401k Plan data: PAYLESS DRUG STORE, INC. 401(K) PLAN plan

PAYLESS DRUG STORE, INC. 401(K) PLAN 401k Plan overview

Plan Name	PAYLESS DRUG STORE, INC. 401(K) PLAN
Plan identification number	001

PAYLESS DRUG STORE, INC. 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

PAYLESS DRUG STORES, INC. has sponsored the creation of one or more 401k plans.

Company Name: PAYLESS DRUG STORES, INC.

Employer identification number (EIN): 943382598

NAIC Classification: 446110
NAIC Description: Pharmacies and Drug Stores

Additional information about PAYLESS DRUG STORES, INC.

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division

Incorporation Date: 1999-10-01

Company Identification Number: 71372487

Legal Registered Office Address: 1127 BROADWAY ST NE STE 310

SALEM
United States of America (USA)
97301

More information about PAYLESS DRUG STORES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PAYLESS DRUG STORE, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2014-01-01 ANDREW J KLEFFNER
001 2013-01-01 ANDREW J KLEFFNER
001 2012-01-01 ANDREW J KLEFFNER
001 2011-01-01 ANDREW J KLEFFNER
001 2010-01-01 JIM FOSTER
001 2009-01-01 JEANETTE SPENCE

Plan id#	Filing Submission Date	Name of Administrator
001	2014-01-01	ANDREW J KLEFFNER
001	2013-01-01	ANDREW J KLEFFNER
001	2012-01-01	ANDREW J KLEFFNER
001	2011-01-01	ANDREW J KLEFFNER
001	2010-01-01	JIM FOSTER
001	2009-01-01	JEANETTE SPENCE

Plan Statistics for PAYLESS DRUG STORE, INC. 401(K) PLAN

401k plan membership statisitcs for PAYLESS DRUG STORE, INC. 401(K) PLAN

Measure Date Value
2014: PAYLESS DRUG STORE, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 293
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 235
Number of retired or separated participants receiving benefits 2014-01-01 1
Number of other retired or separated participants entitled to future benefits 2014-01-01 51
Total of all active and inactive participants 2014-01-01 287
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 288
Number of participants with account balances 2014-01-01 176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 10
2013: PAYLESS DRUG STORE, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 308
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 239
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 52
Total of all active and inactive participants 2013-01-01 291
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 291
Number of participants with account balances 2013-01-01 192
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 22
2012: PAYLESS DRUG STORE, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 307
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 272
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 36
Total of all active and inactive participants 2012-01-01 308
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 308
Number of participants with account balances 2012-01-01 212
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 25
2011: PAYLESS DRUG STORE, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 305
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 271
Number of other retired or separated participants entitled to future benefits 2011-01-01 26
Total of all active and inactive participants 2011-01-01 297
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 297
Number of participants with account balances 2011-01-01 228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 19
2010: PAYLESS DRUG STORE, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 306
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 273
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 22
Total of all active and inactive participants 2010-01-01 295
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 295
Number of participants with account balances 2010-01-01 235
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 23
2009: PAYLESS DRUG STORE, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 243
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 259
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 25
Total of all active and inactive participants 2009-01-01 284
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 284
Number of participants with account balances 2009-01-01 242
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 19

Measure	Date	Value
2014: PAYLESS DRUG STORE, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	293
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	235
Number of retired or separated participants receiving benefits	2014-01-01	1
Number of other retired or separated participants entitled to future benefits	2014-01-01	51
Total of all active and inactive participants	2014-01-01	287
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	288
Number of participants with account balances	2014-01-01	176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	10
2013: PAYLESS DRUG STORE, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	308
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	239
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	52
Total of all active and inactive participants	2013-01-01	291
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	291
Number of participants with account balances	2013-01-01	192
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	22
2012: PAYLESS DRUG STORE, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	307
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	272
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	36
Total of all active and inactive participants	2012-01-01	308
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	308
Number of participants with account balances	2012-01-01	212
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	25
2011: PAYLESS DRUG STORE, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	305
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	271
Number of other retired or separated participants entitled to future benefits	2011-01-01	26
Total of all active and inactive participants	2011-01-01	297
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	297
Number of participants with account balances	2011-01-01	228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	19
2010: PAYLESS DRUG STORE, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	306
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	273
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	22
Total of all active and inactive participants	2010-01-01	295
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	295
Number of participants with account balances	2010-01-01	235
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	23
2009: PAYLESS DRUG STORE, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	243
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	259
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	25
Total of all active and inactive participants	2009-01-01	284
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	284
Number of participants with account balances	2009-01-01	242
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	19

