401k Plan data: JERRY LEE'S GROCERY, INC. 401(K) PLAN plan

JERRY LEE'S GROCERY, INC. 401(K) PLAN 401k Plan overview

Plan Name	JERRY LEE'S GROCERY, INC. 401(K) PLAN
Plan identification number	002

JERRY LEE'S GROCERY, INC. 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

JERRY LEE'S GROCERY, INC. has sponsored the creation of one or more 401k plans.

Company Name: JERRY LEE'S GROCERY, INC.

Employer identification number (EIN): 640509904

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JERRY LEE'S GROCERY, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 RONDA DEFORREST 2023-10-13
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 RONDA DEFORREST
002 2016-01-01 RONDA DEFORREST
002 2015-01-01 RONDA DEEORREST RONDA DEEORREST 2016-10-10
002 2014-01-01 RONDA DEFORREST RONDA DEFORREST 2015-08-10
002 2013-01-01 JERRY LEE JERRY LEE 2014-08-12
002 2012-01-01 JERRY LEE JERRY LEE 2013-09-09
002 2011-01-01 JERRY LEE JERRY LEE 2012-07-23
002 2010-01-01 JERRY LEE
002 2009-01-01 JERRY LEE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01	RONDA DEFORREST	2023-10-13
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	RONDA DEFORREST
002	2016-01-01	RONDA DEFORREST
002	2015-01-01	RONDA DEEORREST		RONDA DEEORREST	2016-10-10
002	2014-01-01	RONDA DEFORREST		RONDA DEFORREST	2015-08-10
002	2013-01-01	JERRY LEE		JERRY LEE	2014-08-12
002	2012-01-01	JERRY LEE		JERRY LEE	2013-09-09
002	2011-01-01	JERRY LEE		JERRY LEE	2012-07-23
002	2010-01-01	JERRY LEE
002	2009-01-01	JERRY LEE

