401k Plan data: POTTERS II, LLC 401(K) PLAN plan

POTTERS II, LLC 401(K) PLAN 401k Plan overview

Plan Name	POTTERS II, LLC 401(K) PLAN
Plan identification number	002

POTTERS II, LLC 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Plan requiring that all or part of employer contributions be invested and held, at least for a limited period, in employer securities.

401k Sponsoring company profile

POTTERS II, LLC has sponsored the creation of one or more 401k plans.

Company Name: POTTERS II, LLC

Employer identification number (EIN): 640887386

NAIC Classification: 722513
NAIC Description: Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan POTTERS II, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2014-01-01
002 2014-01-01
002 2013-01-01
002 2012-01-01 BRIAN JORDAN 2013-03-25 BRIAN JORDAN 2013-03-25
002 2011-01-01 BRIAN JORDAN BRIAN JORDAN 2012-02-21
002 2010-01-01 BRIAN JORDAN BRIAN JORDAN 2011-03-22

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2014-01-01
002	2014-01-01
002	2013-01-01
002	2012-01-01	BRIAN JORDAN	2013-03-25	BRIAN JORDAN	2013-03-25
002	2011-01-01	BRIAN JORDAN		BRIAN JORDAN	2012-02-21
002	2010-01-01	BRIAN JORDAN		BRIAN JORDAN	2011-03-22

Plan Statistics for POTTERS II, LLC 401(K) PLAN

401k plan membership statisitcs for POTTERS II, LLC 401(K) PLAN

Measure Date Value
2014: POTTERS II, LLC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 125
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 99
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 7
Total of all active and inactive participants 2014-01-01 106
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 106
Number of participants with account balances 2014-01-01 58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 10
2013: POTTERS II, LLC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 128
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 81
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 6
Total of all active and inactive participants 2013-01-01 87
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 87
Number of participants with account balances 2013-01-01 49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 19
2011: POTTERS II, LLC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 81
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 85
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 1
Total of all active and inactive participants 2011-01-01 86
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 86
Number of participants with account balances 2011-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: POTTERS II, LLC 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 77
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 74
Number of other retired or separated participants entitled to future benefits 2010-01-01 1
Total of all active and inactive participants 2010-01-01 75
Total participants 2010-01-01 75
Number of participants with account balances 2010-01-01 34

Measure	Date	Value
2014: POTTERS II, LLC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	125
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	99
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	7
Total of all active and inactive participants	2014-01-01	106
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	106
Number of participants with account balances	2014-01-01	58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	10
2013: POTTERS II, LLC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	128
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	81
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	6
Total of all active and inactive participants	2013-01-01	87
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	87
Number of participants with account balances	2013-01-01	49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	19
2011: POTTERS II, LLC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	81
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	85
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	1
Total of all active and inactive participants	2011-01-01	86
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	86
Number of participants with account balances	2011-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: POTTERS II, LLC 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	77
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	74
Number of other retired or separated participants entitled to future benefits	2010-01-01	1
Total of all active and inactive participants	2010-01-01	75
Total participants	2010-01-01	75
Number of participants with account balances	2010-01-01	34