Financial Data on PAYLESS DRUG STORE, INC. 401(K) PLAN

Measure	Date	Value
2014 : PAYLESS DRUG STORE, INC. 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$13,656
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$21,035
Total income from all sources (including contributions)	2014-12-31	$996,734
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$713,579
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$656,679
Value of total corrective distributions	2014-12-31	$981
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$628,901
Value of total assets at end of year	2014-12-31	$6,115,027
Value of total assets at beginning of year	2014-12-31	$5,839,251
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$55,919
Total interest from all sources	2014-12-31	$3,387
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$572,612
Participant contributions at end of year	2014-12-31	$123,299
Participant contributions at beginning of year	2014-12-31	$79,273
Participant contributions at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$6,372
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$7,523
Liabilities. Value of operating payables at end of year	2014-12-31	$13,656
Liabilities. Value of operating payables at beginning of year	2014-12-31	$13,512
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$283,155
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$6,101,371
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$5,818,216
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$5,991,728
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$5,759,454
Interest on participant loans	2014-12-31	$3,393
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$-6
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$364,446
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$49,917
Employer contributions (assets) at beginning of year	2014-12-31	$524
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$656,679
Contract administrator fees	2014-12-31	$55,919
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	KIECKHAFER SCHIFFER & COMPANY LLP
Accountancy firm EIN	2014-12-31	330688321
2013 : PAYLESS DRUG STORE, INC. 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$21,035
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$13,000
Total income from all sources (including contributions)	2013-12-31	$1,772,287
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$1,062,328
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,006,664
Value of total corrective distributions	2013-12-31	$169
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$743,285
Value of total assets at end of year	2013-12-31	$5,839,251
Value of total assets at beginning of year	2013-12-31	$5,121,257
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$55,495
Total interest from all sources	2013-12-31	$3,346
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$375,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$664,089
Participant contributions at end of year	2013-12-31	$79,273
Participant contributions at beginning of year	2013-12-31	$120,104
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$28,692
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$9,421
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$7,523
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$1,445
Liabilities. Value of operating payables at end of year	2013-12-31	$13,512
Liabilities. Value of operating payables at beginning of year	2013-12-31	$11,555
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$709,959
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$5,818,216
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$5,108,257
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$5,759,454
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$4,969,443
Interest on participant loans	2013-12-31	$3,362
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$-16
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,025,656
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$69,775
Employer contributions (assets) at end of year	2013-12-31	$524
Employer contributions (assets) at beginning of year	2013-12-31	$3,018
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,006,664
Contract administrator fees	2013-12-31	$55,495
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	THOMPSON KESSLER WIEST& BORQUIST PC
Accountancy firm EIN	2013-12-31	205888003
2012 : PAYLESS DRUG STORE, INC. 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$13,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$24,912
Total income from all sources (including contributions)	2012-12-31	$1,367,943
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$586,731
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$538,346
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$828,841
Value of total assets at end of year	2012-12-31	$5,121,257
Value of total assets at beginning of year	2012-12-31	$4,351,957
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$48,385
Total interest from all sources	2012-12-31	$4,359
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$130,482
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$130,482
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$570,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$747,135
Participant contributions at end of year	2012-12-31	$120,104
Participant contributions at beginning of year	2012-12-31	$144,877
Participant contributions at end of year	2012-12-31	$28,692
Participant contributions at beginning of year	2012-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$9,374
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$1,445
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$15,080
Liabilities. Value of operating payables at end of year	2012-12-31	$11,555
Liabilities. Value of operating payables at beginning of year	2012-12-31	$9,832
Total non interest bearing cash at beginning of year	2012-12-31	$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	2012-12-31	No
Value of net income/loss	2012-12-31	$781,212
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$5,108,257
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$4,327,045
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$4,969,443
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$4,207,080
Interest on participant loans	2012-12-31	$4,359
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$404,261
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$72,332
Employer contributions (assets) at end of year	2012-12-31	$3,018
