401k Plan data: ROTHMAN FURNITURE STORES UNION 401(K) PLAN plan

ROTHMAN FURNITURE STORES UNION 401(K) PLAN 401k Plan overview

Plan Name	ROTHMAN FURNITURE STORES UNION 401(K) PLAN
Plan identification number	004

ROTHMAN FURNITURE STORES UNION 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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.
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

ROTHMAN FURNITURE STORES, INC. has sponsored the creation of one or more 401k plans.

Company Name: ROTHMAN FURNITURE STORES, INC.

Employer identification number (EIN): 430625107

NAIC Classification: 442110
NAIC Description: Furniture Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROTHMAN FURNITURE STORES UNION 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2016-07-01 JAY STEINBACK
004 2015-07-01 JAY STEINBACK
004 2014-07-01 JAY STEINBACK
004 2014-07-01 JAY STEINBACK
004 2013-07-01
004 2012-07-01 VICTORIA S. SMITH VICTORIA S. SMITH 2014-04-14
004 2011-07-01 VICTORIA S. SMITH VICTORIA S. SMITH 2013-04-12
004 2009-07-01 DALE STEINBACK DALE STEINBACK 2011-04-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
004	2016-07-01	JAY STEINBACK
004	2015-07-01	JAY STEINBACK
004	2014-07-01	JAY STEINBACK
004	2014-07-01	JAY STEINBACK
004	2013-07-01
004	2012-07-01	VICTORIA S. SMITH	VICTORIA S. SMITH	2014-04-14
004	2011-07-01	VICTORIA S. SMITH	VICTORIA S. SMITH	2013-04-12
004	2009-07-01	DALE STEINBACK	DALE STEINBACK	2011-04-14

Plan Statistics for ROTHMAN FURNITURE STORES UNION 401(K) PLAN

401k plan membership statisitcs for ROTHMAN FURNITURE STORES UNION 401(K) PLAN

Measure Date Value
2016: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 132
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 0
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 0
Total of all active and inactive participants 2016-07-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 0
Total participants 2016-07-01 0
Number of participants with account balances 2016-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 0
2015: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 121
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 110
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 12
Total of all active and inactive participants 2015-07-01 122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 0
Total participants 2015-07-01 122
Number of participants with account balances 2015-07-01 26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 0
2014: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 137
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 89
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 13
Total of all active and inactive participants 2014-07-01 102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 102
Number of participants with account balances 2014-07-01 28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 140
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 125
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 4
Total of all active and inactive participants 2013-07-01 129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 129
Number of participants with account balances 2013-07-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 0
2012: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 137
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 116
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 4
Total of all active and inactive participants 2012-07-01 120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 120
Number of participants with account balances 2012-07-01 35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 0
2011: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 145
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 120
Number of other retired or separated participants entitled to future benefits 2011-07-01 4
Total of all active and inactive participants 2011-07-01 124
Total participants 2011-07-01 124
Number of participants with account balances 2011-07-01 36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0
2009: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 144
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 141
Number of other retired or separated participants entitled to future benefits 2009-07-01 4
Total of all active and inactive participants 2009-07-01 145
Total participants 2009-07-01 145
Number of participants with account balances 2009-07-01 44
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 0

Measure	Date	Value
2016: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	132
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	0
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	0
Total of all active and inactive participants	2016-07-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	0
Total participants	2016-07-01	0
Number of participants with account balances	2016-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	0
2015: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	121
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	110
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	12
Total of all active and inactive participants	2015-07-01	122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	0
Total participants	2015-07-01	122
Number of participants with account balances	2015-07-01	26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
2014: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	137
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	89
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	13
Total of all active and inactive participants	2014-07-01	102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	102
Number of participants with account balances	2014-07-01	28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	140
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	125
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	4
Total of all active and inactive participants	2013-07-01	129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	129
Number of participants with account balances	2013-07-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	0
2012: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	137
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	116
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	4
Total of all active and inactive participants	2012-07-01	120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	120
Number of participants with account balances	2012-07-01	35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	0
2011: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	145
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	120
Number of other retired or separated participants entitled to future benefits	2011-07-01	4
Total of all active and inactive participants	2011-07-01	124
Total participants	2011-07-01	124
Number of participants with account balances	2011-07-01	36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
2009: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	144
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	141
Number of other retired or separated participants entitled to future benefits	2009-07-01	4
Total of all active and inactive participants	2009-07-01	145
Total participants	2009-07-01	145
Number of participants with account balances	2009-07-01	44
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	0

