401k Plan data: LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN plan

LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 401k Plan overview

Plan Name	LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN
Plan identification number	003

LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Money purchase (other than target benefit)

401k Sponsoring company profile

BOARD OF TRUSTEES, LOS ANGELES HOTEL-RESTAURANT has sponsored the creation of one or more 401k plans.

Company Name: BOARD OF TRUSTEES, LOS ANGELES HOTEL-RESTAURANT

Employer identification number (EIN): 951776480

NAIC Classification: 722110
NAIC Description: Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2012-01-01 MATTHEW WALKER
003 2011-01-01 MATTHEW WALKER
003 2010-01-01 TIMOTHY HARRIS
003 2009-01-01 ROLLY THROCKMORTON

Plan id#	Filing Submission Date	Name of Administrator
003	2012-01-01	MATTHEW WALKER
003	2011-01-01	MATTHEW WALKER
003	2010-01-01	TIMOTHY HARRIS
003	2009-01-01	ROLLY THROCKMORTON

Plan Statistics for LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN

401k plan membership statisitcs for LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN

Measure Date Value
2012: LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
Total of all active and inactive participants 2012-01-01 0
Total participants 2012-01-01 0
2011: LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 5
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 3
Total of all active and inactive participants 2011-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 8
2010: LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 8
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 0
Total of all active and inactive participants 2010-01-01 8
Total participants 2010-01-01 8
2009: LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 7
Number of retired or separated participants receiving benefits 2009-01-01 1
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 8
Number of participants with account balances 2009-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2012: LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
Total of all active and inactive participants	2012-01-01	0
Total participants	2012-01-01	0
2011: LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	5
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	3
Total of all active and inactive participants	2011-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	8
2010: LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	8
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	0
Total of all active and inactive participants	2010-01-01	8
Total participants	2010-01-01	8
2009: LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	7
Number of retired or separated participants receiving benefits	2009-01-01	1
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	8
Number of participants with account balances	2009-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN

Measure	Date	Value
2012 : LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-11-06	$0
Total plan liabilities at beginning of year	2012-11-06	$7
Total income from all sources	2012-11-06	$117,169
Expenses. Total of all expenses incurred	2012-11-06	$1,988,296
Benefits paid (including direct rollovers)	2012-11-06	$1,988,296
Total plan assets at end of year	2012-11-06	$0
Total plan assets at beginning of year	2012-11-06	$1,871,134
Value of fidelity bond covering the plan	2012-11-06	$1,500,000
Other income received	2012-11-06	$73,289
Net income (gross income less expenses)	2012-11-06	$-1,871,127
Net plan assets at end of year (total assets less liabilities)	2012-11-06	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-11-06	$1,871,127
Total contributions received or receivable from employer(s)	2012-11-06	$43,880
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-11-06	$0
Funding deficiency by the employer to the plan for this plan year	2012-11-06	$0
Minimum employer required contribution for this plan year	2012-11-06	$43,880
Amount contributed by the employer to the plan for this plan year	2012-11-06	$43,880
2011 : LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2011 401k financial data
Total plan liabilities at end of year	2011-12-31	$7
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$136,474
Expenses. Total of all expenses incurred	2011-12-31	$554,316
Benefits paid (including direct rollovers)	2011-12-31	$554,316
Total plan assets at end of year	2011-12-31	$1,871,134
Total plan assets at beginning of year	2011-12-31	$2,288,969
Value of fidelity bond covering the plan	2011-12-31	$1,500,000
Other income received	2011-12-31	$55,680
Net income (gross income less expenses)	2011-12-31	$-417,842
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,871,127
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$2,288,969
Total contributions received or receivable from employer(s)	2011-12-31	$80,794
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$80,794
Amount contributed by the employer to the plan for this plan year	2011-12-31	$80,794
2010 : LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$266,915
Expenses. Total of all expenses incurred	2010-12-31	$1,451
Benefits paid (including direct rollovers)	2010-12-31	$1,451
Total plan assets at end of year	2010-12-31	$2,288,969
Total plan assets at beginning of year	2010-12-31	$2,023,505
Value of fidelity bond covering the plan	2010-12-31	$1,500,000
Other income received	2010-12-31	$180,856
Net income (gross income less expenses)	2010-12-31	$265,464
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$2,288,969
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,023,505
Total contributions received or receivable from employer(s)	2010-12-31	$86,059
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$86,059
Amount contributed by the employer to the plan for this plan year	2010-12-31	$86,059
2009 : LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT 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
Funding deficiency by the employer to the plan for this plan year	2009-12-31	$0
Minimum employer required contribution for this plan year	2009-12-31	$82,279
Amount contributed by the employer to the plan for this plan year	2009-12-31	$82,279

Form 5500 Responses for LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN

2012: LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	This submission is the final filing	Yes
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: LOS ANGELES HOTEL-RESTAURANT EMPLOYER-UNION WELFARE FUND RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
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:	BOARD OF TRUSTEES, LOS ANGELES HOTEL-RESTAURANT
Employer identification number (EIN):	951776480
NAIC Classification:	722110
NAIC Description:	Full-Service Restaurants