Plan Statistics for JERRY LEE'S GROCERY, INC. 401(K) PLAN

401k plan membership statisitcs for JERRY LEE'S GROCERY, INC. 401(K) PLAN

Measure Date Value
2022: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 176
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 0
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 0
Number of participants with account balances 2022-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 167
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 108
Number of retired or separated participants receiving benefits 2021-01-01 24
Number of other retired or separated participants entitled to future benefits 2021-01-01 27
Total of all active and inactive participants 2021-01-01 159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 159
Number of participants with account balances 2021-01-01 116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 1
2020: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 158
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 113
Number of retired or separated participants receiving benefits 2020-01-01 21
Number of other retired or separated participants entitled to future benefits 2020-01-01 24
Total of all active and inactive participants 2020-01-01 158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 158
Number of participants with account balances 2020-01-01 113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 169
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 135
Number of retired or separated participants receiving benefits 2019-01-01 21
Number of other retired or separated participants entitled to future benefits 2019-01-01 11
Total of all active and inactive participants 2019-01-01 167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 1
Total participants 2019-01-01 168
Number of participants with account balances 2019-01-01 113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 130
Number of retired or separated participants receiving benefits 2018-01-01 40
Number of other retired or separated participants entitled to future benefits 2018-01-01 6
Total of all active and inactive participants 2018-01-01 176
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 176
Number of participants with account balances 2018-01-01 128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 163
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 122
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 39
Total of all active and inactive participants 2017-01-01 161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 161
Number of participants with account balances 2017-01-01 121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 157
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 152
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 18
Total of all active and inactive participants 2016-01-01 170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 170
Number of participants with account balances 2016-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 124
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 24
Total of all active and inactive participants 2015-01-01 148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 148
Number of participants with account balances 2015-01-01 107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 2
2014: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 148
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 118
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 27
Total of all active and inactive participants 2014-01-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 145
Number of participants with account balances 2014-01-01 92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 2
2013: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 146
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 105
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 27
Total of all active and inactive participants 2013-01-01 132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 132
Number of participants with account balances 2013-01-01 89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 2
2012: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 107
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 21
Total of all active and inactive participants 2012-01-01 128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 1
Total participants 2012-01-01 129
Number of participants with account balances 2012-01-01 78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 2
2011: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 143
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 118
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 19
Total of all active and inactive participants 2011-01-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 137
Number of participants with account balances 2011-01-01 80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 2
2010: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 144
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 118
Number of retired or separated participants receiving benefits 2010-01-01 1
Number of other retired or separated participants entitled to future benefits 2010-01-01 20
Total of all active and inactive participants 2010-01-01 139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 139
Number of participants with account balances 2010-01-01 88
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 4
2009: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 155
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 116
Number of retired or separated participants receiving benefits 2009-01-01 1
Number of other retired or separated participants entitled to future benefits 2009-01-01 21
Total of all active and inactive participants 2009-01-01 138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 138
Number of participants with account balances 2009-01-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2022: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	176
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	0
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	0
Number of participants with account balances	2022-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	167
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	108
Number of retired or separated participants receiving benefits	2021-01-01	24
Number of other retired or separated participants entitled to future benefits	2021-01-01	27
Total of all active and inactive participants	2021-01-01	159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	159
Number of participants with account balances	2021-01-01	116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	1
2020: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	158
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	113
Number of retired or separated participants receiving benefits	2020-01-01	21
Number of other retired or separated participants entitled to future benefits	2020-01-01	24
Total of all active and inactive participants	2020-01-01	158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	158
Number of participants with account balances	2020-01-01	113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	169
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	135
Number of retired or separated participants receiving benefits	2019-01-01	21
Number of other retired or separated participants entitled to future benefits	2019-01-01	11
Total of all active and inactive participants	2019-01-01	167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	1
Total participants	2019-01-01	168
Number of participants with account balances	2019-01-01	113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	130
Number of retired or separated participants receiving benefits	2018-01-01	40
Number of other retired or separated participants entitled to future benefits	2018-01-01	6
Total of all active and inactive participants	2018-01-01	176
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	176
Number of participants with account balances	2018-01-01	128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	163
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	122
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	39
Total of all active and inactive participants	2017-01-01	161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	161
Number of participants with account balances	2017-01-01	121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	157
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	152
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	18
Total of all active and inactive participants	2016-01-01	170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	170
Number of participants with account balances	2016-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	124
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	24
Total of all active and inactive participants	2015-01-01	148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	148
Number of participants with account balances	2015-01-01	107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	2
2014: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	148
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	118
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	27
Total of all active and inactive participants	2014-01-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	145
Number of participants with account balances	2014-01-01	92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	2
2013: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	146
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	105
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	27
Total of all active and inactive participants	2013-01-01	132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	132
Number of participants with account balances	2013-01-01	89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	2
2012: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	107
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	21
Total of all active and inactive participants	2012-01-01	128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	1
Total participants	2012-01-01	129
Number of participants with account balances	2012-01-01	78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	2
2011: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	143
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	118
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	19
Total of all active and inactive participants	2011-01-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	137
Number of participants with account balances	2011-01-01	80
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	2
2010: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	118
Number of retired or separated participants receiving benefits	2010-01-01	1
Number of other retired or separated participants entitled to future benefits	2010-01-01	20
Total of all active and inactive participants	2010-01-01	139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	139
Number of participants with account balances	2010-01-01	88
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	4
2009: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	155
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	116
Number of retired or separated participants receiving benefits	2009-01-01	1
Number of other retired or separated participants entitled to future benefits	2009-01-01	21
Total of all active and inactive participants	2009-01-01	138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	138
Number of participants with account balances	2009-01-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on JERRY LEE'S GROCERY, INC. 401(K) PLAN