Financial Data on ROTHMAN FURNITURE STORES UNION 401(K) PLAN

Measure	Date	Value
2016 : ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-19	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-19	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-19	$0
Total income from all sources (including contributions)	2016-12-19	$15,612
Total loss/gain on sale of assets	2016-12-19	$0
Total of all expenses incurred	2016-12-19	$369,784
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-19	$365,773
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-19	$1,779
Value of total assets at end of year	2016-12-19	$0
Value of total assets at beginning of year	2016-12-19	$354,172
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-19	$4,011
Total interest from all sources	2016-12-19	$198
Total dividends received (eg from common stock, registered investment company shares)	2016-12-19	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-19	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-19	$0
Was this plan covered by a fidelity bond	2016-12-19	Yes
Value of fidelity bond cover	2016-12-19	$500,000
If this is an individual account plan, was there a blackout period	2016-12-19	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-19	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-19	No
Contributions received from participants	2016-12-19	$1,779
Participant contributions at end of year	2016-12-19	$0
Participant contributions at beginning of year	2016-12-19	$10,147
Total non interest bearing cash at end of year	2016-12-19	$0
Total non interest bearing cash at beginning of year	2016-12-19	$152
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-19	No
Value of net income/loss	2016-12-19	$-354,172
Value of net assets at end of year (total assets less liabilities)	2016-12-19	$0
Value of net assets at beginning of year (total assets less liabilities)	2016-12-19	$354,172
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-19	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-19	No
Were any leases to which the plan was party in default or uncollectible	2016-12-19	No
Value of interest in pooled separate accounts at end of year	2016-12-19	$0
Value of interest in pooled separate accounts at beginning of year	2016-12-19	$341,757
Interest on participant loans	2016-12-19	$198
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-19	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-19	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-19	$2,116
Net investment gain/loss from pooled separate accounts	2016-12-19	$13,635
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-19	No
Was there a failure to transmit to the plan any participant contributions	2016-12-19	No
Has the plan failed to provide any benefit when due under the plan	2016-12-19	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-19	$365,773
Contract administrator fees	2016-12-19	$4,011
Did the plan have assets held for investment	2016-12-19	No
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	2016-12-19	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-19	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-19	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-19	Disclaimer
Accountancy firm name	2016-12-19	C.J. SCHLOSSER & COMPANY, L.L.C.
Accountancy firm EIN	2016-12-19	371031116
Total unrealized appreciation/depreciation of assets	2016-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total income from all sources (including contributions)	2016-06-30	$5,805
Total loss/gain on sale of assets	2016-06-30	$0
Total of all expenses incurred	2016-06-30	$13,926
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$8,758
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$10,115
Value of total assets at end of year	2016-06-30	$354,172
Value of total assets at beginning of year	2016-06-30	$362,293
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$5,168
Total interest from all sources	2016-06-30	$526
Total dividends received (eg from common stock, registered investment company shares)	2016-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Was this plan covered by a fidelity bond	2016-06-30	Yes
Value of fidelity bond cover	2016-06-30	$500,000
If this is an individual account plan, was there a blackout period	2016-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2016-06-30	No
Contributions received from participants	2016-06-30	$10,115
Participant contributions at end of year	2016-06-30	$10,147
Participant contributions at beginning of year	2016-06-30	$12,887
Other income not declared elsewhere	2016-06-30	$-43
Total non interest bearing cash at end of year	2016-06-30	$152
Total non interest bearing cash at beginning of year	2016-06-30	$152
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Value of net income/loss	2016-06-30	$-8,121
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$354,172
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$362,293
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-06-30	No
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Value of interest in pooled separate accounts at end of year	2016-06-30	$341,757
Value of interest in pooled separate accounts at beginning of year	2016-06-30	$347,114
Interest on participant loans	2016-06-30	$524
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-06-30	$2
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-06-30	$2,116
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-06-30	$2,140
Net investment gain/loss from pooled separate accounts	2016-06-30	$-4,793
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-06-30	No
Was there a failure to transmit to the plan any participant contributions	2016-06-30	No
Has the plan failed to provide any benefit when due under the plan	2016-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$8,758
Contract administrator fees	2016-06-30	$5,168
Did the plan have assets held for investment	2016-06-30	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	2016-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-06-30	No
2015 : ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total income from all sources (including contributions)	2015-06-30	$20,082
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$61,510
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$55,703
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$10,420
Value of total assets at end of year	2015-06-30	$362,293
Value of total assets at beginning of year	2015-06-30	$403,721
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$5,807
Total interest from all sources	2015-06-30	$652
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$500,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$10,420
Participant contributions at end of year	2015-06-30	$12,887
Participant contributions at beginning of year	2015-06-30	$15,664
Other income not declared elsewhere	2015-06-30	$152
Total non interest bearing cash at end of year	2015-06-30	$152
Total non interest bearing cash at beginning of year	2015-06-30	$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	2015-06-30	No
Value of net income/loss	2015-06-30	$-41,428
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$362,293
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$403,721
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Value of interest in pooled separate accounts at end of year	2015-06-30	$347,114
Value of interest in pooled separate accounts at beginning of year	2015-06-30	$385,892
Interest on participant loans	2015-06-30	$650
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-06-30	$2
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$2,140
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$2,165
Net investment gain/loss from pooled separate accounts	2015-06-30	$8,858
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	No
Was there a failure to transmit to the plan any participant contributions	2015-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$55,703
Contract administrator fees	2015-06-30	$5,807
Did the plan have assets held for investment	2015-06-30	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	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-06-30	Disclaimer
Accountancy firm name	2015-06-30	BENDER WELTMAN THOMAS PERRY & CO.
