

401k plan membership statisitcs for EMPLOYEE INJURY BENEFIT PLAN

Measure Date Value
2015: EMPLOYEE INJURY BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 380
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Total of all active and inactive participants 2015-01-01 0
Total participants 2015-01-01 0
2014: EMPLOYEE INJURY BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 342
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 380
Total of all active and inactive participants 2014-01-01 380
Total participants 2014-01-01 380
2013: EMPLOYEE INJURY BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 298
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 342
Total of all active and inactive participants 2013-01-01 342
Total participants 2013-01-01 342
2012: EMPLOYEE INJURY BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 282
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 298
Total of all active and inactive participants 2012-01-01 298
Total participants 2012-01-01 298
2011: EMPLOYEE INJURY BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-09-01 287
Total number of active participants reported on line 7a of the Form 5500 2011-09-01 282
Total of all active and inactive participants 2011-09-01 282
Total participants 2011-09-01 282
2010: EMPLOYEE INJURY BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-09-01 121
Total number of active participants reported on line 7a of the Form 5500 2010-09-01 287
Total of all active and inactive participants 2010-09-01 287
Total participants 2010-09-01 287
2009: EMPLOYEE INJURY BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-09-01 130
Total number of active participants reported on line 7a of the Form 5500 2009-09-01 121
Number of retired or separated participants receiving benefits 2009-09-01 0
Number of other retired or separated participants entitled to future benefits 2009-09-01 0
Total of all active and inactive participants 2009-09-01 121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-09-01 0
Total participants 2009-09-01 121
Number of participants with account balances 2009-09-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-09-01 0
Number of employers contributing to the scheme 2009-09-01 0

Measure	Date	Value
2015: EMPLOYEE INJURY BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	380
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Total of all active and inactive participants	2015-01-01	0
Total participants	2015-01-01	0
2014: EMPLOYEE INJURY BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	342
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	380
Total of all active and inactive participants	2014-01-01	380
Total participants	2014-01-01	380
2013: EMPLOYEE INJURY BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	298
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	342
Total of all active and inactive participants	2013-01-01	342
Total participants	2013-01-01	342
2012: EMPLOYEE INJURY BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	282
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	298
Total of all active and inactive participants	2012-01-01	298
Total participants	2012-01-01	298
2011: EMPLOYEE INJURY BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-09-01	287
Total number of active participants reported on line 7a of the Form 5500	2011-09-01	282
Total of all active and inactive participants	2011-09-01	282
Total participants	2011-09-01	282
2010: EMPLOYEE INJURY BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-09-01	121
Total number of active participants reported on line 7a of the Form 5500	2010-09-01	287
Total of all active and inactive participants	2010-09-01	287
Total participants	2010-09-01	287
2009: EMPLOYEE INJURY BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-09-01	130
Total number of active participants reported on line 7a of the Form 5500	2009-09-01	121
Number of retired or separated participants receiving benefits	2009-09-01	0
Number of other retired or separated participants entitled to future benefits	2009-09-01	0
Total of all active and inactive participants	2009-09-01	121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-09-01	0
Total participants	2009-09-01	121
Number of participants with account balances	2009-09-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-09-01	0
Number of employers contributing to the scheme	2009-09-01	0

Form 5500 Responses for EMPLOYEE INJURY BENEFIT PLAN

2015: 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	Yes
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: 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: 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: 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: EMPLOYEE INJURY BENEFIT PLAN 2011 form 5500 responses
2011-09-01	Type of plan entity	Single employer plan
2011-09-01	Submission has been amended	Yes
2011-09-01	This submission is the final filing	No
2011-09-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-09-01	Plan is a collectively bargained plan	No
2011-09-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-09-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: EMPLOYEE INJURY BENEFIT PLAN 2010 form 5500 responses
2010-09-01	Type of plan entity	Single employer plan
2010-09-01	Submission has been amended	No
2010-09-01	This submission is the final filing	No
2010-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-09-01	Plan is a collectively bargained plan	No
2010-09-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-09-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: EMPLOYEE INJURY BENEFIT PLAN 2009 form 5500 responses
2009-09-01	Type of plan entity	Single employer plan
2009-09-01	Submission has been amended	No
2009-09-01	This submission is the final filing	No
2009-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-09-01	Plan is a collectively bargained plan	No
2009-09-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-09-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	POLYTEX FIBERS, CORP.
Employer identification number (EIN):	760033677
NAIC Classification:	326100

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1982-09-24
Company Identification Number:	0062356600
Legal Registered Office Address:	9341 BAYTHORNE DR HOUSTON United States of America (USA) 77041