Measure	Date	Value
2022 : JERRY LEE'S GROCERY, INC. 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$35
Total income from all sources (including contributions)	2022-12-31	$-297,745
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$2,927,333
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$2,898,436
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$164,512
Value of total assets at end of year	2022-12-31	$0
Value of total assets at beginning of year	2022-12-31	$3,225,113
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$28,897
Total interest from all sources	2022-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2022-12-31	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$300,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$104,912
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$69
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$35
Administrative expenses (other) incurred	2022-12-31	$8,524
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$377
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-3,225,078
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$3,225,078
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$7,663
Value of interest in pooled separate accounts at end of year	2022-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$3,159,004
Net investment gain/loss from pooled separate accounts	2022-12-31	$-462,257
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$59,600
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$65,663
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$2,898,436
Contract administrator fees	2022-12-31	$12,710
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	WOLFE, MCDUFF & OPPIE, P.A.
Accountancy firm EIN	2022-12-31	640891412
2021 : JERRY LEE'S GROCERY, INC. 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$35
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$35
Total income from all sources (including contributions)	2021-12-31	$569,980
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$256,080
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$230,869
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$213,484
Value of total assets at end of year	2021-12-31	$3,225,113
Value of total assets at beginning of year	2021-12-31	$2,911,213
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$25,211
Total interest from all sources	2021-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$300,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$126,436
Participant contributions at end of year	2021-12-31	$69
Participant contributions at beginning of year	2021-12-31	$69
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$21,620
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$35
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$35
Total non interest bearing cash at end of year	2021-12-31	$377
Total non interest bearing cash at beginning of year	2021-12-31	$74
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$313,900
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$3,225,078
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,911,178
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in pooled separate accounts at end of year	2021-12-31	$3,159,004
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$2,840,835
Net investment gain/loss from pooled separate accounts	2021-12-31	$356,496
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$65,428
Employer contributions (assets) at end of year	2021-12-31	$65,663
Employer contributions (assets) at beginning of year	2021-12-31	$70,235
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$230,869
Contract administrator fees	2021-12-31	$25,211
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	WOLFE, MCDUFF & OPPIE, P.A.
Accountancy firm EIN	2021-12-31	640891412
2020 : JERRY LEE'S GROCERY, INC. 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$35
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$1,137
Total income from all sources (including contributions)	2020-12-31	$598,604
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$208,657
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$199,856
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$202,004
Value of total assets at end of year	2020-12-31	$2,911,213
Value of total assets at beginning of year	2020-12-31	$2,522,368
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$8,801
Total interest from all sources	2020-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$300,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$131,981
Participant contributions at end of year	2020-12-31	$69
Participant contributions at beginning of year	2020-12-31	$5,537
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$35
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$1,137
Total non interest bearing cash at end of year	2020-12-31	$74
Total non interest bearing cash at beginning of year	2020-12-31	$74
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$389,947
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,911,178
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,521,231
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in pooled separate accounts at end of year	2020-12-31	$2,840,835
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$2,442,522
Net investment gain/loss from pooled separate accounts	2020-12-31	$396,600
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$70,023
Employer contributions (assets) at end of year	2020-12-31	$70,235
Employer contributions (assets) at beginning of year	2020-12-31	$74,235
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$199,856
Contract administrator fees	2020-12-31	$8,801
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	WOLFE, MCDUFF & OPPIE, P.A.
Accountancy firm EIN	2020-12-31	640891412
2019 : JERRY LEE'S GROCERY, INC. 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$1,137
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$108
Total income from all sources (including contributions)	2019-12-31	$585,428
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$93,694
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$90,747
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$206,074
Value of total assets at end of year	2019-12-31	$2,522,368
Value of total assets at beginning of year	2019-12-31	$2,029,605
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$2,947
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$2,947
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$250,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$132,074