Accountancy firm EIN	2015-06-30	431698328
2014 : ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2014-06-30	$52,205
Total unrealized appreciation/depreciation of assets	2014-06-30	$52,205
Total income from all sources (including contributions)	2014-06-30	$66,228
Total of all expenses incurred	2014-06-30	$37,429
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$31,888
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$13,875
Value of total assets at end of year	2014-06-30	$403,721
Value of total assets at beginning of year	2014-06-30	$374,922
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$5,541
Total interest from all sources	2014-06-30	$148
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$500,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$13,875
Participant contributions at end of year	2014-06-30	$15,664
Participant contributions at end of year	2014-06-30	$0
Participant contributions at beginning of year	2014-06-30	$560
Assets. Other investments not covered elsewhere at beginning of year	2014-06-30	$0
Total non interest bearing cash at end of year	2014-06-30	$0
Total non interest bearing cash at beginning of year	2014-06-30	$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	2014-06-30	No
Value of net income/loss	2014-06-30	$28,799
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$403,721
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$374,922
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of interest in pooled separate accounts at end of year	2014-06-30	$385,892
Value of interest in pooled separate accounts at beginning of year	2014-06-30	$371,595
Interest on participant loans	2014-06-30	$144
Interest earned on other investments	2014-06-30	$4
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$2,165
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$2,767
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$31,888
Contract administrator fees	2014-06-30	$5,541
Did the plan have assets held for investment	2014-06-30	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	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	BENDER WELTMAN THOMAS PERRY & CO.
Accountancy firm EIN	2014-06-30	431698328
2013 : ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total income from all sources (including contributions)	2013-06-30	$50,955
Total of all expenses incurred	2013-06-30	$5,533
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$214
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$18,255
Value of total assets at end of year	2013-06-30	$374,922
Value of total assets at beginning of year	2013-06-30	$329,500
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$5,319
Total interest from all sources	2013-06-30	$15
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$500,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$18,255
Participant contributions at end of year	2013-06-30	$560
Participant contributions at beginning of year	2013-06-30	$10
Total non interest bearing cash at end of year	2013-06-30	$0
Total non interest bearing cash at beginning of year	2013-06-30	$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	2013-06-30	No
Value of net income/loss	2013-06-30	$45,422
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$374,922
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$329,500
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Value of interest in pooled separate accounts at end of year	2013-06-30	$371,595
Value of interest in pooled separate accounts at beginning of year	2013-06-30	$326,754
Interest earned on other investments	2013-06-30	$15
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$2,767
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$2,736
Net investment gain/loss from pooled separate accounts	2013-06-30	$32,685
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	No
Was there a failure to transmit to the plan any participant contributions	2013-06-30	No
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$214
Contract administrator fees	2013-06-30	$5,319
Did the plan have assets held for investment	2013-06-30	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	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	BENDER WELTMAN THOMAS PERRY & CO.
Accountancy firm EIN	2013-06-30	431698328
2012 : ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total income from all sources (including contributions)	2012-06-30	$19,257
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$45,288
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$40,287
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$20,361
Value of total assets at end of year	2012-06-30	$329,500
Value of total assets at beginning of year	2012-06-30	$355,531
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$5,001
Total interest from all sources	2012-06-30	$15
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$500,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$20,361
Participant contributions at end of year	2012-06-30	$10
Participant contributions at beginning of year	2012-06-30	$10
Total non interest bearing cash at end of year	2012-06-30	$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	2012-06-30	No
Value of net income/loss	2012-06-30	$-26,031
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$329,500
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$355,531
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest in pooled separate accounts at end of year	2012-06-30	$326,754
Value of interest in pooled separate accounts at beginning of year	2012-06-30	$352,828
Interest earned on other investments	2012-06-30	$15
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$2,736
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$2,693
Net investment gain/loss from pooled separate accounts	2012-06-30	$-1,119
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$40,287
Contract administrator fees	2012-06-30	$5,001
Did the plan have assets held for investment	2012-06-30	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	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	BENDER WELTMAN THOMAS PERRY & CO.
Accountancy firm EIN	2012-06-30	431698328
2011 : ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total income from all sources (including contributions)	2011-06-30	$76,667
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$91,298
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$85,585
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$28,977
Value of total assets at end of year	2011-06-30	$355,531
Value of total assets at beginning of year	2011-06-30	$370,162
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$5,713
Total interest from all sources	2011-06-30	$13
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$500,000
If this is an individual account plan, was there a blackout period	2011-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Contributions received from participants	2011-06-30	$28,977
Participant contributions at end of year	2011-06-30	$10
Participant contributions at beginning of year	2011-06-30	$10
Total non interest bearing cash at beginning of year	2011-06-30	$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	2011-06-30	No
Value of net income/loss	2011-06-30	$-14,631
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$355,531
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$370,162
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Value of interest in pooled separate accounts at end of year	2011-06-30	$352,828
Value of interest in pooled separate accounts at beginning of year	2011-06-30	$367,762
Interest earned on other investments	2011-06-30	$13
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$2,693
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$2,390
Net investment gain/loss from pooled separate accounts	2011-06-30	$47,677
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	No
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$85,585
Contract administrator fees	2011-06-30	$5,713
Did the plan have assets held for investment	2011-06-30	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	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	BENDER WELTMAN THOMAS PERRY & CO.
Accountancy firm EIN	2011-06-30	431698328