Financial Data on POTTERS II, LLC 401(K) PLAN

Measure	Date	Value
2014 : POTTERS II, LLC 401(K) PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$10,970
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$7,533
Total income from all sources (including contributions)	2014-12-31	$190,514
Total of all expenses incurred	2014-12-31	$131,925
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$83,580
Expenses. Certain deemed distributions of participant loans	2014-12-31	$24,607
Value of total corrective distributions	2014-12-31	$9,959
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$136,129
Value of total assets at end of year	2014-12-31	$1,002,081
Value of total assets at beginning of year	2014-12-31	$940,055
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$13,779
Total interest from all sources	2014-12-31	$2,980
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$53,483
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$53,483
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$75,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$103,627
Assets. Loans (other than to participants) at end of year	2014-12-31	$56,983
Assets. Loans (other than to participants) at beginning of year	2014-12-31	$56,079
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$10,970
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$7,533
Other income not declared elsewhere	2014-12-31	$3,208
Administrative expenses (other) incurred	2014-12-31	$3,208
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	$58,589
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$991,111
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$932,522
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	$10,571
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$941,657
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$882,449
Interest on participant loans	2014-12-31	$2,980
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$3,441
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,527
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-5,286
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	$32,502
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$83,580
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	T. E. LOTT & COMPANY
Accountancy firm EIN	2014-12-31	640575804
2013 : POTTERS II, LLC 401(K) PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$7,533
Total income from all sources (including contributions)	2013-12-31	$270,850
Total of all expenses incurred	2013-12-31	$71,474
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$60,656
Expenses. Certain deemed distributions of participant loans	2013-12-31	$762
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$137,296
Value of total assets at end of year	2013-12-31	$940,055
Value of total assets at beginning of year	2013-12-31	$733,146
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$10,056
Total interest from all sources	2013-12-31	$932
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$36,020
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$36,020
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$75,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$105,614
Assets. Loans (other than to participants) at end of year	2013-12-31	$56,079
Assets. Loans (other than to participants) at beginning of year	2013-12-31	$44,594
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$7,533
Other income not declared elsewhere	2013-12-31	$2,750
Administrative expenses (other) incurred	2013-12-31	$2,750
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	$199,376
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$932,522
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$733,146
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	$7,306
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$882,449
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$688,552
Interest on participant loans	2013-12-31	$920
Interest earned on other investments	2013-12-31	$12
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1,527
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$93,852
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	$31,682
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$60,656
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	T.E. LOTT & COMPANY
Accountancy firm EIN	2013-12-31	640575804
2011 : POTTERS II, LLC 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$138,804
Expenses. Total of all expenses incurred	2011-12-31	$28,984
Benefits paid (including direct rollovers)	2011-12-31	$28,984
Total plan assets at end of year	2011-12-31	$535,105
Total plan assets at beginning of year	2011-12-31	$425,285
Value of fidelity bond covering the plan	2011-12-31	$45,000
Total contributions received or receivable from participants	2011-12-31	$105,760
Other income received	2011-12-31	$-28,155
Net income (gross income less expenses)	2011-12-31	$109,820
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$535,105
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$425,285
Total contributions received or receivable from employer(s)	2011-12-31	$61,199
2010 : POTTERS II, LLC 401(K) PLAN 2010 401k financial data
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$167,459
Expenses. Total of all expenses incurred	2010-12-31	$21,472
Benefits paid (including direct rollovers)	2010-12-31	$21,472
Total plan assets at end of year	2010-12-31	$425,285
Total plan assets at beginning of year	2010-12-31	$279,298
Value of fidelity bond covering the plan	2010-12-31	$15,000
Total contributions received or receivable from participants	2010-12-31	$81,261
Other income received	2010-12-31	$40,613
Net income (gross income less expenses)	2010-12-31	$145,987
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$425,285
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$279,298
Total contributions received or receivable from employer(s)	2010-12-31	$45,585

Form 5500 Responses for POTTERS II, LLC 401(K) PLAN

2014: POTTERS II, LLC 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	Yes
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: POTTERS II, LLC 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	Yes
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
2011: POTTERS II, LLC 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: POTTERS II, LLC 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

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

33498-01

Policy instance

Insurance contract or identification number	33498-01
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $30
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $30
Insurance broker organization code?	3
Insurance broker name	JOHN HENSON

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

33498-01

Policy instance

Insurance contract or identification number	33498-01
Number of Individuals Covered	0
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $11
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $10
Insurance broker organization code?	3
Insurance broker name	ANSELVENO GUTIERREZ

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Company Name:	POTTERS II, LLC
Employer identification number (EIN):	640887386
NAIC Classification:	722513
NAIC Description:	Limited-Service Restaurants