Participant contributions at end of year	2019-12-31	$5,537
Participant contributions at beginning of year	2019-12-31	$55
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$1,137
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$108
Total non interest bearing cash at end of year	2019-12-31	$74
Total non interest bearing cash at beginning of year	2019-12-31	$74
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$491,734
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,521,231
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,029,497
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$2,442,522
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$1,959,486
Net investment gain/loss from pooled separate accounts	2019-12-31	$379,354
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$74,000
Employer contributions (assets) at end of year	2019-12-31	$74,235
Employer contributions (assets) at beginning of year	2019-12-31	$69,990
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$90,747
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	WOLFE, MCDUFF & OPPIE, P.A.
Accountancy firm EIN	2019-12-31	640891412
2018 : JERRY LEE'S GROCERY, INC. 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$108
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$49,875
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$136,589
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$136,589
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$193,100
Value of total assets at end of year	2018-12-31	$2,029,605
Value of total assets at beginning of year	2018-12-31	$2,116,211
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$0
Total interest from all sources	2018-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$250,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$123,110
Participant contributions at end of year	2018-12-31	$55
Participant contributions at beginning of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$108
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Total non interest bearing cash at end of year	2018-12-31	$74
Total non interest bearing cash at beginning of year	2018-12-31	$74
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-86,714
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,029,497
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,116,211
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in pooled separate accounts at end of year	2018-12-31	$1,959,486
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$2,046,254
Net investment gain/loss from pooled separate accounts	2018-12-31	$-143,225
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$69,990
Employer contributions (assets) at end of year	2018-12-31	$69,990
Employer contributions (assets) at beginning of year	2018-12-31	$69,883
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$136,589
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	WOLFE, MCDUFF & OPPIE, P.A.
Accountancy firm EIN	2018-12-31	640891412
2017 : JERRY LEE'S GROCERY, INC. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$1,060
Total income from all sources (including contributions)	2017-12-31	$509,108
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$955,884
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$952,220
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$189,846
Value of total assets at end of year	2017-12-31	$2,116,211
Value of total assets at beginning of year	2017-12-31	$2,564,047
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$3,664
Total interest from all sources	2017-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$250,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$119,493
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$1,060
Other income not declared elsewhere	2017-12-31	$-152
Total non interest bearing cash at end of year	2017-12-31	$74
Total non interest bearing cash at beginning of year	2017-12-31	$1,268
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-446,776
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,116,211
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,562,987
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in pooled separate accounts at end of year	2017-12-31	$2,046,254
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$2,487,457
Net investment gain/loss from pooled separate accounts	2017-12-31	$319,414
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$70,353
Employer contributions (assets) at end of year	2017-12-31	$69,883
Employer contributions (assets) at beginning of year	2017-12-31	$75,322
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$952,220
Contract administrator fees	2017-12-31	$3,664
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	WOLFE, MCDUFF & OPPIE, P.A.
Accountancy firm EIN	2017-12-31	640891412
2016 : JERRY LEE'S GROCERY, INC. 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	$1,060
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$1,076
Total income from all sources (including contributions)	2016-12-31	$365,357
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$28,170
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$26,780
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$199,946
Value of total assets at end of year	2016-12-31	$2,564,047
Value of total assets at beginning of year	2016-12-31	$2,226,876
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,390
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$250,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$123,931
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$1,060
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$1,076
Total non interest bearing cash at end of year	2016-12-31	$1,268
Total non interest bearing cash at beginning of year	2016-12-31	$1,125
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	$337,187
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,562,987
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,225,800
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
Value of interest in pooled separate accounts at end of year	2016-12-31	$2,487,457
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$2,155,452
Net investment gain/loss from pooled separate accounts	2016-12-31	$165,411
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
Contributions received in cash from employer	2016-12-31	$76,015
Employer contributions (assets) at end of year	2016-12-31	$75,322
Employer contributions (assets) at beginning of year	2016-12-31	$70,299
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$26,780
Contract administrator fees	2016-12-31	$1,390
