401k Plan data: CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS plan

CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS 401k Plan overview

Plan Name	CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS
Plan identification number	001

CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
Stock bonus
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.
ESOP other than a leveraged ESOP - A completed Schedule E must be attached to a Form 5500 filed for an Employee Stock Ownership Plan (ESOP).

401k Sponsoring company profile

CORNERSTONE BANCSHARES, INC. has sponsored the creation of one or more 401k plans.

Company Name: CORNERSTONE BANCSHARES, INC.

Employer identification number (EIN): 200839370

NAIC Classification: 522110
NAIC Description: Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-01-01 FRANK H. ROACH FRANK H. ROACH 2012-07-26
001 2009-01-01 FRANK H. ROACH FRANK H. ROACH 2010-07-22

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2011-01-01	FRANK H. ROACH		FRANK H. ROACH	2012-07-26
001	2009-01-01	FRANK H. ROACH		FRANK H. ROACH	2010-07-22

Plan Statistics for CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS

401k plan membership statisitcs for CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS

Measure Date Value
2011: CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS 2011 401k membership
Total participants, beginning-of-year 2011-01-01 62
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 65
Number of retired or separated participants receiving benefits 2011-01-01 17
Number of other retired or separated participants entitled to future benefits 2011-01-01 20
Total of all active and inactive participants 2011-01-01 102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 102
Number of participants with account balances 2011-01-01 92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS 2009 401k membership
Total participants, beginning-of-year 2009-01-01 65
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 49
Number of retired or separated participants receiving benefits 2009-01-01 5
Number of other retired or separated participants entitled to future benefits 2009-01-01 21
Total of all active and inactive participants 2009-01-01 75
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 75
Number of participants with account balances 2009-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS 2011 401k membership
Total participants, beginning-of-year	2011-01-01	62
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	65
Number of retired or separated participants receiving benefits	2011-01-01	17
Number of other retired or separated participants entitled to future benefits	2011-01-01	20
Total of all active and inactive participants	2011-01-01	102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	102
Number of participants with account balances	2011-01-01	92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS 2009 401k membership
Total participants, beginning-of-year	2009-01-01	65
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	49
Number of retired or separated participants receiving benefits	2009-01-01	5
Number of other retired or separated participants entitled to future benefits	2009-01-01	21
Total of all active and inactive participants	2009-01-01	75
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	75
Number of participants with account balances	2009-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS

Measure	Date	Value
2011 : CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS 2011 401k financial data
Total plan liabilities at end of year	2011-12-31	$123
Total plan liabilities at beginning of year	2011-12-31	$124
Total income from all sources	2011-12-31	$75,792
Expenses. Total of all expenses incurred	2011-12-31	$88,415
Benefits paid (including direct rollovers)	2011-12-31	$88,415
Total plan assets at end of year	2011-12-31	$1,078,809
Total plan assets at beginning of year	2011-12-31	$1,091,433
Value of fidelity bond covering the plan	2011-12-31	$3,000,000
Total contributions received or receivable from participants	2011-12-31	$146,318
Contributions received from other sources (not participants or employers)	2011-12-31	$76,858
Other income received	2011-12-31	$-148,175
Net income (gross income less expenses)	2011-12-31	$-12,623
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,078,686
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,091,309
Assets. Value of employer securities	2011-12-31	$119,972
Total contributions received or receivable from employer(s)	2011-12-31	$791
2010 : CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS 2010 401k financial data
Total plan liabilities at end of year	2010-12-31	$124
Total plan liabilities at beginning of year	2010-12-31	$782
Total income from all sources	2010-12-31	$-303,129
Expenses. Total of all expenses incurred	2010-12-31	$105,212
Benefits paid (including direct rollovers)	2010-12-31	$105,212
Total plan assets at end of year	2010-12-31	$1,091,433
Total plan assets at beginning of year	2010-12-31	$1,500,432
Value of fidelity bond covering the plan	2010-12-31	$3,000,000
Total contributions received or receivable from participants	2010-12-31	$97,967
Contributions received from other sources (not participants or employers)	2010-12-31	$100,002
Other income received	2010-12-31	$-501,098
Net income (gross income less expenses)	2010-12-31	$-408,341
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,091,309
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,499,650
Assets. Value of employer securities	2010-12-31	$239,945

Form 5500 Responses for CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS

2011: CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS 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: CORNERSTONE BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN W/ 401(K) PROVISIONS 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:	CORNERSTONE BANCSHARES, INC.
Employer identification number (EIN):	200839370
NAIC Classification:	522110
NAIC Description:	Commercial Banking