401k Plan data: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN plan

CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 401k Plan overview

Plan Name	CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN
Plan identification number	001

CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.

401k Sponsoring company profile

NICOLE M. DIGBY DBA CHICK-FIL-A AT MAIN STREET VA FSU has sponsored the creation of one or more 401k plans.

Company Name: NICOLE M. DIGBY DBA CHICK-FIL-A AT MAIN STREET VA FSU

Employer identification number (EIN): 061677689

NAIC Classification: 722513
NAIC Description: Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHICK-FIL-A AT MAIN STREET SAFE HARBOR 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 NICOLE M. DIGBY NICOLE M. DIGBY 2015-10-14
001 2013-01-01 NICOLE M. DIGBY NICOLE M. DIGBY 2014-10-07
001 2012-01-01 NICOLE M. DIGBY NICOLE M. DIGBY 2013-10-14
001 2011-01-01 NICOLE M. DIGBY NICOLE M. DIGBY 2012-10-09
001 2009-01-01 NICOLE M. DIGBY NICOLE M. DIGBY 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2014-01-01	NICOLE M. DIGBY	NICOLE M. DIGBY	2015-10-14
001	2013-01-01	NICOLE M. DIGBY	NICOLE M. DIGBY	2014-10-07
001	2012-01-01	NICOLE M. DIGBY	NICOLE M. DIGBY	2013-10-14
001	2011-01-01	NICOLE M. DIGBY	NICOLE M. DIGBY	2012-10-09
001	2009-01-01	NICOLE M. DIGBY	NICOLE M. DIGBY	2010-10-14

Plan Statistics for CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN

401k plan membership statisitcs for CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN

Measure Date Value
2014: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 12
Number of retired or separated participants receiving benefits 2014-01-01 5
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 17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 17
Number of participants with account balances 2014-01-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 12
Number of retired or separated participants receiving benefits 2013-01-01 5
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 17
Number of participants with account balances 2013-01-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 11
Number of retired or separated participants receiving benefits 2012-01-01 6
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 17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 17
Number of participants with account balances 2012-01-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 10
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 5
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 10
Number of participants with account balances 2011-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 6
Number of retired or separated participants receiving benefits 2009-01-01 4
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 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 10
Number of participants with account balances 2009-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2014: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	12
Number of retired or separated participants receiving benefits	2014-01-01	5
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	17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	17
Number of participants with account balances	2014-01-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	12
Number of retired or separated participants receiving benefits	2013-01-01	5
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	17
Number of participants with account balances	2013-01-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	11
Number of retired or separated participants receiving benefits	2012-01-01	6
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	17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	17
Number of participants with account balances	2012-01-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	10
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	5
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	10
Number of participants with account balances	2011-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	6
Number of retired or separated participants receiving benefits	2009-01-01	4
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	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	10
Number of participants with account balances	2009-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN

Measure	Date	Value
2014 : CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$47,856
Expenses. Total of all expenses incurred	2014-12-31	$0
Total plan assets at end of year	2014-12-31	$348,106
Total plan assets at beginning of year	2014-12-31	$300,250
Value of fidelity bond covering the plan	2014-12-31	$40,000
Total contributions received or receivable from participants	2014-12-31	$23,047
Other income received	2014-12-31	$8,973
Net income (gross income less expenses)	2014-12-31	$47,856
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$348,106
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$300,250
Total contributions received or receivable from employer(s)	2014-12-31	$15,836
2013 : CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$81,328
Expenses. Total of all expenses incurred	2013-12-31	$2,198
Benefits paid (including direct rollovers)	2013-12-31	$2,198
Total plan assets at end of year	2013-12-31	$300,250
Total plan assets at beginning of year	2013-12-31	$221,120
Value of fidelity bond covering the plan	2013-12-31	$30,000
Total contributions received or receivable from participants	2013-12-31	$22,990
Other income received	2013-12-31	$44,163
Net income (gross income less expenses)	2013-12-31	$79,130
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$300,250
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$221,120
Total contributions received or receivable from employer(s)	2013-12-31	$14,175
2012 : CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$59,557
Expenses. Total of all expenses incurred	2012-12-31	$11,912
Benefits paid (including direct rollovers)	2012-12-31	$11,912
Total plan assets at end of year	2012-12-31	$221,120
Total plan assets at beginning of year	2012-12-31	$173,475
Value of fidelity bond covering the plan	2012-12-31	$30,000
Total contributions received or receivable from participants	2012-12-31	$23,355
Other income received	2012-12-31	$21,899
Net income (gross income less expenses)	2012-12-31	$47,645
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$221,120
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$173,475
Total contributions received or receivable from employer(s)	2012-12-31	$14,303
2011 : CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$19,956
Expenses. Total of all expenses incurred	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$173,475
Total plan assets at beginning of year	2011-12-31	$153,519
Value of fidelity bond covering the plan	2011-12-31	$20,000
Total contributions received or receivable from participants	2011-12-31	$20,415
Other income received	2011-12-31	$-11,030
Net income (gross income less expenses)	2011-12-31	$19,956
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$173,475
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$153,519
Total contributions received or receivable from employer(s)	2011-12-31	$10,571
2010 : CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$40,726
Expenses. Total of all expenses incurred	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$153,519
Total plan assets at beginning of year	2010-12-31	$112,793
Total contributions received or receivable from participants	2010-12-31	$20,665
Other income received	2010-12-31	$10,493
Net income (gross income less expenses)	2010-12-31	$40,726
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$153,519
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$112,793
Total contributions received or receivable from employer(s)	2010-12-31	$9,568

Form 5500 Responses for CHICK-FIL-A AT MAIN STREET SAFE HARBOR 401(K) PLAN

2014: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 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: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 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: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 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: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 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
2009: CHICK-FIL-A AT MAIN STREET SAFE HARBOR 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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	NICOLE M. DIGBY DBA CHICK-FIL-A AT MAIN STREET VA FSU
Employer identification number (EIN):	061677689
NAIC Classification:	722513
NAIC Description:	Limited-Service Restaurants