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	WOLFE, MCDUFF & OPPIE, P.A.
Accountancy firm EIN	2016-12-31	640891412
2015 : JERRY LEE'S GROCERY, INC. 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$1,076
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$163,230
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$501,483
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$499,421
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$193,097
Value of total assets at end of year	2015-12-31	$2,226,876
Value of total assets at beginning of year	2015-12-31	$2,564,053
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$2,062
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Administrative expenses professional fees incurred	2015-12-31	$1,900
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$119,103
Participant contributions at beginning of year	2015-12-31	$1,009
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$1,076
Other income not declared elsewhere	2015-12-31	$-1,125
Administrative expenses (other) incurred	2015-12-31	$0
Total non interest bearing cash at end of year	2015-12-31	$1,125
Total non interest bearing cash at beginning of year	2015-12-31	$195
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-338,253
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$2,225,800
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$2,564,053
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$2,155,452
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$2,507,586
Net investment gain/loss from pooled separate accounts	2015-12-31	$-28,742
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$73,994
Employer contributions (assets) at end of year	2015-12-31	$70,299
Employer contributions (assets) at beginning of year	2015-12-31	$55,263
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$499,421
Contract administrator fees	2015-12-31	$162
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	WOLFE, MCDUFF & OPPIE, P.A.
Accountancy firm EIN	2015-12-31	640891412
2014 : JERRY LEE'S GROCERY, INC. 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$257,264
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$240,100
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$238,970
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$162,293
Value of total assets at end of year	2014-12-31	$2,564,053
Value of total assets at beginning of year	2014-12-31	$2,546,889
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$1,130
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$101,084
Participant contributions at end of year	2014-12-31	$1,009
Participant contributions at beginning of year	2014-12-31	$1,645
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$5,885
Administrative expenses (other) incurred	2014-12-31	$1,000
Total non interest bearing cash at end of year	2014-12-31	$195
Total non interest bearing cash at beginning of year	2014-12-31	$345
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$17,164
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$2,564,053
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$2,546,889
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$130
Value of interest in pooled separate accounts at end of year	2014-12-31	$2,507,586
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$2,516,420
Net investment gain/loss from pooled separate accounts	2014-12-31	$94,971
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$55,324
Employer contributions (assets) at end of year	2014-12-31	$55,263
Employer contributions (assets) at beginning of year	2014-12-31	$28,479
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$238,970
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	SMITH DUKES & BUCKALEW, LLP
Accountancy firm EIN	2014-12-31	630191630
2013 : JERRY LEE'S GROCERY, INC. 401(K) PLAN 2013 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$374,578
Total of all expenses incurred	2013-12-31	$100,847
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$99,330
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$93,965
Value of total assets at end of year	2013-12-31	$2,546,889
Value of total assets at beginning of year	2013-12-31	$2,273,158
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,517
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$65,473
Participant contributions at end of year	2013-12-31	$1,645
Participant contributions at beginning of year	2013-12-31	$1,017
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$0
Administrative expenses (other) incurred	2013-12-31	$1,400
Total non interest bearing cash at end of year	2013-12-31	$345
Total non interest bearing cash at beginning of year	2013-12-31	$391
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$273,731
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$2,546,889
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$2,273,158
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$117
Value of interest in pooled separate accounts at end of year	2013-12-31	$2,516,420
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$2,246,489
Net investment gain/loss from pooled separate accounts	2013-12-31	$280,613
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$28,492
Employer contributions (assets) at end of year	2013-12-31	$28,479
Employer contributions (assets) at beginning of year	2013-12-31	$25,261
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$99,330
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	SMITH DUKES & BUCKALEW, LLP
Accountancy firm EIN	2013-12-31	630191630
2012 : JERRY LEE'S GROCERY, INC. 401(K) PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$359,450
Total of all expenses incurred	2012-12-31	$182,809
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$182,104
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$84,920
Value of total assets at end of year	2012-12-31	$2,273,158
Value of total assets at beginning of year	2012-12-31	$2,096,517
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$705
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$59,659
Participant contributions at end of year	2012-12-31	$1,017
Participant contributions at beginning of year	2012-12-31	$30
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$600
Total non interest bearing cash at end of year	2012-12-31	$391
Total non interest bearing cash at beginning of year	2012-12-31	$1,147
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$176,641
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$2,273,158
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$2,096,517
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$105
