401k Plan data: THOMAS R. MATTHEWS, JR. 401(K) PLAN plan

THOMAS R. MATTHEWS, JR. 401(K) PLAN 401k Plan overview

Plan Name	THOMAS R. MATTHEWS, JR. 401(K) PLAN
Plan identification number	001

THOMAS R. MATTHEWS, JR. 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

THOMAS R. MATTHEWS, JR. DBA PIGGLY WIGGLY 6 has sponsored the creation of one or more 401k plans.

Company Name: THOMAS R. MATTHEWS, JR. DBA PIGGLY WIGGLY 6

Employer identification number (EIN): 561387987

NAIC Classification: 445110
NAIC Description: Supermarkets and Other Grocery (except Convenience) Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THOMAS R. MATTHEWS, JR. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 LISA W MATTHEWS 2023-10-11
001 2021-01-01 THOMAS MATTHEWS 2022-10-11
001 2020-01-01 LISA W MATTHEWS 2021-10-13
001 2019-01-01 THOMAS R MATTHEWS 2020-10-09
001 2018-01-01 THOMAS R. MATTHEWS JR 2019-09-26
001 2017-01-01 THOMAS R. MATTHEWS JR 2018-09-25
001 2016-01-01 THOMAS R MATTHEWS 2017-10-13
001 2016-01-01
001 2015-01-01 LISA W. MATTHEWS 2016-06-28
001 2014-01-01 LISA W. MATTHEWS 2015-07-29
001 2013-01-01 LISA MATTHEWS 2014-08-27
001 2012-01-01 THOMAS R. MATTHEWS, JR.
001 2011-01-01 THOMAS R. MATTHEWS 2012-10-03
001 2010-01-01 THOMAS R MATTHEWS 2011-10-11 THOMAS R MATTHEWS 2011-10-11

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	LISA W MATTHEWS	2023-10-11
001	2021-01-01	THOMAS MATTHEWS	2022-10-11
001	2020-01-01	LISA W MATTHEWS	2021-10-13
001	2019-01-01	THOMAS R MATTHEWS	2020-10-09
001	2018-01-01	THOMAS R. MATTHEWS JR	2019-09-26
001	2017-01-01	THOMAS R. MATTHEWS JR	2018-09-25
001	2016-01-01	THOMAS R MATTHEWS	2017-10-13
001	2016-01-01
001	2015-01-01	LISA W. MATTHEWS	2016-06-28
001	2014-01-01	LISA W. MATTHEWS	2015-07-29
001	2013-01-01	LISA MATTHEWS	2014-08-27
001	2012-01-01	THOMAS R. MATTHEWS, JR.
001	2011-01-01	THOMAS R. MATTHEWS	2012-10-03
001	2010-01-01	THOMAS R MATTHEWS	2011-10-11	THOMAS R MATTHEWS	2011-10-11

Plan Statistics for THOMAS R. MATTHEWS, JR. 401(K) PLAN

401k plan membership statisitcs for THOMAS R. MATTHEWS, JR. 401(K) PLAN

Measure Date Value
2016: THOMAS R. MATTHEWS, JR. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 105
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 86
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 29
Total of all active and inactive participants 2016-01-01 115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 115
Number of participants with account balances 2016-01-01 67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 1
2012: THOMAS R. MATTHEWS, JR. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 93
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 4
Total of all active and inactive participants 2012-01-01 97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 97
Number of participants with account balances 2012-01-01 29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2016: THOMAS R. MATTHEWS, JR. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	105
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	86
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	29
Total of all active and inactive participants	2016-01-01	115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	115
Number of participants with account balances	2016-01-01	67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	1
2012: THOMAS R. MATTHEWS, JR. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	93
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	4
Total of all active and inactive participants	2012-01-01	97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	97
Number of participants with account balances	2012-01-01	29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on THOMAS R. MATTHEWS, JR. 401(K) PLAN

Measure	Date	Value
2016 : THOMAS R. MATTHEWS, JR. 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$9,096
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$0
Expenses. Certain deemed distributions of participant loans	2016-12-31	$0
Value of total corrective distributions	2016-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$8,435
Value of total assets at end of year	2016-12-31	$48,842
Value of total assets at beginning of year	2016-12-31	$39,746
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$0
Total interest from all sources	2016-12-31	$63
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$285
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$285
Assets. Real estate other than employer real property at beginning of year	2016-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	No
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$4,334
Participant contributions at end of year	2016-12-31	$1,053
Participant contributions at beginning of year	2016-12-31	$1,662
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$0
Administrative expenses (other) incurred	2016-12-31	$0
Liabilities. Value of operating payables at beginning of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$9,096
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$48,842
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$39,746
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Assets. partnership/joint venture interests at beginning of year	2016-12-31	$0
Investment advisory and management fees	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$9,393
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$7,308
Interest on participant loans	2016-12-31	$32
Value of interest in master investment trust accounts at end of year	2016-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2016-12-31	$0
Value of interest in common/collective trusts at end of year	2016-12-31	$0
Value of interest in common/collective trusts at beginning of year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$38,396
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$30,776
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$30,776
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$31
Assets. Value of investments in 103.12 investment entities at end of year	2016-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2016-12-31	$0
Asset value of US Government securities at beginning of year	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$313
Net investment gain/loss from pooled separate accounts	2016-12-31	$0
Net investment gain or loss from common/collective trusts	2016-12-31	$0
Net gain/loss from 103.12 investment entities	2016-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Assets. Invements in employer securities at beginning of year	2016-12-31	$0
Assets. Value of employer real property at beginning of year	2016-12-31	$0
Contributions received in cash from employer	2016-12-31	$4,101
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2016-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2016-12-31	$0
Contract administrator fees	2016-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2016-12-31	$0
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Liabilities. Value of acquisition indebtedness at beginning of year	2016-12-31	$0
2012 : THOMAS R. MATTHEWS, JR. 401(K) PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$18,673
Expenses. Total of all expenses incurred	2012-12-31	$8,761
Benefits paid (including direct rollovers)	2012-12-31	$7,333
Total plan assets at end of year	2012-12-31	$178,536
Total plan assets at beginning of year	2012-12-31	$168,624
Value of fidelity bond covering the plan	2012-12-31	$0
Total contributions received or receivable from participants	2012-12-31	$25,214
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$-30,172
Net income (gross income less expenses)	2012-12-31	$9,912
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$178,536
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$168,624
Total contributions received or receivable from employer(s)	2012-12-31	$23,631
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$1,428
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0

Form 5500 Responses for THOMAS R. MATTHEWS, JR. 401(K) PLAN

2016: THOMAS R. MATTHEWS, JR. 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2012: THOMAS R. MATTHEWS, JR. 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

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA819480

Policy instance

Insurance contract or identification number	GA819480
Number of Individuals Covered	0
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
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
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?	No
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

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Company Name:	THOMAS R. MATTHEWS, JR. DBA PIGGLY WIGGLY 6
Employer identification number (EIN):	561387987
NAIC Classification:	445110
NAIC Description:	Supermarkets and Other Grocery (except Convenience) Stores