Form 5500 Responses for ROTHMAN FURNITURE STORES UNION 401(K) PLAN

2016: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	Yes
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2016-07-01	Plan is a collectively bargained plan	Yes
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan funding arrangement – Trust	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement - Trust	Yes
2015: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	Yes
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	Yes
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	Yes
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	Yes
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2011: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	Yes
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2009: ROTHMAN FURNITURE STORES UNION 401(K) PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	Yes
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

14079

Policy instance

Insurance contract or identification number	14079
Number of Individuals Covered	36
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $2,811
Total amount of fees paid to insurance company	USD $134
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,618
Insurance broker organization code?	3
Amount paid for insurance broker fees	134
Additional information about fees paid to insurance broker	MISCELLANEOUS SERVICE FEE
Insurance broker name	MORGAN STANLEY SMITH BARNEY

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

14079

Policy instance

Insurance contract or identification number	14079
Number of Individuals Covered	37
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $3,057
Total amount of fees paid to insurance company	USD $108
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,860
Insurance broker organization code?	3
Amount paid for insurance broker fees	108
Additional information about fees paid to insurance broker	MISCELLANEOUS SERVICE FEE
Insurance broker name	MORGAN STANLEY SMITH BARNEY

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

14079

Policy instance

Insurance contract or identification number	14079
Number of Individuals Covered	31
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $2,625
Total amount of fees paid to insurance company	USD $108
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,625
Insurance broker organization code?	3
Amount paid for insurance broker fees	108
Additional information about fees paid to insurance broker	MISCELLANEOUS SERVICE FEE
Insurance broker name	MORGAN STANLEY SMITH BARNEY

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

14079

Policy instance

Insurance contract or identification number	14079
Number of Individuals Covered	23
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $2,786
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $2,675
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY SMITH BARNEY

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

14079

Policy instance

Insurance contract or identification number	14079
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $2,782
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

14079

Policy instance

Insurance contract or identification number	14079
Number of Individuals Covered	48
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $2,857
Total amount of fees paid to insurance company	USD $161
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes

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Company Name:	ROTHMAN FURNITURE STORES, INC.
Employer identification number (EIN):	430625107
NAIC Classification:	442110
NAIC Description:	Furniture Stores