Value of interest in pooled separate accounts at end of year	2012-12-31	$2,246,489
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$2,067,353
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$0
Asset value of US Government securities at beginning of year	2012-12-31	$0
Net investment gain/loss from pooled separate accounts	2012-12-31	$274,530
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$25,261
Employer contributions (assets) at end of year	2012-12-31	$25,261
Employer contributions (assets) at beginning of year	2012-12-31	$27,987
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$182,104
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	SMITH DUKES & BUCKALEW, LLP
Accountancy firm EIN	2012-12-31	630191630
2011 : JERRY LEE'S GROCERY, INC. 401(K) PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$-232,983
Total unrealized appreciation/depreciation of assets	2011-12-31	$-232,983
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$77,052
Total loss/gain on sale of assets	2011-12-31	$281,869
Total of all expenses incurred	2011-12-31	$86,424
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$65,852
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$93,457
Value of total assets at end of year	2011-12-31	$2,096,517
Value of total assets at beginning of year	2011-12-31	$2,105,889
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$20,572
Total interest from all sources	2011-12-31	$16,308
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$12,092
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$65,470
Participant contributions at end of year	2011-12-31	$30
Participant contributions at beginning of year	2011-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$867,516
Administrative expenses (other) incurred	2011-12-31	$15,779
Total non interest bearing cash at end of year	2011-12-31	$1,147
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-9,372
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$2,096,517
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$2,105,889
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Investment advisory and management fees	2011-12-31	$4,152
Value of interest in pooled separate accounts at end of year	2011-12-31	$2,067,353
Interest earned on other investments	2011-12-31	$14,115
Income. Interest from US Government securities	2011-12-31	$179
Income. Interest from corporate debt instruments	2011-12-31	$1,513
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$286,333
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$286,333
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$501
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$0
Asset value of US Government securities at end of year	2011-12-31	$0
Asset value of US Government securities at beginning of year	2011-12-31	$8,276
Net investment gain/loss from pooled separate accounts	2011-12-31	$-93,691
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$27,987
Employer contributions (assets) at end of year	2011-12-31	$27,987
Employer contributions (assets) at beginning of year	2011-12-31	$26,627
Income. Dividends from preferred stock	2011-12-31	$406
Income. Dividends from common stock	2011-12-31	$11,686
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$65,852
Asset. Corporate debt instrument preferred debt at beginning of year	2011-12-31	$15,575
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$101,128
Contract administrator fees	2011-12-31	$641
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$800,434
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Aggregate proceeds on sale of assets	2011-12-31	$281,869
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	SMITH DUKES & BUCKALEW, LLP
Accountancy firm EIN	2011-12-31	630191630
2010 : JERRY LEE'S GROCERY, INC. 401(K) PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$103,636
Total unrealized appreciation/depreciation of assets	2010-12-31	$103,636
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$257,568
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$127,016
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$106,506
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$88,381
Value of total assets at end of year	2010-12-31	$2,105,889
Value of total assets at beginning of year	2010-12-31	$1,975,337
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$20,510
Total interest from all sources	2010-12-31	$42,258
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$23,293
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$13,135
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$61,734
Participant contributions at end of year	2010-12-31	$0
Participant contributions at beginning of year	2010-12-31	$1,154
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$867,516
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$886,803
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$130,552
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$2,105,889
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,975,337
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Investment advisory and management fees	2010-12-31	$7,375
Interest earned on other investments	2010-12-31	$29,486
Income. Interest from US Government securities	2010-12-31	$562
Income. Interest from corporate debt instruments	2010-12-31	$7,405
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$286,333
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$235,993
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$235,993
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$4,805
Asset value of US Government securities at end of year	2010-12-31	$8,276
Asset value of US Government securities at beginning of year	2010-12-31	$12,036
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$26,647
Employer contributions (assets) at end of year	2010-12-31	$26,627
Employer contributions (assets) at beginning of year	2010-12-31	$26,419
Income. Dividends from common stock	2010-12-31	$23,293
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$106,506
Asset. Corporate debt instrument preferred debt at end of year	2010-12-31	$15,575
Asset. Corporate debt instrument preferred debt at beginning of year	2010-12-31	$11,976
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$101,128
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$83,104
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$800,434
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$717,852
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	SMITH DUKES & BUCKALEW, LLP
Accountancy firm EIN	2010-12-31	630191630