Employer contributions (assets) at beginning of year	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$538,346
Contract administrator fees	2012-12-31	$48,385
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	THOMPSON KESSLER WEIST BORQUIST PC
Accountancy firm EIN	2012-12-31	205888003
2011 : PAYLESS DRUG STORE, INC. 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$24,912
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$17,400
Total income from all sources (including contributions)	2011-12-31	$811,840
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$238,124
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$180,633
Value of total corrective distributions	2011-12-31	$15,081
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$809,139
Value of total assets at end of year	2011-12-31	$4,351,957
Value of total assets at beginning of year	2011-12-31	$3,770,729
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$42,410
Total interest from all sources	2011-12-31	$4,053
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$109,148
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$109,148
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$475,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$713,962
Participant contributions at end of year	2011-12-31	$144,877
Participant contributions at beginning of year	2011-12-31	$120,033
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$16,560
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$15,081
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$8,721
Liabilities. Value of operating payables at end of year	2011-12-31	$9,831
Liabilities. Value of operating payables at beginning of year	2011-12-31	$8,679
Total non interest bearing cash at end of year	2011-12-31	$0
Total non interest bearing cash at beginning of year	2011-12-31	$302
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$573,716
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,327,045
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$3,753,329
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$4,207,080
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$3,650,394
Interest on participant loans	2011-12-31	$4,053
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-110,500
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$78,617
Employer contributions (assets) at end of year	2011-12-31	$0
Employer contributions (assets) at beginning of year	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$180,633
Contract administrator fees	2011-12-31	$42,410
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	THOMPSON KESSLER WIEST BORQUIST PC
Accountancy firm EIN	2011-12-31	205888003
2010 : PAYLESS DRUG STORE, INC. 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$17,400
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$12,721
Total income from all sources (including contributions)	2010-12-31	$1,156,512
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$199,975
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$149,078
Value of total corrective distributions	2010-12-31	$11,165
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$794,533
Value of total assets at end of year	2010-12-31	$3,770,729
Value of total assets at beginning of year	2010-12-31	$2,809,513
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$39,732
Total interest from all sources	2010-12-31	$3,367
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$78,860
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$78,860
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$350,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$677,138
Participant contributions at end of year	2010-12-31	$120,033
Participant contributions at beginning of year	2010-12-31	$69,108
Participant contributions at end of year	2010-12-31	$0
Participant contributions at beginning of year	2010-12-31	$23,174
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$38,730
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$41
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$8,721
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$12,721
Liabilities. Value of operating payables at end of year	2010-12-31	$8,679
Total non interest bearing cash at end of year	2010-12-31	$302
Total non interest bearing cash at beginning of year	2010-12-31	$274
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$956,537
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$3,753,329
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$2,796,792
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$3,650,394
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$2,713,971
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$0
Interest on participant loans	2010-12-31	$3,053
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$314
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$279,752
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$78,665
Employer contributions (assets) at end of year	2010-12-31	$0
Employer contributions (assets) at beginning of year	2010-12-31	$2,945
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$149,078
Contract administrator fees	2010-12-31	$39,732
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	THOMPSON KESSLER WIEST & BORQUIST
Accountancy firm EIN	2010-12-31	205888003
2009 : PAYLESS DRUG STORE, INC. 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for PAYLESS DRUG STORE, INC. 401(K) PLAN

2014: PAYLESS DRUG STORE, INC. 401(K) 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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: PAYLESS DRUG STORE, INC. 401(K) 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 – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: PAYLESS DRUG STORE, INC. 401(K) 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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: PAYLESS DRUG STORE, INC. 401(K) 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: PAYLESS DRUG STORE, INC. 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: PAYLESS DRUG STORE, INC. 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
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 – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	PAYLESS DRUG STORES, INC.
Employer identification number (EIN):	943382598
NAIC Classification:	446110
NAIC Description:	Pharmacies and Drug Stores

Jurisdiction of Incorporation:	Oregon Secretary of State Corporations Division
Incorporation Date:	1999-10-01
Company Identification Number:	71372487
Legal Registered Office Address:	1127 BROADWAY ST NE STE 310 SALEM United States of America (USA) 97301