Form 5500 Responses for JERRY LEE'S GROCERY, INC. 401(K) PLAN

2022: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	Yes
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: JERRY LEE'S GROCERY, INC. 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 – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: JERRY LEE'S GROCERY, INC. 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 – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: JERRY LEE'S GROCERY, INC. 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 – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: JERRY LEE'S GROCERY, INC. 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 – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: JERRY LEE'S GROCERY, INC. 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: JERRY LEE'S GROCERY, INC. 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

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

101772

Policy instance

Insurance contract or identification number	101772
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $8,714
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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?	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
Commission paid to Insurance Broker	USD $8,455
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

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

Policy contract number

101772

Policy instance

Insurance contract or identification number	101772
Number of Individuals Covered	112
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $1,300
Total amount of fees paid to insurance company	USD $1,515
Are there contracts with allocated funds for individual policies?	0
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?	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
Amount paid for insurance broker fees	1515
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $1,300

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

Policy contract number

101772

Policy instance

Insurance contract or identification number	101772
Number of Individuals Covered	113
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $4,372
Total amount of fees paid to insurance company	USD $2,697
Are there contracts with allocated funds for individual policies?	0
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?	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
Commission paid to Insurance Broker	USD $4,372
Insurance broker organization code?	3
Amount paid for insurance broker fees	2697
Additional information about fees paid to insurance broker	TPA FEES

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

Policy contract number

101772

Policy instance

Insurance contract or identification number	101772
Number of Individuals Covered	109
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $5,553
Total amount of fees paid to insurance company	USD $3,111
Are there contracts with allocated funds for individual policies?	0
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?	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
Commission paid to Insurance Broker	USD $5,553
Insurance broker organization code?	3
Amount paid for insurance broker fees	3111
Additional information about fees paid to insurance broker	TPA FEES

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

Policy contract number

101772

Policy instance

Insurance contract or identification number	101772
Number of Individuals Covered	108
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $5,235
Total amount of fees paid to insurance company	USD $3,580
Are there contracts with allocated funds for individual policies?	0
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?	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
Commission paid to Insurance Broker	USD $5,235
Insurance broker organization code?	3
Amount paid for insurance broker fees	3580
Additional information about fees paid to insurance broker	TPA FEES

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

Policy contract number

101772

Policy instance

Insurance contract or identification number	101772
Number of Individuals Covered	110
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $7,340
Total amount of fees paid to insurance company	USD $2,750
Are there contracts with allocated funds for individual policies?	0
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?	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
Commission paid to Insurance Broker	USD $6,173
Insurance broker organization code?	3
Amount paid for insurance broker fees	2750
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	STEVENS DOWD & COMPANY

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

Policy contract number

101772

Policy instance

Insurance contract or identification number	101772
Number of Individuals Covered	104
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $7,136
Total amount of fees paid to insurance company	USD $1,900
Commission paid to Insurance Broker	USD $5,869
Insurance broker organization code?	4
Amount paid for insurance broker fees	1900
Insurance broker name	STEVENS DOWD & COMPANY

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

Policy contract number

101772

Policy instance

Insurance contract or identification number	101772
Number of Individuals Covered	108
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $6,331
Total amount of fees paid to insurance company	USD $2,298
Commission paid to Insurance Broker	USD $6,331
Insurance broker organization code?	4
Amount paid for insurance broker fees	2298
Insurance broker name	STEVENS DOWD & COMPANY

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

Policy contract number

101772

Policy instance

Insurance contract or identification number	101772
Number of Individuals Covered	92
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,928
Total amount of fees paid to insurance company	USD $1,494
Commission paid to Insurance Broker	USD $5,928
Insurance broker organization code?	4
Amount paid for insurance broker fees	1494
Insurance broker name	STEVENS DOWD & COMPANY

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

Policy contract number

101772

Policy instance

Insurance contract or identification number	101772
Number of Individuals Covered	79
Insurance policy start date	2012-06-20
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,368
Total amount of fees paid to insurance company	USD $2,207
Commission paid to Insurance Broker	USD $3,368
Insurance broker organization code?	4
Amount paid for insurance broker fees	2207
Insurance broker name	STEVENS DOWD & COMPANY

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

Policy contract number

101772

Policy instance

Insurance contract or identification number	101772
Number of Individuals Covered	82
Insurance policy start date	2011-06-20
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $21,761
Total amount of fees paid to insurance company	USD $4,584

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Company Name:	JERRY LEE'S GROCERY, INC.
Employer identification number (EIN):	640509904
NAIC Classification:	445110
NAIC Description:	Supermarkets and Other Grocery (except Convenience) Stores